Dermatology Questions? Ask an Online Dermatologist.
Thank you for asking your question. Did your physician perform a culture or scraping or was his/her diagnosis based on their clinical impression.? Most fungal infections do not ooze.
Thank you for your reply. Is it possible to forward a picture or two? Do you have a prior history of any skin problems? Any family history of skin problems? Where is the rash exactly?
Thank you for the pictures. How many of these patches do you have? Do they itch?
I will go ahead and give my opinion which might change with a further history. First, I have to disagree with my colleague, this does not appear to be a fungus ( Tinea Corporis). If this itches, the most likely diagnosis is nummular eczema. This is a relatively common condition consisting of round ( nummular is from the Greek word coin-shaped), and often oozing patches, usually occurring on the legs. The hallmark of this condition is itching. If there is no itching involved, I would be reluctant to make this diagnosis.
Is this itching?
Pretty sure this is Nummular Ezcema. The only other thing I can think of would be impetigo. However, the fluid looks clear and not like pus so I prefer Nummular Eczema as the diagnosis. I would recommend Domeboro astringent or powder compresses ( aluminum acetate). Apply for ten minutes twice a day. This should dry the area. Then apply Hydrocortisone ointment 1% on the area. You can put saran wrap over this at night. You might need a stronger steroid than over the counter, but that should give you a start. It is important to dry the areas out with warm compresses.
I would discontinue the Diflucan.
I would recommend culturing this to be sure it is not impetigo in which case an anti-staph antibiotic such as Doxycyline would be helpful. An oral pill is not indicated for Nummular Eczema.
Basically, if you presented to my office with this I would work around the diagnosis of Nummular Eczema. Dry the area up and then apply a potent topical corticosteroid.
Fairly quickly once the area dries out. You can use warm tap water compresses if you have trouble finding the aluminum acetate soaks. But some cases do not respond that easily in which case I have had to use steroid injections into the patches.
You too. Please Keep me informed.