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dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4069
Experience:  30 years practice in general and cosmetic dermatology
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I've had this rash 2 weeks now. I first noticed it 2

Customer Question

I've had this rash for about 2 weeks now. I first noticed it 2 weeks ago after a sexual encounter. All I received was oral sex but don't know if this is std related or what. The rash has a maculopapular look, and the very first few days I noticed it, they itched like hell. And had used benadryl for a couple of nights which calmed the itch. But rash doesn't seem to go away. In fact, it seems to he spreading. It started out as clusters to both shoulders / scapulas, then rapidly noticed a spread within a matter of hours to my sides (both upper rib areas). Again they look clustered together but aren't painful or itchy. I've noticed a couple spots on my abdomen, and now noticed to spots on the upper part of my left thigh. I seem to be noticing new spots everyday and it's starting to get worrisome. I can't quite tell if they're bug bites or what. They're not getting bigger or smaller, just the same size but spreading. I've got a few pics to show what they look like and the other areas they've spread to have the same presentation. Do you have any idea what this could be and is it contagious?
Submitted: 1 year ago.
Category: Dermatology
Expert:  Dr. Pravin replied 1 year ago.

Welcome and Thank you for your query posted.
My name is***** and being a Skin, Hair and Nail specialist I would be able to
provide you with an appropriate solution to your concern.
Please note that my Goal is to provide you with an Excellent Service .
Before I answer your question I would like to get some more information:
Do you have history of Diabetes?

Do you work in a hot environment ?
Please note that the answer provided is for information purpose only and does not
substitute a Doctor ­ Patient Consultation in Clinic

Customer: replied 1 year ago.
No I do not have any medical problems or live/work in a hot environment
Expert:  Dr. Pravin replied 1 year ago.

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.

Customer: replied 1 year ago.
I agree that it might be a fungal skin issue, but I'm not sure about the "folliculitis" part. I don't have hair on my shoulders or anywhere else I have seen the rash. And it's not because I shave, I just don't have hair there. I've got a genetic condition where I don't have strong male sex traits or characteristics and therefore don't have much body hair. My whole thing is, besides feeling more tired/sleepy, easily fatigued or without energy lately, I don't generally feel immunocompromised to where a fungal overgrowth should occur. But then that also worries me that I might have an underlying medical issue that's causing this fungal outbreak. Also what clinical presentation led you to the diagnosis of candida folliculitis? These are all learning experiences and ways to build my knowledge so if you don't mind explaining, I would be grateful.
Expert:  Dr. Pravin replied 1 year ago.

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.

Customer: replied 1 year ago.
Okay. That is most definitely reassuring, just wondering if it is a local situation or systemic especially since it I am noticing new spots in different areas of my body now...and believe you me, I've been a little OCD with checking my skin since noticing this rash
Expert:  Dr. Pravin replied 1 year ago.

Thank you for your reply.

This is definitely local in spread. There is no systemic fungal spread for sure. Do not worry about this.

Do you want me to release the rating service application on your page so you can provide me a feedback for my opinion provided ?

Customer: replied 1 year ago.
Okay before we move forward with that I just had other questions. First, with the kind of fungal skin condition you're thinking it is, it never really had any pustule presentation to it. If I'm not mistaken, you're thinking it's something similar to pitysorium folliculitis right? I probably did not spell the first part right but hope you know what I'm referring to. But reading on that fungal skin condition it says the presentation is usually papular followed by pustules - I am not noticing that part at all
Expert:  Dr. Pravin replied 1 year ago.

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.