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Q: Rash ( Answered 5 out of 5 stars,   1 Comment )
Subject: Rash
Category: Health > Medicine
Asked by: rozz-ga
List Price: $50.00
Posted: 30 Nov 2003 05:16 PST
Expires: 30 Dec 2003 05:16 PST
Question ID: 281858
I have a very itchy rash covering most of my upper body.   Red skin
with tiny dots. Burns and itches in patches.    Sometimes better,
sometimes intolerable.  Has not responded to antihistamines or
Cortisone cream.  Can you tell me
what it is?  I have tried eliminating foods, etc. to no avail. 
Physician visits have not been helpful.

Request for Question Clarification by crabcakes-ga on 30 Nov 2003 08:51 PST
Hi rozz,
I'd like to ask you a few questions to help me better research your question.
-How long have you had this rash?
-Have you started taking nay new medications? 
-Have you recently changed bath products or laundry detergents?
-Any new pets?

What has the doctor suggested other than cortisone?

I'll start my research while I wait!
Thank you, crabcakes-gs

Clarification of Question by rozz-ga on 30 Nov 2003 10:25 PST
I have had this rash for approx. 2 mos., worsening progressively,
started off as hives.   No new pets, no change in laundry detergents,
no new meds., etc.
Visited a physician times 2.  He gave me increasing strengths of
antihistamines and suggested cortisone cream.   I'm thinking the rash
looks a bit like prickly heat in babies.   Hope this helps.

Request for Question Clarification by crabcakes-ga on 30 Nov 2003 11:27 PST
Thank you for responding! I am working now on your question and will
post as soon as I complete the answer!
Subject: Re: Rash
Answered By: crabcakes-ga on 30 Nov 2003 13:58 PST
Rated:5 out of 5 stars
Hello rozz,

If it appears like someone sprinkled paprika on your back, or a zodiac
of red stars appears on your chest ? it?s a rash! Rashes can be warm
or cool, itchy or not, dry, moist, stinging or not! Rashes are an
indication that your body is not happy with its current condition!
Rashes can appear in odd places and not necessarily where you may
expect: An allergy to acetone (nail polish remover) can cause an
eye-lid rash!

A ?skin rash? is a catch-all term that describes inflammation, change
in skin color, change in skin texture, and/or the presence of spots
and bumps on the skin. Some rashes may itch, burn, swell or tingle,
and some just aesthetically annoy us, with no discomfort at all! Some
rashes make a brief appearance and disappear, and others can be
recurring or chronic (long-lasting).

The source of a skin rash, as you now know, can be very elusive, as
there are hundreds of types of rashes. Doctors may need to diagnose a
rash by looking at the skin with a Woods Lamp, or sending a blood
sample or skin scrapings to the lab for testing.

Causes of rashes include:

Infections-bacteria, fungi and even viruses can cause a skin rash.
I could say it no better than this page on the  Medicine Net web site:
?Fungal infections have nothing to do with hygiene -- clean people get
them too. Despite their reputation, fungal rashes are not commonly
caught from dogs or other animals, nor are they easily transmitted in
gyms, showers, pools, or locker rooms. In most cases they are not
highly contagious between people either. Treatment is usually
straightforward. Many effective antifungal creams can be bought that
the drug store without a prescription, including clotrimazole 1% and
terbinafine 1%.Bacterial infections: The most common bacterial
infection of the skin is impetigo. Impetigo is caused by staph or
strep germs and is much more common in children than adults. Again,
poor hygiene plays little or no role. Nonprescription antibacterial
creams like bacitracin or Neosporin are not very effective. Oral
antibiotics or prescription-strength creams like Bactroban are usually
Outbreaks of this sort are usually either viral or allergic. 
Viral rash: While viral infections of the skin itself, like herpes or
shingles (a cousin of chickenpox), are mostly localized to one part of
the body, viral rashes are more often symmetrical and everywhere.
Patients with such rashes may or may not have other viral symptoms
like coughing, sneezing or an stomach upset (nausea). Viral rashes
usually last a few days to a week and go way on their own.?

Irritants and Allergens - Poison ivy, cosmetics, soaps, medications,
insect bites, foods,pets, allergies to a host of things, and an overly
dry environment. When the body comes in contact with an allergen, it
reacts with an immune response and produces an antibody (IgE). This
antibody then attaches to basophils or mast cells in the tissues. When
you next have contact with the allergen, the basophils or mast cells
release chemicals/histamines causing allergic reactions such as
itching, and in severe cases anaphylactic shock!

