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Ask Dr. S. Attili Your Own Question
Dr. S. Attili
Dr. S. Attili, Dermatologist & Dermatopathologist
Category: Dermatology
Satisfied Customers: 5175
Experience:  MRCP (Dermatology), Int. Board Certification in Dermatopathology
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What can cause red blotches on face, neck and upper chest;

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what can cause red blotches on face, neck and upper chest; and it itches...get it intermittently; not related to perume, soaps, detergent or foods as I have ruled them out...could it be an autoimmune problem?
Hi. I will do my best to advise. However, please note that this does not substitute an in-person consultation with a doctor.
Can you upload pictures?
Customer: replied 4 years ago.

I just uploaded 3 picture...2 neck and one face. Currently not as bad as it sometimes gets....can you confirm that you received the pictures? Thanks

Sorry no. You have a few options for sending me pictures:
1. The quickest: upload the pictures here using the upload icon in your reply/chat box. Please see this tutorial page if you don't know how.
This option will not be available to mobile/ipad users. You can try emailing the photos to yourself (making sure you chose the largest size of the image while emailing) and access/ upload them via your computer, if you have one.
2. Upload the pictures to online photo sharing websites like Flickr/photobox/picasa web albums and paste the link here.
3. Alternatively you can email them directly to***@******.*** with the subject line 'FAO dermatology expert Dr. Sasi Attili'. Please note that you HAVE to send them from the email address you registered with on justanswer OR paste the link to your question in your email, or else the email won't be forwarded to me. Also do note though that emails might take up to 24 hours to be forwarded to me (and hence first two options preferable), though usually they are forwarded within a few hours.
I shall get back once I receive the photos. Hope to hear from you soon.
Customer: replied 4 years ago.

Thanks. How often does the breakout occur? How long does it last each time? How long have you had the problem for?
Customer: replied 4 years ago.

Intermittently...seems to be more frequent over the last 6 months...approx 1-2 times/month; also itchy. Lasts different time periods...anywhere from a few day to a week. It has been happening for about 18 months...sorry cannot be more specific....probably waited longer than i should have...more annoying than anything else. Tried benedryl (po and topical) and OTC topical lotions for both ezcema and psoriasis with no relief.

ok. This looks like an eczema and on the head and neck area, the commonest reason for it is either an allergy to sunlight (do you think this could be a possibility? Do you have the problem throughout the year?), or more likely, an allergy to a topical (cosmetic/ perfume). Is there anything you have not thought off? What about a scarf that you might be using around your neck?
Customer: replied 4 years ago.

Do not think it is sunlight as no worse in summer or on vacations in south. have not changed cosmetics (actually use hypoallergenic makeup and detergent) not wear scarfs. I also tried to keep area open when it starts "acting up" as much as possible..cannot think of anything else that I haven't told you. Also, would eczema just show up on your neck as i have googled both eczema and psoriasis prior to e-mailing you and they appear more scaly and the pictures didn't resemble mine...also they didn't seem to be as localized as mine are (to chest, neck and face). Have you seen something different in your practice?

No. Psoriasis looks quite different and once it flares, can take months to settle and isn't itchy. I have little doubt that what you have is an eczema and am quite confident that this is an allergic reaction to something, as there is really nothing else that would behave like this. Are you able to see a dermatologist and get patch (allergy) testing done?
Customer: replied 4 years ago.

That is what I was thinking...I will schedule an appointment with my PCP and a dermatologist to try and see what this is so it can be treated....thanks for the advice (wish it was more definite but know it is difficult via e-mail).

Have a good day.

Please do that. What you need is patch testing. You can read all about it here:
Do get back if I can be of further assistance and do keep me posted as to how you get along.
Best wishes
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