Any known history of eczema or contact allergies?
Do you usually wear a favorite necklace?
Any fever or swelling, bruise/bleed, pus/discharge, or tenderness to touch at this red ring?
Dear Dr OAB,
There has been no bruising, peeling etc. I am on Humira and thought maybe I was grwing out yeast as have in a couple of other places. I have not had any pain and no jewelry is near this area. The redness started about a year ago and has been resistant to everything I have tried.
For what condition are you taking the Humira? As the medication is used to treat inflammatory conditions, the condition itself may be the cause of the rash, in which case your doctor should be made aware.
1% of patients taking Humira develop a fixed drug reaction, meaning a localized rash in response to the medication. Although the face, palms or soles, and elbows or knees are the more common sites of such a reaction, it is possible to affect one area of the neck.
As the rash has not responded to anti-fungal medication, it is probably not a fungus or yeast. As you do not frequently wear jewelry, a metal allergy is unlikely. You do not report any symptoms that would point toward an obvious skin bacterial infection. It could be a localized eczematous reaction--this being the case, I suggest you pick one spot on the ring and try over-the-counter 1% hydrocortisone cream 2-3 times per day for 2 weeks. Should you notice improvement with this (even before the full 2 weeks), you may ask your doctor about a prescription-strength eczema cream (e.g., Locoid cream works quite rapidly for many of my patients).