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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: OB GYN
Satisfied Customers: 17354
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My Mom is 91 and on hospice! I have been a FNP for 40 yrs

Customer Question

My Mom is 91 and on hospice! I have been a FNP for 40 yrs she and her nurses had me check her extensive genital rash extending from the vagina down her inner thighs and also her rectum outward at least 3 to 4 inches, the rash in scaley and purplish somewhat itchy! She has severe osteoporosis 2 hip replacements a leaterbottled stomach from severe gastritis! She likely has lymphoma of gastric cancer. She has early satiety and drinks Chardonnay for her pain! She had a fall developed a facial/ sinus infection and just completed a 14day course of augmentum. Her face, sinuses etc are better but not completely resolved! She also has long standing HTN hypothyroidism yrs ago she did use Premarin cream Helpo
Submitted: 2 months ago.
Category: OB GYN
Expert:  Dr. D. Love replied 2 months ago.

Hello from JustAnswer.

Can you attach a picture of the rash?

Has anything been tried on the rash?

Customer: replied 2 months ago.
I live about 125 miles from so nystatin was tried as was possibly Orc cortisone ointment with no relief!
Customer: replied 2 months ago.
I don't have a photo either but it's awkward taking photos of your Mom's private parts
Customer: replied 2 months ago.
The rash isextensive, scaley dry and purplish red and dry ! I would like my Mom more comfortable!
Customer: replied 2 months ago.
My mom who usually never takes anything for pain was empirically started of morphine drops BID
Expert:  Dr. D. Love replied 2 months ago.

Without being able to see the rash, I would be most concerned with a yeast/fungal rash, which could have been made worse while on the Augmentin. As you know, the Nystatin is an antifungal. If there is a persistent yeast/fungal infection despite Nystatin, then a trial of a different medicine, such as clotrimazole may be an option. It also may be an option to use an oral antifungal, such as fluconazole.

This may also be further complicated by the fact that her face and sinuses are not completely resolved, so she may need a longer course of antibiotics.

It is certainly possible that this could be a primary inflammation of the skin. There also can be involvement of the skin with lymphoma. However, the pattern of spreading from the vagina and the rectum is more often seen with a yeast/fungal infection.

Regardless of the cause, it also may be soothing to apply cool compresses or to apply topical lidocaine. Neither of these will treat the condition, but she may be able to be more comfortable.

If I can provide any additional information, please let me know.

Customer: replied 2 months ago.
Thanks! Her Dr has been called away on an emergent family crisis! You confirmed my instincts and appreciate all of your help! I can see if the nurses could take a photo tomorrow ! It's after midnight here!
Expert:  Dr. D. Love replied 2 months ago.

You are very welcome.

Let me know if I can provide any further assistance.

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