Dear all,

I´m a little frustrated - my hubby with a chronic skin history (psoriasis) has some kind of another *hellofanitching* rash for months and has been to docs in Samitivej & Bumrungrad.

All three docs tell the same: avoid sweating, do not use soap while showering, take these atarax (they kill the symptoms, but do not cure) and - sorry - repeat all the things every sensible human with a skin history has known for centuries.

Proper diagnostics (like taking a sample, blood test) have not been done, he was told to wait for one month (*yesthisistrue!*) and then take a full physical, after that an allergy test (do I see some Dollar signs here?). The Bumrungrad doc even kind of accused him being a "hospital hopper" because he told her that he had seen a doc at another hospital before *yesthisisstilltrue*

We´re really losing our confidence quite fast - if there is any place or -one you can recommend, highly appreciated.

Thanks and wishing u all an itch-free weekend

Without knowing what the rash looks like and the qualifications of the doctors you consulted i can't really comment on whether or not more of a diagnostic work up was called for. If the appearance of the rash was suggestive of a possible fungal infection then skin scrapings would have been in order but it is possible it is obvious from its appearance that it is either "prickly heat" or an allergic reaction.

Blood tests are not going to be of much use unless an underlying systemic diosease is suspected.

Before suggesting doctors it would help to have some idea of whether this is likely a skin infection, a sign of another systemic disease process, or an allergy/stress response.

Can you post a picture of the rash, and also:

1. list all the treatments that have already been tried and that he did not respond to? (I'm particularly wondering about antifungal creams/powders and any topical steroids)
2. list all medications he takes for any reason and how long he's been on them relative to appearance of the rash.
3. Clarify where on the body the rash is located and whether its location has changed or spread since onset (this gives clues as to whether it is likely to be an allergy vs local skin infection).
4. clarify whether he has any other symptoms or has noticed any other physical changes in the past few months
5. describe past medical history other than the psoriasis

At this point I'm in the dark as to even the type of specialist to suggest let alone whom.