Dermatology Questions? Ask an Online Dermatologist.
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Thank you very much for the photos sent.
It indicates that you have a yeast / fungal infection of the hair follicles which is called Candidal folliculitis .
You would need to apply over the counter Canesten or Lotrimin cream on the area twice a day for 10 days.
You would need to take Oral Claritine once at night for 10 days to reduce the itching.
You can use cetaphil cleansing lotion to cleanse the area daily.
This is not bug bite nor is it anything malignant nor psoriasis.
IN case it does not heal with the above over the counter methods you would need to take Oral prescription antifungal called Fluconazole once a week for 6 to 8 weeks.
Once it is healed you can apply Zeasorb powder in the area daily after a shower to prevent recurrence.
Please do let me know if you have any further queries.
The discrete distribution of the lesions , with the mild redness in some and some leaving behind marks.
The hair follicles which I am referring to are not the visible follicles but to the thin fine long hair that may not be visible . If you look against the sunlight you would see them ( like small lanugo or vellus hair that are present in all human beings) It is not necessary that only the visible hair thick dark black hair needs to be involved in this condition. All these thin hair have a small shaft or passage within the skin that allows the fungus to grow and cause this kind of rash.
This is not related to the lowered immunity or being in an immunocompromised state. Do not worry .
It is very commonly seen in our practice.
Thank you for your reply.
This is definitely local in spread. There is no systemic fungal spread for sure. Do not worry about this.
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from the photo the lesions look discrete in distribution on the shoulder , trunk .
They look papular and some flat in some like the ones on the shoulder and a few on the trunk.
It is not necessary to see visible pus in all of them and all do not need to be papular.
You also do have a few acneiform eruptions in between as seen in the photo.
The distribution and morphology of the lesions is very classic of this candidal folliculitis or pityrosporum folliculitis.