Something particularly interesting was the statement I found on this
American Academy of Dermatology site  ?If you're sensitive to poison
ivy, oak, and sumac, you may also be allergic to oils from plants from
other countries.  A furniture lacquer obtained from the Japanese
lacquer tree contains such an oil, as do mango rinds and cashew

Foods & Food additives:
Highly allergenic foods include: Milk, eggs, tomatoes, wheat, nuts,
especially peanuts, shellfish,and soy.

Food additives such as sulfites, artificial colors and sweetners, BHT,
MSG, benzoates can cause a rash and itching, but this is not
considered a ?true allergy?.

Albert Einstein College of Medicine

Drug reactions:
Drug Rashes can be caused by an allergy to a medication, or
photo-sensitivity caused by the drug. Steroids and antibiotics are the
prime offenders.


Systemic illnesses- Not likely the cause of your rash, but included
for educational purposes: Lyme disease, Lupus, rheumatic fever, strep
infections, meningitis, Rocky Mountain Spotted Fever, among others
cause rashes.

Photos of Rocky Mountain Spotted Fever


Infestations - Lice, scabies and particularly dust mites cause rashes

Reducing dust, which effectively helps reduce mites can clear up
eczema. From ?This is a relatively simple intervention
and could have a dramatic effect on children (and adults) with eczema.
If you use the mattress cover, it is a good idea to tape over the
zipper in order to effectively contain the dust. It will take a couple
of weeks before you notice the difference, but most people in the
study did have significant reductions in their eczema. If it does seem
to make a difference for you, I would recommend considering other
house-dust control measures, such as removing carpeting in the
Note: Other allergic conditions such as hayfever and asthma are known
to be triggered by house dust mites as well. Enclosing your mattress
in a gortex cover can also help these problems.?

Unknown ? The causes baffle health care providers-psoriasis and
eczema, and may be caused by stress, hormonal level changes,
auto-immune disorders, and genetic make-up; The tendency to develop
allergic rashes tend to run in families.

Rashes can also be a reaction to exercise! The Physsportmed web site
states: ? Cholinergic urticaria can develop when the core body
temperature increases during exercise; it involves large numbers of 1-
to 2-mm wheals that appear 2 to 30 minutes after beginning strenuous
exercise. The wheals usually disappear spontaneously 20 to 90 minutes
after stopping exercise, and the reaction rarely progresses to
respiratory symptoms.?

Stress-induced rashes:

?Skin rashes can also be the early signs of a number of serious, even
life-threatening, diseases, among them, meningitis, Lyme disease,
typhoid fever, and Rocky Mountain spotted fever. See your family
doctor or dermatologist if skin rashes enter your life, especially if
you have other symptoms, like fever, swollen lymph nodes, infection,
headache, shortness of breath, sensitivity to light, a stiff neck, or
achy joints. Many people don?t understand that skin rashes can be
important clues to serious diseases," said Dr. Drage. "Although most
rashes are not life-threatening, some must be treated seriously. A
dermatologist is trained to tell which rashes require more extensive
medical testing and treatment."


Since your rash is causing ?spots? or ?dots? it is considered a
localized rash, and probably not due to any systemic illness. The fact
that your doctor found nothing else, and that your current rash
started out as hives, indicates that your rash could well be an

Rashes with that consist of reddened skin and bumps/dots  are often
diagnostic of an allergy.

Eczema/Atopic dermatitis: Causes are not totally known or understood.
In your  clarification you ruled out soaps and cosmetics, but these
can be a cause of rashes. Long hot showers have been implicated in
atopic dermatitis, and chlorine bothers some people. Mineral oil,
dust, sand, cigarette smoke and solvents are known irritants.

Stress, anger or some sort of emotional upheaval can trigger atopic
dermatitis, as can a very dry environment. Sometimes called simply
dermatitis, is a skin condition that can affect any age. Symptoms
include dry itchy skin, and in the severe form the skin becomes broken
and bleeding. Eczema is not contagious, but the tendency to develop
eczema is hereditary. An overreactive immune system is thought to be
associated with eczema, and as mentioned below, phototherapy helps. 
Known eczema triggers are chemicals, detergents, nickel, and fungi.

