### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
On and off over the past several years I have developed a rash along the mid and lower area of my spine/back. It consists of tiny, barely visible bumps that are just slightly raised. The rash at the same time appears along the outside of my right Tibia bone (leg)only. On my leg several years ago the rash was very strong and I broke the skin scratching it which caused scarring.They in no way resemble blisters, pustules, shingles or scabies infestation . They are not flaky or scaly or scabbing. It can wake me up during the night; being itchy. It is very sensitive to heat especially the hot water of a shower. I have been to my doctor who prescribes me with a steroidal cream and that is effective in clearing the rash. However I would like to understand why I get this rash. Is it stress related? My diet is good and I get plenty of sleep. I do not drink alcohol. I smoke tobacco and I drink coffee - in moderation.

### output:

Hi there. It seems like a case of Erotic eczema to me, the most important thing in controlling this type of eczema is to keep the area moisturized, to avoid very hot and cold shower, frequent washing and harsh perfumed soaps or body shower products. Kindly keep the area moisturized with white petroleum jelly and use non perfumed and mild soaps for baths. In between you can use Topical steroids and sedating anti histamine like Atari 25 mg once before going to bed. I am sure these measure will prove helpful but if not then you have to do some blood tests like liver, renal and thyroid function tests along with a full blood count to exclude internal causes of the itch because It's not always the local(environmental) causes which result in itch. I hope you'll be benefited from the discussion. All the best.