What Causes Small Red Spots With Scaly Skin Around The Neck And On The Face?

Posted on Mon, 5 Dec 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 5 Dec 2016 Answered on

Tue, 27 Dec 2016 Last reviewed on

Question : My 94 year old mother began experiencing a rash on her shoulders about three months ago. It is tiny red spots with scaly skin around and spread to her neck, face and head. It itches, looks dry and scaly at times. We have seen a doctor and a dermatologist twice each. The doctor prescribed steroids three times, increasing the dose. But as soon as she goes off of them, the rash returns. The dermatologist agreed that she can't stay on oral steroids for long, and began prescribing different steroidal creams and ointments. None of there have helped and some blistered her skin, plus are very expensive. The rash has not been given a name so I don't know what to look up. It has begun to spread to her breasts and stomach. We've tried changing everything she is in contact with. Nothing helps. She was also given an antibiotic by the dermatologist because she thought some of the places might have gotten infected. Any suggestions? She lives in a memory care center. This doesn't seem to be contagious since my dad nor I have gotten it from her.

Answered by Dr. Dr. Kakkar (-5 hours later)

Brief Answer:
Kindly upload a few Images

Detailed Answer:
Hello. Thank you for writing to us

I am dr.kakkar (dermatologist). I have gone through your query and I have noted your concern.

I regquest you to kindly upload a few Images of the skin condition/ rash so that I am able to guide you better. You may upload Images in "Reports Section" Or you may mail me Images at YYYY@YYYY with the subject line of the mail as Attention:Dr.Kakkar.

Regards

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

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

Hi, I have provided some attachments. Please review them.

Answered by Dr. Dr. Kakkar (18 hours later)

Brief Answer:
Eczematous dermatitis

Detailed Answer:
Thank you.
I have reviewed the Images.

She has eczematous dermatitis.
Her skin is dry/ xerotic to old age and that is the main reason for eczematous rash. Moreover scratching would make it worse and prone to infection.
First of all I would suggest her to keep her skin moisturised. She may use an intensive moisturiser e.g Ammonium lactate (Am lactin lotion) or Urea based moisturiser.
In addition I would suggest that she uses a potent topical steroid e.g clobetasol propionate 0.05% cream for a few days. She may mix 1:1 with the mosituriser and use it twice daily. Once the rash subsides she may discontinue the steroid cream and just continue with the mosituriser.
Later on, a mild flare may be more effectively controlled with a topical calcineurin inhibitor (non steroidal) e.g tacrolimus 0.1% ointment.
An oral antihistamine, particularly Doxepin 10 mg, twice daily would be effective and would also relieve her anxiety.

Regards

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

Follow up: Dr. Dr. Kakkar (16 minutes later)

Thank you for your help. We will give this a try.

Answered by Dr. Dr. Kakkar (1 minute later)

Brief Answer:
You are welcome

Detailed Answer:
Thank you for writing to us

Regards

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