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Persistent Rash in a 36-Year-Old Male

9/16/2025, 2:40:19 AMMale25-34

Greetings everyone, To provide some context, I am a 36-year-old male with no significant health issues. I maintain an exercise routine, working out four to five times weekly, and my diet is decent—neither exceptionally healthy nor overly poor. My alcohol consumption is moderate, around six to ten beers weekly. I am also on a daily regimen of famotidine and Lexapro, which I have been taking for an extended period without problems. The concern I wish to discuss began in late March, when a rash emerged on my chest, abdomen, back, and sides. This rash is not itchy and has not correlated with any changes in my medication, dietary habits, or lifestyle. I have consulted several doctors, including two dermatologists. After undergoing a biopsy, I received the following results: "The results indicate pityriasiform dermatitis. This is not a definitive diagnosis but provides an insight into the category of skin rash present. We suspect that your condition is likely pityriasis rosea or pityriasis lichenoides." I have experimented with a couple of topical prescription steroid creams, but unfortunately, I haven't noticed any improvement. Currently, I feel somewhat lost regarding the next steps. The dermatologists mentioned that resolution could take several months, yet it has already been six months and the condition remains unchanged. Any advice or insights would be greatly appreciated! P.S. This is my very first post, so I hope I’m doing it correctly!

ArthritisMultiple SclerosisCrohn's Disease

Answers (1)

Cony

9/16/2025, 2:40:40 AM

OpenHealth AI

It sounds like you're dealing with a persistent rash that has been quite frustrating, and I understand how concerning this can be. Based on your description, it's important to recognize that both pityriasis rosea and pityriasis lichenoides are usually self-limiting skin conditions, but the duration you’ve experienced is longer than typical. Here are the main points to consider and some actionable steps you can take moving forward.

1. Understand Your Condition

  • Pityriasis Rosea: Often starts with a "herald patch" and resolves on its own within 6-12 weeks, but some cases can linger longer.
  • Pityriasis Lichenoides: Similar presentation but can often require more targeted treatments.

2. Next Steps

  1. Monitor Symptoms: Keep looking for any changes to the rash or additional symptoms (such as fever or fatigue). Take note if it spreads, changes in appearance, or any other new symptoms arise. Document these changes regularly.

  2. Topical Treatments: Since topical steroids haven't worked, consider discussing with your dermatologist the following options:

    • Calcineurin Inhibitors (such as tacrolimus or pimecrolimus): These can reduce inflammatory responses and may be effective for your condition.
    • Moisturizers: Regularly apply fragrance-free moisturizers to keep the skin hydrated, which might help soothe the rash.
  3. Sunlight Exposure: Moderate sun exposure may help some cases of pityriasis rosea, as UV light can reduce inflammation. However, be cautious to avoid sunburn.

  4. Consider Lifestyle Factors: Even slight changes can affect skin issues:

    • Review any new soaps, detergents, or fabrics you have used since the rash began. These can sometimes trigger or exacerbate skin conditions.
    • Assess stress levels, as stress can influence skin health; consider relaxation techniques or counseling if you feel it’s impacting you.
  5. Follow-Up: Since your condition has persisted beyond the expected time frame, consider revisiting a dermatologist or looking for one who specializes in skin disorders. Discuss the possibility of further diagnostic testing or alternative treatments.

Remember to be patient with your skin as it can take time for conditions to resolve. It's vital to stay proactive in managing your skin health while maintaining open lines of communication with your healthcare team. Please don’t hesitate to reach out for any more specific questions or clarifications!

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