Timeline & Symptoms

Onset: ~mid-July.

Initial distribution: began on lower limbs, progressed upwards to thighs, buttocks, and the sides of the waist at the level of the diaphragm.

Later involvement: arms (mainly biceps) with fewer but similar lesions.

On legs: larger, flat, itchy patches.
Some lesions appeared on soles and heels, which were tender and painful.

On forearms and hands: multiple small, raised papules resembling dyshidrotic eczema, very itchy, sometimes painful. (After 15 days)

Over time, new lesions appeared over the suprapubic region , lower abdomen). These were firmer, painful, and itchy compared to earlier lesions. After the zempred dose

Itching: severe to mild or low, varries., worse at night initially,  itches mainly at the spot of rash or lesions,  , aggravated by heat and sweating.


Tests

CBC – normal

CRP – normal


Doctor 1 (Day ~5–6)

Impression: insect bite/scabies.

Prescription: Permethrin lotion, Albendazole, Calamine lotion.


Doctor 2 (2 week later; Physician)

Impression: allergic/parasitic.

Prescription: Albendazole (repeat), Hydroxyzine, Fexofenadine (Allegra), Fluconazole 150 mg single dose, Calamine lotion.


Doctor 3 (Dermatologist; first visit ~15 days after onset, then follow-up ~10 days later)

First visit:

Impression: nonspecific rash, possibility of allergic/autoimmune reaction considered.

Prescription: Neogenta-F cream, Montelukast + antihistamine (twice daily), Zempred 16 mg once daily for 5 days, Albendazole + Ivermectin for 2 days, Nevlon lotion twice daily.
The rashes on hand disappeared fully, but are coming back again.
During zempred itching reduced but not disappeared fully untill day 3 even after day 3 there was slight itchyness. 
But during this time had severe body pain specially around joints and pain in the skin on touch.
Went after stopped  the medication.  Pain was more on muscular level,joint was not exactly painfull. More like a crampm like DOMS


Follow-up (10 days later):

Symptoms: itching returned once steroids and cream were stopped, with new lesions over buttocks and suprapubic region, painful and itchy.

Impression: suspected Pityriasis rosea or viral exanthem.

Prescription: Azithromycin 500 mg once daily for 5 days (empty stomach), Omnacortil 10 mg once daily for 5 days, Clonate-F cream twice daily for 5 days, Atarax (Hydroxyzine) 25 mg nightly for 20 days.
 
On the same day visited next doctor,  wasn't satisfied by and was overwhelmed .didnt follow the new medicine


Doctor 4 (Latest; 25 August)
Examination: ruled out urticaria (blanch test negative), ruled out chikungunya (no joint stiffness), ruled out pityriasis rosea.

Didnt tell me the diagnosis

Prescription: Methotrexate (Folitrax) 7.5 mg once weekly for 1 month, Folic acid 5 mg twice weekly, Zempred 15 mg once daily after breakfast for 10 days, Bilastine 20 mg nightly for 20 days.
days. he didn't explain me anything avout the medication,  specially that its immunosuppressive. 



Did not had methotrexate for atleast 20 days, was traveling.  After taking my frstt dose, i had cold sore flare up, been a 6 days still not going away.



I am thinking not have it.



Right now i have this samll rashes on hand but now it has spread all over to body (4 th pic)

What is it

Hear my plea for help, i am depressed. Having this weird rash, what is it. Long story below.