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What is this skin rash?

April 24, 2002

Two weeks ago I started getting spots around my body. I went to the doctor and he said it was folliculitus. After a course of antibiotics it was a lot worse. I am covered. Another docter said it was an allergic reaction. I am now taking antihistamines but 2 weeks on it is worse and extremeley itchy. The spots are a bit like blisters then they go dry and flaky. Can you offer any help? -- Sharon, United Kingdom

Many skin conditions have similar characteristics, making it difficult to diagnose and treat them. Physicians may treat by a process of elimination. For example, if it appears to be folliculitis, the doctor may prescribe antibiotics. However, if the condition worsens after a few days, the doctor will likely change the treatment. If the infection clears up, the physician may treat the underlying condition that led to scratching and infection.

If your condition becomes worse during treatment, always let your physician know. I've seen patients go from doctor to doctor, and give all the credit to the one who finally found the problem. But if all the symptoms point to three possible conditions, and other doctors have treated the first two with no relief, it is not hard to treat the third condition and be lauded a hero.

On the other hand, some conditions are self-limiting. A physician may prescribe what seems to be a miracle cure. But the condition may have simply run it's course. For example, in our office we often see reactions to poison ivy. Symptoms are somewhat similar to those you describe. Severe reactions or areas that become infected should always be treated by a physician. But non-prescription creams and lotions can alleviate itching in milder cases. Poison ivy goes away by itself in a few weeks even without treatment. If you suspect poison ivy, talk with your physician about whether treatment is indicated.

The American Academy of Family Physicians offers an excellent flow chart for self care of skin rashes. See the footnotes below.

I once asked a dermatologist how he was able diagnose and treat skin conditions other physicians had not helped, and he attributed it to a "trained eye." If your skin condition does not get better, you may need it examined by a trained eye. Ask your physician to refer you to a dermatologist.

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