The National Eczema Society web site:


For some relief  of eczema/atopic dermatitis:

--Take short, cool or warm-water (not HOT) showers
--Emollient lotions, such as Aveeno or Kalmaderm
--Use mild soap/hypoallergenic such as Aveeno or Cetaphil
--Air dry or pat dry
--Moisturize with a mild fragrance free lotion 
--Avoid skin infections
--Avoid scratching by keeping your nails short
--Avoid wool and synthetic fibers. Try cotton clothing instead.
--Use a humidifier in the home
--Reduce house dust and mites
--Use cotton bedding
--Use a milder detergent. You said you have not changed your
detergent, but perhaps the manufacturer has changed formulas. You
could try washing your clothes and bedding in Ivory Snow or some other
very mild detergent and seeing if this helps. ?There are many methods
of reducing the itchiness of the skin and minimizing the damage from
scratching. Cotton clothing and bedding keep the skin cool and allow
it to breathe, whereas synthetic fabrics and wool can irritate. The
use of a non-biological washing powder and avoidance of fabric
softeners, can also help to reduce the itchiness of the skin.?


--Topical steroids (cortisone) The use of cortisone ointments are
usually helpful. You say you have already tried them without success.
You may need to apply the cream/ointment more liberally, or apply it
more often.(My 2 year old granddaughter suffers with a severe case of
eczema. After buying several expensive prescription cortisone creams
that did not work, I bought over the counter, store brand 1% cortisone
cream. It *almost* cured her, and worked far better than the
prescription varieties. (Rashes do run in our family?my chest and back
are often broken out, and bromates in store bought breads irritate
me)I am not suggesting that you abandon any of your doctor?s
therapies-some remedies work better for some than others.

According to the National Eczema Society (and my granddaughter?s 
dermatologist), there is no need to fear using topical steroids ?as
long as steroids are used appropriately and as directed by your
doctor, the likelihood of side effects is very rare. Reported
side-effects have been largely due to the use of very potent steroid
preparations over long periods of time.?

Benadryl (Diphenhydramine) cream can help alleviate itching.

--Oral steroids, in very severe cases

--Topical Immunomodulators: New drugs such as Tacrolimus ointment
(Protopic) and Pimecrolimus cream (Elidel)
You can read a factsheet about Tacrolimus here.
(This site is written in frames, which does not allow me to give you
the direct link. In order to reach the pages to which I am referring,
you will need to click the ?About Eczema? link in the right hand
column of the page, and then click on the links such as ?What is
Eczema? and ? Is There a Cure for Eczema?
 You can read a factsheet about Pimecrolimus here:

Protopic lotion is a new prescription steroid-free immunomodulator for eczema

--Phototherapy  Photo-therapy using UV light may help. The
ultra-violet B rays help suppress the immune response in skin cells.

Some pictures of eczema/dermatitis may be seen here:*Warning:Some may
be extreme and  graphic

You mentioned your rash is similar to prickly heat rash. A prickly
heat rash looks very similar to a folliculitis rash, but upon
examining it with a magnifying glass, no follicle irritation is seen.
Prickly heat rash is caused by inflammation and blockage of the sweat
ducts, reacting to exposure to heat and high humidity. ?Prickly heat
is treated with gentle cleansing of the skin. I like using Stri-Dex
Acne Medicated Sensitive Skin Pads; the salicylic acid helps to unplug
the pores. Hydrocortisone cream (not ointment) can help with itching.
Sometimes antihistamines are needed for the itching (and sleep). If
the rash is infected, antibiotics may also be needed. With treatment,
prickly heat should disappear within 2 or 3 days. An important note:
fever can produce prickly heat, but is not caused by it - if your
child has a fever, you still need to find the reason.? website says this about prickly heat rash:
·Wear light, loose-fitting soft clothes. Avoid clothing that traps
heat and moisture. Natural fabrics such as cotton are best.
·Stay in cool or air-conditioned, or well-ventilated environments. Use
a fan if necessary.
·Take frequent cool baths or showers. Dry yourself thoroughly and dust
bland types of powder (such as unperfumed talcum powder) on body
creases and affected areas.
·Apply calamine lotion or prickly rash lotions to soothe the affected
areas, but avoid using ointments or creams?they keep the skin warm and
moist and may make the condition worse.
·Do not scratch.

Dr. Spock?s web site says??If you choose to do something about the
rash, simply try wiping off the skin with water and patting it dry.
You can also pat the rash several times a day with a bicarbonate of
soda solution (1 teaspoon bicarbonate of soda to 1 cup water) on
absorbent cotton. Another treatment is dusting with cornstarch powder.

