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Rashy question
Hi guys - For the past few months I've had these weird rashes. I first noticed a mostly flat, non-itchy rash on my upper chest. My pcp said it looked kind of vascular and there was no follow-up. A month or so ago I was surprised to realize that another rash (also flat and not itchy) had developed on the back of both upper legs. It is gradually creeping around to the sides and fronts of my upper legs.
I'm on Dupixent which has successfully controlled my eczema, and prior to starting treatment 3 yrs ago my eczema did not look like these newer rashes. I saw my allergist-immunologist last week. He said that the rash on my chest (not posted here) looked like rosacea. This does not make sense to me - my face is clear and I have no Hx of rosacea whatsoever. The rash on my legs looks like eczema to him. It does not look or behave like breakthrough eczema, at least not in my experience. He ordered a tryptase lab which was normal.
I'm wondering how common it is (or is not) for Dupixent to stop working. From my online looking it does not seem like it's a common thing.
What other tests would you folks suggest? I don't see my dermatologist until September and it's near impossible to get an early cancellation appt with her.
The photo with all the white specks is the leg photo - the specks are just dust on the mirror I had to use to try to photograph the back of my upper leg.
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So odd! I’m seeing dermatologist tomorrow about rash on chest, thighs, and upper arms. I’m concerned it’s from recently started (4 mos) statin and sun reaction. About 4 years ago, after I had COVID, I developed flat non itchy rash on lower legs. It lasted about 4 months and then went away. No doctor could tell me what it was. It bled if I shaved my legs and just looked bad but… Good luck!
I can't edit my post now but I did include a photo of the chest rash.
@ezjersey719 Thanks for replying. I had pretty normal skin until about 5 years ago during a stressful time with my husband's health. I developed chronic urticaria and it lasted about 2 years, at which time it subsided and the eczema started. I have POTS/dysautonomia which can be related to rashes. I also recently learned through a breath test that I have a gut bacterial overgrowth and that imbalance can also manifest in skin issues. So these current rashes I have may or may not be related to the other things going on. I've never had covid.
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2 ReactionsI also developed gastro issues around that time - also still a mystery.
Your Dermatologist should not be too busy to see a changing rash on a
regular patient taking an advanced therapy. Is their front office overly protective?
Keep bugging the office and ask about a telemedicine check.
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2 Reactions@seniormed You're not wrong, but the department is way overbooked. This is so typical nowadays for most specialties (and even in primary care), at least in my area. I did get in quickly to see my immunologist who actually oversees my Dupixent treatment - I'm just not totally comfortable with what he thinks about the rashes. I certainly would start bugging my dermatologist's office if the rashes spread a lot more or change in some other way or I start having other symptoms. When I do see her, I may ask if she would take over management of the Dupixent treatment (or whatever else might be appropriate).
jacquincalifornia. dupixent can cause increased sensitivity to Malassezia yeast resulting in rash. Malassezia is a common harmless yeast present on the skin of most adults. You may have an overgrowth that you could treat with otc antifungals. Your rash could be concerning for shingles which is more usual on the chest and abdomen, but I have seen it manifest solely on the legs. The worry with shingles is the ensuing nerve damage. The dermatologist will sort it. Can you check in with an alternate dermatologist or at least call in for cancellations.
@gently Thanks gently. I am on the early cancellation list for a dermatology appt. I think if it was shingles it would have run its course by now because I've had these rashes since before March and no other shingles-type symptoms. However, I do have an overgrowth - a recent breath test showed I have IMO (intestinal methanogen overgrowth). Waiting for the very expensive drug for it to be approved... But it's quite possible that when the gut microbiome is out of balance, the skin microbiome could be too. I appreciate your feedback. I'll read more about Malassezia yeast, never heard of it before unless under a different name.