Not convinced it's eczema

Posted by steves2 @steves2, Feb 14, 2023

I was to a dermatologist about a year ago for the pictured rash that started a couple years prior with the occasional red spot on my lower legs above the ankle. Over time, it has spread so that it can be anywhere on my legs as well as being more common on my arms. It does not itch nor is it painful. If I didn't see it, I wouldn't know it's there.

I thought it might be chlorine in the water (since it worsened after I moved to a city with heavy chlorination), but that ended up being a red herring. Sun exposure *might* have made it better, but it was kind of erratic until after the summer was over regardless. It seemed to get dramatically more widespread while I was doing an elimination diet to figure out silent reflux/food allergy triggers. However, that could be a coincidence. Topical steroids did nothing, which is very unusual for me since I could basically watch them work on contact dermatitis when I was a kid. Switching to unscented soaps, applying lotion heavily, Most any of the common blood tests came back normal; I'm still waiting on some results. It might be one of my meds, but skin issues are a very rare occurrence and I hadn't had a prescription/dosage change for at least three years prior to the onset of the rash.

I have other symptoms that suggest EDS, and my PCP will evaluate that should all of my blood work come back normal. I also am getting a second opinion from another dermatologist in about a month. I'm just curious if anyone else has had something like this.

Interested in more discussions like this? Go to the Skin Health Support Group.

gardeningjunkie | @gardeningjunkie | Feb 18, 2023

The 5 Day Extended Patch Test for Allergic Contact Dermatitis, ACD, is expensive. I believe the basic test kit, a good brand is The True Test, runs $1500.00 with administration by a derm or allergist licensed for this testing. Not all derms or allergists are licensed for this test. My Medicare paid for it, but I was severely symptomatic, considering suicide, based on lack of sleep and misery. Yet we both agree, your papuales don't look or feel like classic ACD.
Research this test and keep in in a notebook with your skin symptoms, photos and information. Each of us has to do lots of personal research, even with the best of doctors. Your issues can't be ignored, something is clearly causing these papuales. Your PCP should make referrals to other specialists if they can't figure it out.

hawkssr | @hawkssr | Feb 19, 2023

In reply to @steves2 "It looks like Grovers appears most often on chest, neck, and back... about the only places..." + (show)

I have GD on those three areas and my stomach. Also went to my scalp mainly at the hairline of of neck. Sometime spots will show up on back of thighs and knees. My GD is super itchy especially at night. There is a forum that’s very good for Grover’s if interested.

steves2 | @steves2 | Mar 15, 2023

So, I saw the dermatologist this morning. She is very certain that it is Guttate psoriasis. Just to cover all bases, she ordered an ANTISTRREPTOLYSIN lab (since I've been having some throat-related issues somewhat coincident with the rash.

I have Clobetasol waiting for me to pick up, though it will continue to wait until I get a reply regarding use and side effects.

Looking at images that get pulled up with an internet search, I can see some that are similar to what I have (though much denser... I hope that isn't the direction this is going ).

steves2 | @steves2 | Mar 20, 2023

In reply to @steves2 "So, I saw the dermatologist this morning. She is very certain that it is Guttate psoriasis...." + (show)

The test came back - as I expected - negative.

I remembered that the doctor was surprised that the lesions got worse with an elimination diet I was on (and kind of still am).

So, I looked into it more and found that of the top 20 or so anti-inflammatory foods/herbs/spices, I had cut out most of those from my diet (and seldom ate most of the rest). I've been having reflux(ish) issues for a little longer than the rash, so there are some foods I was anti-inflammatories I was avoiding all along.

While I wasn't eating much on the inflammatory list, I'm cutting as many of those out as I can while I try to incorporate more of the anti-inflammatory foods into my diet.

I won't be seeing the doctor again for 4 months, so I figure I have time to try this before going to the Clobetasol.

ladyaceintx1 | @ladyaceintx1 | Mar 21, 2023

Hello, and yes, I have a similar rash on my bilat legs from the knees to my ankles usually. The rash starts spontaneously and no OTC topicals work. I recently went to a Dermatologist who became very interested because he thinks I have Henoch-Schonlein Purpura (HSP) which is caused by inflammation in the blood vessels of the skin. Do a Google search and look at the pictures and then discuss your findings with your Dermatologist.
Good luck to you.

steves2 | @steves2 | Mar 23, 2023

In reply to @ladyaceintx1 "Hello, and yes, I have a similar rash on my bilat legs from the knees to..." + (show)

Thanks for the suggestion. Like with eczema (and now psoriasis), I don't have the typical symptoms for Henoch-Schonlein Purpura. Good luck to you, as well.

steves2 | @steves2 | May 28, 2023

To follow up, the Clobetasol worked some. My skin heals faster, but it kept coming back.

What has worked more (I think) is switching to shorts. The number of new spots has dropped to close to zero.

My PCP thinks maybe the friction of pants is enough to exacerbate it. Not sure what I'm going to do in the Wisconsin winter lol.

I did try an anti-inflammatory diet but that really didn't seem to do anything.

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