Skin - Circular Red Patches?

I've scoured all the skin-related posts and couldn't find an answer for this one.  I'm having my second bout this year with red, circular rash-like skin irritations that two Johns Hopkins dermotologists can't seem to diagnose.  They're thinking of bringing me in front of a committee of docs to try and figure it out!

These patches are not painful at all and do not really itch - and don't appear to be seasonal.  They show up at the joints (elbows mostly, but a little at the knees) and only on the underside, but they also run appear on my abdomen (where they are the worst), chest, and even an eyelid!  They generally start on an elbow and spread over weeks and months - they start as small circles and grow to 2"-3" in diameter, sometimes merging with others.  The skin itself eventually looks like a blister broke a long time ago (only there was never a blister) and the skin inside the circle is scale-y and flaky.

I've tried two different topical creams and the first time this happened the second cream, Pandel, worked right away.  A biopsy showed it was some kind of eczema and I was told not to worry.  But the condition came back within months and now the dermotologist is stumped.  I'm waiting on results from a second, more extensive biopsy. 

I have to think this is Crohn's related - and the doctor is beginning to think it is somehow related to inflammatory disease - but does this sound familiar to anyone?  It's definitely not the worst Crohn's related thing in the world, but I'm really anxious to know what it is and how it might be treated.  My best guess is that it will be recurring and I'll always have to try different creams or may an oral med (steroids?)...

Any insight would be appreciated! 

Hi you could be having a reachsion to remicade. I would call your doctor asap. to see if its.

My son was just diagnosed with some warts on his arm. They are reddish (most of them) and hurt some. I forget the name of the wart. I hope you find answers soon! karen

So I am not the only one with mystery skin things going on.....if the blotches continue, I would suspect psoriasis too. I have had several bouts of odd blotches, multiple rounds of fifth disease (a childhood disease you are only supposed to be able to get once), pityasis, and one really whacked out time when my skin blew up to twice my size and burned like it was on fire. That last one started with a blotch on my back, that disappearred and a blotch then appeared on my stomach, then it went to the full blown inflammation and burning sensation. I was told that it was a virus--can't rem the name at the moment, but it had initials with a "C" in it somewhere
I sincerely believe these odd skin issues, that no doc believes I have and think I am exaggerating, are a result of our messed up immune system.
Please keep me up to date on what you find...both you Crohnsy and dustspeck! I will share anything I find too....it stinks not knowing and we have to stick to gether

I agree with mojo...sounds like psorasis to me too. I have it on my belly, back, shoulders & extremities. Patches sound pretty much like you explained. Mine appearred on my resect scar area first after surgery. I use 2 different types of steriod creams from the dermatologist, no perfumes, only castile soap (made from olive oil), natural bristle bath brush (exfoliater) and dead sea salt/ mineral oil baths 2x a week. It keeps it somewhat under control. However, this week I have a new patch on my neck!

This past summer I've had 3 very circular red size patches on my belly, they started out as a little red mark and grew almost to the size of a quarter. Pinch of white in the center but not open as a sore would be..
Unlike the ones you describe mine were terribly itchy. Two occurred on my belly area and one just under the breast. At first I thought they were boils but they had more of a flat surface and weren't oozing so I am in the dark as to what they were.. They took about 2 weeks to go away although I still have the pink marks to show where they occured.

 

I should mention that the 3 didn't pop up at the same time, one first and the other 2 several months later.

It sounds a lot like psoriasis to me, mine is not itchy, but have had it in varying degrees for 40 years. Since moving to Florida 30 yrs ago, it has been under control pretty much. Usually goes away when on steroids. I got an unexpected outbreak on my elbows after starting pred and entocort in Jan. Went away pretty fast. I just heard about lichen planus today on another thread, so I looked it up, and it seems to sound pretty similiar to psoriasis in appearance. Try this site http://www.nlm.nih.gov/medlineplus/ency/imagepages/2491.htm to view some pics.

It's surprising that a team of doctors could not figure out what you have. Correct me if I'm wrong, but you didn't say the rash was itchy, flaky or painful. This rules out psorasis and other common conditions like eczema.

From what you've said, it sounds like you have Petechia and/or Purpura.

Wikipedia says,

Purpura (from the Latin, purpura, meaning "purple") is the appearance of red or purple discolorations on the skin that do not blanch on applying pressure. They are caused by bleeding underneath the skin. Purpura measure 0.3-1cm, while petechiae measure less than 3mm, and ecchymoses greater than 1cm.

A petechia, plural petechiae is a small (1-2mm) red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood vessels). The most common cause of petechiae is through physical trauma such as a hard bout of coughing, vomiting or crying which can result in facial petechiae, especially around the eyes.

This is one of the many skin-related symptoms that result from Crohn's disease. You may be able to reverse your symptoms in a month or two with Vitamin C supplementation. I would recommend 600-1000mg per day, but not to exceed 1000 mg.

Related:

Vitamin C deficiency - defect in collagen synthesis due to lack of hydroxylation of procollagen. It results in weakened capillary walls.

Best of luck,

icarrriere

i too get this exact rash when my crohns is flaring and when i am not taking prednisolone. (The pred always clears it up)

Dermatologist doesnt know what it is and my GI says that is "more than likely related to the crohns".

My rash does itch and weep; its circular and is always worst across my stomach