RED SKIN SYNDROMES

Chronic worsening eczematous rash patients are frequently tested and reevaluated to search for a cause because they appear to resist treatment with corticosteroids, “the gold standard of treatment.” The patients are usually atopic dermatitis individuals.

Systemic evaluations and various allergic testing coupled with a large variety of topical and systemic medications fail to manage the problem. Typically these patients initially experience a minimal rash that progresses to a more extensive and markedly systemic dermatitis despite increasing amounts and strengths of topical and oral steroids.

Fashion in therapy may have some justification; fashion in diagnosis has none.

Herrick & Tyson

Various syndromes have been named depending upon the body location involved. In evaluating, treating, and managing over 3000 patients with this condition it has become clear that this worsening problem is due to the therapy, namely corticosteroids, not uncontrollable chronic eczema.

Searches for hidden allergens are without value. Cure occurred in all patients after complete cessation of these medications often requiring a withdrawal period of as much as 1-4 years. Withdrawal involved multiple flares of a burning itching rash, edema, oozing of the skin, and infections that often accompanied severe anxiety, horrific itching, sleeplessness, and overwhelming pain.

By Dr Marvin Rapaport, MD|2021-10-19T03:16:57-07:00June 18th, 2015|RSS The Disease|Comments Off

About the Author: Dr Marvin Rapaport, MD

In 1978 I initiated and set up the contact and photo dermatitis clinic at UCLA. There was a need to evaluate a large group of patients who exhibited severe eczematoid rashes, especially on the face. Patients were referred from all over Southern California. All patients underwent a lengthy history and examination. Further evaluations included blood studies, allergy patch testing, special sunlight (photo) testing and skin biopsies. From the start it was apparent that most patients experienced a mild dermatitis on various parts of the body that progressively worsened. Their histories always included numerous doctor visits, multiple physicians, and therapy consisting of an increasing amount of corticosteroids. My testing failed to reveal any specific culprit chemicals, cosmetics, perfumes, workplace or recreational exposures. It became increasingly clear that the physician’s therapy, the corticosteroids, was invariably causing the problem. I wrote 7 scientific articles that were published in the most august peer-reviewed dermatologic journals and I gave many lectures at various dermatology meetings. To this day an unfortunate reluctance exists on the part of most physicians to accept this simple concept.