Skin rash

[Spaniel]

Just recently I have developed a skin rash on my left elbow!       I have been treating it with Dermovate cream which was recommended by the pharmacist.       It hasn't gotten any worse but neither has it healed.      Short of going to a local hospital can anyone recommend a local skin specialist or clinic?

[ajarngreg]

All over Thailand? I mean where are you located?

[BruceMangosteen]

There is a skin clinic on Pattaya Klang, below Big C Extra(same side, towards the beach, past 3rd road, before 2nd road) which has been there for many years. The test of time often is your real guide, both for the rash and a Dr's reputation. Bring along whatever you have been using. Naturally I don' t the hours especially considering it's a holiday period. 

[champers]

3 hours ago, ajarngreg said:

All over Thailand? I mean where are you located?

No it's all over his elbow. We are all posting in the Pattaya thread. Where are you?

[JaiLai]

Try Dermovate ointment.

[brewsterbudgen]

Try Dermovate ointment.

He's already been doing that!!

[JaiLai]

1 hour ago, brewsterbudgen said:

He's already been doing that!!

 

Ointment and cream not the same -

 

[JSixpack]

Might try Quadriderm. Shotgun approach but often works when you don't know exactly what the problem is.

[lamyai3]

Bethasone is good (local generic Betnovate 1%, four times stronger than the usual prescription version in the west), around 65 baht here. Worth trying each of these different creams for a few days each. Specialist clinics are only going to prescribe the same kind of treatment anyway. 

[ajarngreg]

17 minutes ago, lamyai3 said:

Bethasone is good (local generic Betnovate 1%, four times stronger than the usual prescription version in the west), around 65 baht here. Worth trying each of these different creams for a few days each. Specialist clinics are only going to prescribe the same kind of treatment anyway. 

Not really a great advice if you don't know what's causing the rush.

 

  OP, if you could post a photo of the rush, it might be helpful. 

[lamyai3]

2 hours ago, ajarngreg said:

Not really a great advice if you don't know what's causing the rush.

 

  OP, if you could post a photo of the rush, it might be helpful. 

The OP has already been prescribed a topical steroid cream by the pharmacist, so it's likely to be the sort of rash that responds to it. Most of the replies in this thread are suggesting other topical steroids if the first one is ineffective, my suggestion too is for the one I've found to work best. Three or four days should be long enough to see if any of these bring about an improvement or not. After that by all means visit a specialist, but with skin rashes it's very often guesswork on their part anyway, not at all easy to identify the cause in many cases. 

[BruceMangosteen]

Just now, lamyai3 said:

The OP has already been prescribed a topical steroid cream by the pharmacist, so it's likely to be the sort of rash that responds to it. Most of the replies in this thread are suggesting other topical steroids if the first one is ineffective, my suggestion too is for the one I've found to work best. Three or four days should be long enough to see if any of these bring about an improvement or not. After that by all means visit a specialist, but with skin rashes it's very often guesswork on their part anyway, not at all easy to identify the cause in many cases. 

Steroid creams aren't good for rashes. Pharmacist's don't prescribe anything, they suggest. The steroid creams are good for spreading/growing red areas, not bumps. For bumps, depending on the severity and size, use one of the others including "Beta Dipo". Salt water as in ocean swims also helps albeit in Pattaya that can be a double edged sword, risk of other microbes in the water etc.. Good luck and God Bless You.

[lamyai3]

1 hour ago, BruceMangosteen said:

Steroid creams aren't good for rashes. Pharmacist's don't prescribe anything, they suggest. The steroid creams are good for spreading/growing red areas, not bumps. For bumps, depending on the severity and size, use one of the others including "Beta Dipo". Salt water as in ocean swims also helps albeit in Pattaya that can be a double edged sword, risk of other microbes in the water etc.. Good luck and God Bless You.

If a pharmacist suggests something in this area, they would presumably recognise the rash to look like eczema or dermatitis. The only information given by the OP is that it's a rash, nothing at all mentioned about bumps? Although salt water can have a healing effect, I wouldn't recommend putting it anywhere near the sea in Pattaya.

 

Of course seeing a skin specialist is the best alternative, but it's also by far the most expensive, and the treatment is likely to be on a trial and error basis anyway if the cause can't be easily identified. Unless the OP can identify how the rash began (dietary, a swim in the sea etc) it's not necessarily going to be at all easy to work out the cause and best treatment. Since it's a non threatening condition, there's no harm at all following some of the advice in this thread (by various posters) to try a few different creams first.

