When is your rash not what you thought it was?
We were shocked to learn that a diagnosis of “eczema” does not mean you have atopic dermatitis. Over the years, doctors have for some reason decided that any rash that does not look deadly can be called “eczema”. There are thousands if not tens of thousands of people who believe they have eczema, and, years later find out they have lichen planus, hives, ringworm, scabies, or something else. Personally, I would be more than angry at any doctor who let me suffer for years with hives, scabies, or ringworm, which have quick and easy cures.
Why is this allowed to happen? I have no clue. You will realize how old I am when I tell you that I remember doctors coming to the house to diagnose you. They were trusted to know what was wrong with you, and how to make you better, but they were not considered infallible. People also trusted them to tell them when to go to a specialist. Then something changed, and suddenly doctors became people you made appointments with and took time off work to go see, and sat around for hours in waiting rooms to get three minutes of their time. Now the local “norm” is that a nurse or physician's assistant sees you, and sometimes you actually see a doctor, but you are charged the same as though you saw a doctor. Why??? I am not saying that nurses or physician's assistants are not great people who probably know just as much. I am simply saying that I am paying to see a doctor, not a stand in.
As patients, we need to ask to see a doctor, since we are paying for one. As patients, we need to learn what questions to ask to get the treatment we deserve,
For rash patients this is even more important. Doctors have been prescribing the same steroids for all rashes for decades. I know it is the only thing they have that actually helps somewhat, BUT all steroids do is squash the body's response to inflammation. Steroids are prescribed in hopes that your immune system will kick in to handle the rash before the prescription runs out. The “standard treatment” for rashes seems to be “you have x. Take these steroids, and if the condition does not resolve within 6 weeks, come see me then.” Doctors know that most rashes do go away by themselves within 6 weeks, or at least start getting visibly better by then.
Most people we deal with are surprised when we tell them that doctors (in general, not all of them) get a failing grade in diagnosing rashes. If you get a biopsy done, you will know what you are dealing with. You may not like the diagnosis, but at least you will be better able to plan your strategy for your future.