What is this on my sister’s back? Pic included

[Lemonlettuce]

Hi everyone,

I have permission from my sister to post this on her behalf.

She suffered with eczema as a young child but in the last couple of years has experienced various skin issues and doctors are not much help at the moment.

This current ‘rash’ on her back started over a year ago as a little spot and since then it has spread all over. She says it itches all the time and bleeds.

GPs say it’s eczema and gave her betnovoate, hydrocortisone and addex gel- none of these have worked.

Would appreciate any insight- she has asked multiple times for a referral to dermatology but the GPs don’t seem interested at all.

Would appreciate any insight.

I have no idea but I think she needs to insist. If she tells them what you've told us about nothing working, they really should refer. If she feels up to it she might ask the GP why they are not taking her seriously. She must get the message over that she's getting anxious about it now.
Ask for a second opinion, change GP, threaten to make (or actually make) a complaint. This is not good enough. Can you go with her and help her voice her anger and frustration?

Can she afford to see a dermatologist privately?

She needs to be referred to a dermatologist, I'm pretty sure she can insist her GP does this but stand to be corrected. My GP does E consults to the dermatologist dept at our hospital and they get back within 48 hrs, ask if they doe the same. She needs to get a bit forceful now and insist on treatment. It does look very similar to my mum's excema so the GP might be correct but it needs proper treatment.

Oh my goodness - that looks bad!

Has she ever seen a dermatologist for it? The only reason I can think of for them not referring is that it has already been checked out by a dermatologist who said she's fine and there's been no change to her skin.

But if none of that is correct, she needs to insist on a dermatology referral. Are they even looking at her back?

Have they done bloods? Is she well otherwise or does she have any other symptoms?

I think if this has been going on for a year and has not got better with the GP's suggested treatment, she does need to push a bit more for a wider range of investigation/treatment.

Can she see a different GP at the practice?

That isn't eczema.
She needs an urgent derm referral and some bloods taken to properly assess.

Agree about a referral to dermatology

My DD had an itchy rash for years, we tried many different creams and tips from the GP, nothing worked. Saw a dermatologist and she identified it correctly within a minute and we are now using an OTC cream which really helps.

Keep pushing, explain the amount of time you’ve been trying things, basically say you think it is unacceptable not to be referred given the history.

Darier’s? In any case, she needs to see a dermatologist.

Seborrheic keratosis would be my guess but she needs to see a dermatologist

IME GPs are useless with skin complaints

I got referred to a dermatologist for psoriasis that wouldn’t shift- I was lucky and was able to get a private referral via work insurance - and had the right diagnosis and treatment within five minutes

agree with others she needs to insist on referral. Ask to see another GP in the practice as a starting point. And lay it on thick (exaggerate if necessary) how uncomfortable it is and how treatments tried so far have done nothing

I agree with pp. That needs a dermatology opinion asap.

Does look like seborrheic keratosis and if so, dermatologist can scrape off with a curette loopy thing with great results, (I watch all the skin problem shows!). I'm by no means an expert so try to get a dermatologist referral.

That is absolutely not eczema.

DC2 had terrible problems with his skin from birth and we were always fobbed off by the NHS. It wasn't until he was on a trip to South Africa in his early 20s and had to have a steroid injection due to the pain and inflammation from his skin that he was diagnosed with an autoimmune illness.

Push, push, push the doctor. Register with another practice if need be.

Definitely push for a dermatology referral, I’m sorry the GPs aren’t taking it seriously. My mum had something like this many years ago and it was triggered by an immune response

Thank you everyone for your replies- I have asked my sister and she said she asked for an in-depth blood test but they just did a basic one and everything came back ok.

She said she’s going to try and get an appointment with a different GP tomorrow although she has seen a few different ones and they’ve all said eczema. If that fails, I think she needs to have at least a consultation with a dermatologist and then ask to be referred back on the NHS depending on what they say?

Thanks again everyone.

The pitting in the older spots looks like acne to me, that plus heat makes it very itchy, hence the sore patches and slight infection.

IMHO. Some antibiotic or anti fungal wash is needed here I think, and then some cotton sheets and tops to sleep in and wear during the day

Is she diabetic?
Looks like diabetic skin disease?
She needs to insist on a dermatologist.. it needs testing .

Did your sister ever get a diagnosis @Lemonlettuce ?

Possibly lupus. My niece has it and it looks similar but hers doesn’t itch don’t think

I thought so too, very common in older people. Probably have to have them removed privately , as most likely cosmetic.

Doesn’t look like eczema at all.

Your poor sister - my son used to get lots of rashes - his dermo ended up suggesting this site for me to research if need be - its very comprehensive.

If she can afford it - find a private dermo who also works for the NHS locally - they will refer back into NHS if need be.

DermNet® - Dermatology Resource (dermnetnz.org)

Sorry this link to the skin checker on this site might be a good place to start:

DermNet® - DermDiag (dermnetnz.org)