 

Incidentally, the cream you just recommended (Beta-Dipo) is a steroid, and actually identical to the cream I mentioned (Bethasone) - the active ingredients in both are Betamethasone and Neomycin. 

[ajarngreg]

1 hour ago, lamyai3 said:

If a pharmacist suggests something in this area, they would presumably recognise the rash to look like eczema or dermatitis. The only information given by the OP is that it's a rash, nothing at all mentioned about bumps? Although salt water can have a healing effect, I wouldn't recommend putting it anywhere near the sea in Pattaya.

 

Of course seeing a skin specialist is the best alternative, but it's also by far the most expensive, and the treatment is likely to be on a trial and error basis anyway if the cause can't be easily identified. Unless the OP can identify how the rash began (dietary, a swim in the sea etc) it's not necessarily going to be at all easy to work out the cause and best treatment. Since it's a non threatening condition, there's no harm at all following some of the advice in this thread (by various posters) to try a few different creams first.

 

Incidentally, the cream you just recommended (Beta-Dipo) is a steroid, and actually identical to the cream I mentioned (Bethasone) - the active ingredients in both are Betamethasone and Neomycin. 

Considering that none of us, including the OP know what was causing the rash, I would never rely on a pharmacist here.

 

        It could be solved with the OP's pee, some of these rashes have to be dry and putting on any creme would make it more difficult to treat.

 

    If the rash is an infection and the outer skin is only showing that there's something wrong, I'd reckon to see a good dermatologist and not a brigade of forum readers with completely different experiences.

 

  And yes, salt water is healing a lot of such rashes, but it can also be the cause of them. Of course depending what's in the water.

 

       OP, please visit a dermatologist in your area to be on the safe side. There's only one here on this forum I'd trust and that's Sheryl.  

 

       

 

    

[BruceMangosteen]

1 hour ago, lamyai3 said:

 

Incidentally, the cream you just recommended (Beta-Dipo) is a steroid, and actually identical to the cream I mentioned (Bethasone) - the active ingredients in both are Betamethasone and Neomycin. 

Clobetasol Propianate is the ingredient most often given out by pharmacists in Pattaya and Bangkok and it is wrong for the condition assumed. When a person says "rash" it means with bumps. Otherwise it's not a rash! Beta-Dipo isn't in the  steroid creme section area of my kit but it doesn't matter. If it doesn't get better, get to a real Doctor. 

[lamyai3]

7 hours ago, ajarngreg said:

OP, please visit a dermatologist in your area to be on the safe side. 

I have more experience than most people of dermatologists, and can assure you it's a largely hit and miss affair. Several of them (including Harley Street specialists from the West) have admitted as much. 

 

For a non threatening and clearly uninfected condition I would put this in the same category as low level back pain. Try a few things first before wasting money on an expert in a field where conditions often clear spontaneously and causes often remain a mystery. 

[lamyai3]

8 hours ago, BruceMangosteen said:

Clobetasol Propianate is the ingredient most often given out by pharmacists in Pattaya and Bangkok and it is wrong for the condition assumed. When a person says "rash" it means with bumps. Otherwise it's not a rash! Beta-Dipo isn't in the  steroid creme section area of my kit but it doesn't matter. If it doesn't get better, get to a real Doctor. 

Dermovate (which the OP is using) is Clobetasol, more often than not given after other creams don't work..It's highly potent, and somewhat alarming (though not too surprising) to think it's dished out by pharmacists so casually. Betamethasone is in the middle (potent) category, but seems to be far more effective than the weak steroid creams like Hydrocortisone.

 

Rashes frequently have bumps and blistering (Google "different types of rash") and corticosteroids have been prescribed for treatment of eczema and dermatitis type rashes for many decades now. Obviously this is inappropriate if the condition is something different such as a fungal infection for instance - this is an example of an (often flat) rash which would not respond to a steroid cream at all. In fact the information given by the OP is too sparse really to give any meaningful advice. I would agree that if initial treatments don't work, go and see a doctor, who may be able to diagnose what it is on sight. 

 

Incidentally, Beta-Dipo is most certainly a steroid, it's active ingredient is Betamethasone:

https://en.m.wikipedia.org/wiki/Betamethasone

 

 

[Spaniel]

On 4/17/2017 at 5:38 PM, ajarngreg said:

All over Thailand? I mean where are you located?

