Can my husband stop the spread of his itchy red rash? DR ELLIE CANNON answers your questions

Mine The man has had a dark red, itchy rash since August last year.

It started on the back of his knee and has spread to his inner thighs, armpits, ankles, arms and between his fingers.

Ointments and tablets – such as fluconazole – have not yet worked. Is there anything that can be done?

Itchy, sore rashes can destroy patients’ self-confidence – especially when they affect several parts of the body.

If the rash is itchy and has parts of the skin that split, doctors would consider diagnosing a skin condition called dermatitis.

In dermatitis, the skin becomes inflamed and dry.

There are different types – eczema is one type and another is called contact dermatitis, which means that the rash occurs in response to an irritant coming in contact with the skin. Washing power is a common example.

If the rash is itchy and has parts of the skin that split, doctors would consider diagnosing a skin condition called dermatitis. In dermatitis, the skin becomes inflamed and dry.

Sometimes dermatitis can be aggravated by a bacterial or fungal infection that needs to be treated next door.

Dermatitis is usually treated with two creams.

First, an emollient or moisturizing cream, such as Cetraben or Doublebase, to soften and moisturize the skin. This should be applied generously at least three times a day.

A steroid is also used, such as Betnovate or Hydrocortisone, for a set period of time to alleviate the inflammation.

Dermatitis is usually treated with two creams. First, an emollient or moisturizing cream, such as Cetraben or Doublebase, to soften and moisturize the skin. [File image]

Other treatments can be added to this, such as a cream for use in the shower or an antihistamine tablet to reduce the itching.

Applying the creams regularly can be difficult, and patients often have difficulty following the routine.

Anti-fungal treatments or antibiotics may also be suggested if there is an underlying infection. Otherwise, a general practitioner may refer you to a specialist dermatologist or dermatologist.

I’ve been taking antidepressants for two years, but I can not figure out which type is best for me. Flupentixol was the first – but I got shakes.

Then I switched to citalopram, which seemed to work, but the doctors told me that venlafaxine would be more effective. But it gave me panic attacks.

I have also tried sertraline and duloxetine but had bad side effects with both. Should I go back to citalopram?

It is very common for doctors to suggest that patients try another type of antidepressant medication if a particular type causes side effects.

But it is very unusual for doctors to change medication four to five times over a few years, especially when a drug seems to work well.

Picking and changing medications does not make sense, and often results in unwelcome side effects and withdrawal symptoms. This is especially true for medications that treat mental illness.

It is very unusual for doctors to change medication four to five times over a few years, especially when a drug seems to be working well. Picking and changing medications does not make sense, and often results in unwelcome side effects and withdrawal symptoms. [File picture]

Sometimes it is necessary to change a medication even if a patient is feeling well.

This has become more common as the NHS has moved towards some cheaper and safer alternatives. However, a patient’s symptoms and tolerance to the drug should always be a priority.

Flupentixol is an antipsychotic drug: it means that it is used for mental illnesses such as schizophrenia, which involve extremely intrusive thoughts. It is not usually used to treat depression.

However, if someone is stable on flupentixol and is doing well, doctors will not usually suggest a change.

The instructions for use of the medicine recommend a very slow abstinence. It can take two to three months to get the dosage of antidepressant correctly.

It can take months to see the effects. Changing birth control pills regularly in a short time shows that not every pill has been given a chance to be tested properly.

In such cases, stopping and starting are likely to cause unpleasant side effects – rather than the pills themselves.

I have a long-term osteoarthritis problem in my left knee, which is gradually getting worse.

My GP refuses to see me, saying I do not need a scan or further treatment.

But I’m in pain. What can I do?

Patients with osteoarthritis should not just suffer from it.

While there may be no cure for the condition – where the joints become painful and stiff – there are things we can do to control the pain.

A scan would only be worth doing if there was any doubt about the diagnosis. Therapeutically, there are a few options.

Knee osteoarthritis can respond well to weight loss, relieving pressure on the joint.

Muscle strengthening and exercises to protect the joints are also effective.

Patients with osteoarthritis should not just suffer from it. While there may be no cure for the condition – where the joints become painful and stiff – there are things we can do to control the pain. [Stock image]

Simple pain relief such as paracetamol and anti-inflammatory drugs, especially topical ibuprofen gel, may be helpful. GPs can also refer patients to specialists.

The NHS has local physiotherapy or musculoskeletal teams that regularly care for people with knee osteoarthritis.

These health professionals offer individualized exercise and physiotherapy plans as well as steroid injections, which can also sometimes be available at the GP.

Surgery is also on offer for osteoarthritis. This includes both a replacement of the knee and the ability to wash out the joint, especially if locking is a problem.

If a GP does not offer any of this, it is advisable to seek a second opinion, perhaps at another GP.

No jab, no job is a no brainer for NHS staff

I get upset about reports of doctors saying they are willing to lose their jobs to avoid getting a Covid jab.

Despite setbacks by MPs, the Prime Minister is sticking to a vaccine mandate for NHS workers – and from April it will be no jab, no job.

Despite setbacks by MPs, the Prime Minister is sticking to a vaccine mandate for NHS workers – and from April it will be no jab, no job. The photo: Health Secretary Sajid Javid meets staff at a Covid ICU at Kings College Hospital, London on January 7, 2022

I have not yet met a doctor, or any NHS employee for that matter, who is so dismissive of the vaccine that they are willing to lose their jobs because of the problem.

I get the impression that most of those who take this position are outstanding – perhaps they work largely in private practice, just like Dr. Steve James, the anesthesiologist who challenged Health Minister Sajid Javid about the case at King’s College Hospital.

I have little sympathy for this view.

We know that vaccines work and are safe, and most importantly for doctors, they will protect vulnerable patients. So why not just get it done?

But I want to know what you think.

Do you want the nurses and doctors treating you to be stung, or do you think they deserve a choice?