The use of talcum powder is no longer recommended because it is very
irritating to the lungs if

Does your rash resemble this picture?
?Prickly heat is most common when the weather is hot and humid. You
might find the tiny reddish pimples of prickly heat in the crook of
the arm, under your chin, on your chest or back, or on the backs of
your knees. The best cure is to stay cool and dry, and avoid clothing
that's too tight. Be sure to dry your skin off well after you take a
bath or shower. Then, before you dress, sprinkle yourself with a body
powder made from cornstarch.?

The famous Merck Manual web site has an illustration of the physiology
of prickly heat rash:
Merck also has this to say about prickly heat:
?Reducing sweating usually controls the problem. Keeping the skin cool
and dry and avoiding conditions that increase sweating are important;
air conditioning is ideal. Often, lotions are used that contain
corticosteroids, sometimes with a bit of menthol added; however, these
topical treatments are not as effective as modifying the environment
and dressing appropriately.?
Practically the same triggers mentioned above for eczema, can elicit
hives (urticaria). Penicillin or other drug allergy can produce hives,
as can a yeast (Candid albicans) infection. Other common triggers
include allergy injections and foods such as eggs, shellfish, and
strawberries. Viral infections like hepatitis, German measles and mono
can precede a bout of hives. Generally, hives disappear on their own,
but may come and go for years! Chemicals such as perfumes and
household cleaners can be a major cause of hives. Antibodies to
thyroid hormones, food preservatives, and even over the counter NSAIDS
(Non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil) or
Naproxen (Naprosyn) can also trigger hives.
Treatment of hives:
-The antidepressant doxepin, which is also a potent antihistamine,
helps relieve chronic hives
- Antihistamines like Claritin and Benadryl
- Cimetidine (used primarily for ulcers, but also a type of antihistamine)

Well rozz-ga, I hope this helps figure out what is causing you to
itch! Because I am not a physician, and I can?t see your rash, I can?t
tell you positively what is causing your rash. I DO suspect it is an
allergy, a dermatitis of sorts and nothing more serious. Why not try
switching your laundry detergent to Ivory, and using one of the soaps
and lotions I listed above. One over the counter product I just
remembered is DermaRest body wash. This product is meant for folks
with psoriasis, but I use it for my eczema, and it helps considerably.
(If you have access to a military commissary, this product is
considerably cheaper on base) You can see the product here:

 You may even have to resort to a chlorine filter for your shower
head.  I am hoping that some of the creams, lotions and newer
prescriptions may help.

If none of the rash-alleviating recommendations or the over the
counter products do the trick, ask your doctor to try some of the
newer prescriptions above, or refer you to a dermatologist who can get
you some relief! (Check your bread/roll/cereal for brominated makes my daughters and me itch!)

I must add that the information in my answer is for educational
purposes and not intended to replace care and treatment by your

If any part of my answer is not clear, or I have duplicated
information you already had, please request an Answer Clarification,
before rating, and I will be glad to clear things up for you!
I wish you the best!

Clarification of Answer by crabcakes-ga on 30 Nov 2003 14:33 PST
Hello again, rozz,
 I forgot to include some information  in my original answer! 

Tinea Versicolor is caused by a growth of yeast on the skin surface.
Your rash does not really sound like this, but I am including it in
the off chance you think your rash resembles tinea.  "Tinea versicolor
has small, scaly white-to-pink or tan-to-dark spots which can be
scattered over the upper arms, chest and back. They may sometimes
appear on the neck and the face. On light skin, tinea versicolor may
be faint or can appear as tan-to-pink spots, while on dark skin tinea
versicolor may be light or dark."

Pictures of tinea versicolor

This was meant to be included with the "Prickly Heat" section.
Folliculititis Picture:

My apologies for the omission!
rozz-ga rated this answer:5 out of 5 stars and gave an additional tip of: $10.00
Thank you, thank you, thank you!   Checking the pictures you sent, I
was able to definitely identify my rash.   I feel like a huge load has
been lifted off my shoulders.   Thank you again.   Rozz

Subject: Re: Rash
From: crabcakes-ga on 30 Nov 2003 17:41 PST
Thank you rozz, for the lovely stars and the generous tip! I'm glad to have helped!
Regards, crabcakes-ga

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