Pattaya.       

[Spaniel]

On 4/18/2017 at 8:36 AM, JaiLai said:

 

Ointment and cream not the same -

 

 I'm using the cream.    Do you think the ointment would be better?

[Spaniel]

Thanks for all the replies.      The rash seems to have stabilized, not clearing up but not getting any worse.      It itches very slightly and their are a few small "bumps".      I'll give it a few more days, maybe a week, and if no improvement will try that skin clinic mentioned by poster Bruce Mangosteen in  post #3.

[Minnie the Minx]

Unusual to have a rash just on your left elbow, could this possibly be contact dermatitis?

 

A couple of years ago I had this weird rash all over my thumb extending to my wrist and that's what they said it was. Small bumps, red, itchy, annoying. Sorry can't give you the name of the ointment as it was Chinese but took ages to clear up.

 

Good luck and no harm in getting it checked out to treat the source of the problem. Cheers.

[lamyai3]

2 hours ago, Spaniel said:

 I'm using the cream.    Do you think the ointment would be better?

The ointment would be identical regarding the active ingredients, so it's a matter of what's more comfortable. Personally I find creams much better than ointments in a tropical climate (the climate here takes a lot of the dryness out of the skin anyway).

The greasiness of ointment is unpleasant in hot sticky conditions, it doesn't soak in to the skin very well and can cause itchiness in itself.

[sotsira]

6 hours ago, Spaniel said:

Thanks for all the replies.      The rash seems to have stabilized, not clearing up but not getting any worse.      It itches very slightly and their are a few small "bumps".      I'll give it a few more days, maybe a week, and if no improvement will try that skin clinic mentioned by poster Bruce Mangosteen in  post #3.

 I had a similar problem on my foot a while back and tried various steroid creams prescribed by

a GP but none of them would clear up the rash completely. This continued for 3 months.

 

I eventually went to see a dermatologist at Bankok Pattaya Hospital called Dr Anna, showed her the creams i'd been prescribed, and she discarded all but one of them and additionally prescribed me 

some tablets to take.

The rash went completely only after 2 weeks of taking her prescription.

I wish i had gone to her in the first place instead of trying out various creams to no effect.

[JaiLai]

7 hours ago, Spaniel said:

 I'm using the cream.    Do you think the ointment would be better?

I get dry skin on elbows sometimes and tried the cream, someone suggested ointment and it works a treat, cleared up in a day or two.

Can but in 5mg tubes, about 80 baht, it's got a light brown stripe on tube as opposed to a green stripe on the cream.

 

Thanks.

[bkk6060]

Lots of medical experts on here.

Why don't you show us a photo?  From personal experience, maybe it is and infection and not a rash.

[Spaniel]

On 4/20/2017 at 4:55 PM, sotsira said:

 I had a similar problem on my foot a while back and tried various steroid creams prescribed by

a GP but none of them would clear up the rash completely. This continued for 3 months.

 

I eventually went to see a dermatologist at Bankok Pattaya Hospital called Dr Anna, showed her the creams i'd been prescribed, and she discarded all but one of them and additionally prescribed me 

some tablets to take.

The rash went completely only after 2 weeks of taking her prescription.

I wish i had gone to her in the first place instead of trying out various creams to no effect.

Thanks for the Dr. Anna tip.       I am familiar with her having seen her several times over the past few years for skin cancer check-ups.    

[transam]

Sounds like Psoriasis, I have the T-shirt. It can take Dermovate "ointment" quite a while to do anything, sometimes a month before improvement. One of my elbows it did nothing, bit unlucky....

In the end I bought a special UV "wand" that did the trick..

 

Do you have any other irritations, but no sign of rash..?

[Spaniel]

Yesterday (25 April) I went to BPH and saw Dr. Anna concerning my rash.     She did a biopsy and should have the results soon so hoping it's not  serious.

[lamyai3]

On 4/26/2017 at 5:11 PM, Spaniel said:

Yesterday (25 April) I went to BPH and saw Dr. Anna concerning my rash.     She did a biopsy and should have the results soon so hoping it's not  serious.

How did it turn out? 

[Spaniel]

On 5/17/2017 at 6:42 AM, lamyai3 said:

How did it turn out? 

The biopsy was negative, no infection, so that was good news.    She (Dr. Anna) prescribed Fucicort Cream, twice a day.       It's working and the rash is almost gone.