Scabies
Scabies is caused by a mite that burrows itself into the human skin and causes an extremely itchy reaction. It is easily treated with Permethrin (insecticide that kills the mite) and this is safe during breastfeeding.
Tinea Versicolor
This rash is tinea versicolor, a harmless yeast that tends to be minimally symptomatic, but patients wonder what it is. This is treated with ketoconazole (anti-fungal).
Guttate Lichen sclerosis with a Bullous Component
When in doubt, biopsy! This patient was sent to me for nipple discharge and a breast cyst, but I noticed these skin changes when I was examining her. Like so many women, she had put her own health on the back burner when caring for children and keeping up a busy work schedule. We biopsied it, which showed lichen sclerosis, an inflammatory skin condition, for which topical steroids can help relieve symptoms. If you have a rash that no one has an answer to, ask for a biopsy!
Dermatomyositis (Paraneoplastic Syndrome)
Paraneoplastic syndromes occur when the body’s immune system has a reaction to a tumor. These are rare, but should have a physician evaluation and biopsy if it becomes this progressive. This is dermatomyositis, which causes a skin rash, changes around the eyes, and muscle weakness, in a young breast cancer patient.
