HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Darkening Of Skin At Neck And Breast Area?

Posted on Tue, 2 Dec 2014

Question: This Female patient has had darkening of skin at neck and breast areas precluding the now extensive spreading to other areas of her body. The so called darkened dark XXXXXXX appearance may start out as a red rash-like appearance and as a matter of time spreads and turns dark red/brown. She is now covered on her belly, down most of her entire back, inside thighs and calves of both legs. The darkening has not yet occurred fully on thighs and calves. This lady has had congestive heart failure twice now and has been treated and hospitalized since april of 2014. She also is being treated for pulmonary hypertension.

Answered by Dr. Dr. Kakkar (17 minutes later)

Brief Answer:
Upload photographs; Provide more information

Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic.

I am Dr. Kakkar. I have gone through your query.

I would like you upload a few representative photographs of the affected areas. I would be able to understand better once I have a look at the patches.

I would also like to gather more information from you regarding the query.

-Are there any symptoms like itching?
-Is there scaling?chaffing?

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (1 hour later)

The current meds list are here as follows:

Metoprolol ER 25 MG (Beta Blocker) .
Furosemide 40 MG up two twice daily for fluid retention.
Ferrous Sulfate 325 MG due to low iron.
DOK 100 MG (Stool Softener) .
Low Dose aspirin daily.
Levothyroxin 50 MCG with increase to 72 MCG ( Recently ).
Oxycontin CR 40 MG X2 ( Time Released ) For Overall Back Pain.
Amitriptylin 150 MG at night time to allow a more restful sleep.

Other useful info:

Female patient undergoes breathing treatments due to Interstitial Lung
Disease of unknown causes with the use of Duoneb vials daily also.

Answered by Dr. Dr. Kakkar (27 minutes later)

Brief Answer:
Need more information about skin probem+photograph

Detailed Answer:
Hi.

Thanks for the additional input. I don't think the skin problem is due to a drug reaction.
I would like you to upload a few photographs of the skin problem she is suffering from/dark patches that you mention in your query.

You need to click a few photographs of the dark patches and either mail them to YYYY@YYYY with the subject line as :"Attn Dr. Kakkar" Or else you may go to the reports section and upload the photographs using the uploader option.

Also provide me specific information about the skin problem.

-How long since she has these dark patches?
-Are there any symptoms like itching?
-Is there scaling?chaffing?

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (18 minutes later)

I don't have photos to facilitate you as of this moment and this is something we will have to work at. I, myself do not notice scaling or dry skin at all, yet she complains of a great deal of itching. As of her last hospitalization back in 5-15th of September, the dark skin coloration was contained to the center of the chest to include just below the neckline and underneath her breasts... a Crimson Brown Color. As for condition now, The color of her skin is all so much darker at same area described. Note: The new findings are now located on the majority of her stomach reaching into the waistline; which is beginning to go into a darker stage.
As for her back: it is found extensively throughout her entire back towards the hipline and is nearly 15 inches wide throughout and is about to darken some time quite soon. The same condition was also noted during her last hospital stay based on the inner portion of her thighs and has begun to darken a bit. The same condition applies on her calve muscle areas in the lesser degree as compared to thighs. The thighs are lightly reddened as though it is the start of a rash and only a little bit blotchy. This poor woman's skin color on chest and underneath the breasts almost appears black as in a dark skinned negro, I kid you not!!

Answered by Dr. Dr. Kakkar (24 minutes later)

Brief Answer:
Possibility of Tinea (Fungal Infection)

Detailed Answer:
Hi

Judging from the description and the distribution of the rash, I can keep a possibility of extensive Tinea (fungal infection). Since it is very Itchy, that too goes in favour of Tinea.
A photograph would have been very helpful in this case.
A fungal infection classically involves body folds like groin, sub mammary area but once it becomes extensive, it can involve other body sites as well.
Darkening is likely due to post-inflammatory hyperpigmentation associated with the infection and also due to constant scratching.
She may apply an OTC antifungal e.g clotrimazole 1% cream, twice daily. However, for an extensive involvement such as this, oral antifungals e.g fluconazole or terbinafine would also be required in addition to topical antifungals. Oral antifungals are prescription drugs.
I would suggest that you seek an appointment with a dermatologist for a confirmatory diagnosis. A fungal infection can be easily diagnosed by visual inspection. KOH examination is also confirmatory of a fungal infection.

Regards

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj