Recurrent Rash - Tinea Versicolor or something else?

For the past 5 years, I've had a recurrent rash appear on my back during the winter months...and only during the winter/spring months. It starts up around late October/November and goes away in the summer. It's crazy because it seems tinea versicolor is supposed to get worse when it's hot, whereas I feel my rash "hates" the heat and goes away during the summer with no treatment.

I am a half asian half caucasian 24 year old male, 6' tall 160 lbs.

The rash is basically a cluster of small reddish bumps that are very itchy. They cluster at the top of my back as well as a patch in the middle of my back (See pictures).

The first year I got the rash (2006) I went to a college campus health clinic and the dermatologist there said to me "wow, I've never seen anything like this before."

I ended up using Cortizone-10 ointment for the itching and the rash ended up going away in the summer.

Basically repeat the next 3 years.

In 2009, I went to another dermatologist, got a biopsy off my back, the results came back as "spongiotic dermatitis," which apparently is pretty vague, because ANOTHER dermatologist laughed at that biopsy result. That dermatologist took a skin scraping and said it was tinea versicolor, gave me a topical ketoconazole foam and sent me on my way.

Unfortunately, this rash is very resilient. The foam treatment didn't do much, and I started using a combination of the foam, Cortizone-10, and Head-and-Shoulders Intensive Treatment shampoo.

I ended up leaving on the shampoo overnight...which lead to a chemical burn. I went to a family doctor and of course they said "wow I've never seen anything like this before." I basically had a chemical burn on my back combined with this weird bumpy itchy rash. The doctor prescribed some oral 200 mg ketoconazole pills, take 2 once a week for 2 weeks. After the chemical burn went away, surprisingly my skin actually cleared up extremely well. I figured it was from the pills.

Fast forward to present time.

During the summer, my back had been completely clear of any rash/bumps/irritations. 3 weeks ago, I noticed a small, itchy, red bump in the middle of my back...I thought to myself "I am NOT going to let this thing spread." So, I got another tube of Cortizone-10 ointment, along with a bottle of selenium-sulfide shampoo, AND refilled my prescription for ketoconazole pills...

I started out just using the ointment and it just got worse. When I would sleep at night, I would accidentally start scratching my back because of the extreme itching, this obviously didn't help and it has now spread even worse (see pictures). 10 days ago I took my first 400 mg of ketoconazole pills, figuring it would kill it once and for all...rash kept getting worse.

I started using the shampoo, plus the ointment, plus I took another 400 mg of ketoconazole pills 3 days ago and nothing is stopping this beast of a rash.

Is this a misdiagnosis or should I just give it some time? Any comments appreciated. Thanks.

bump, anyone know what this is?

Thanks for the reply. What's weird is that I've had the exact opposite effect in warm climates (Cabo/Cancun for example). I feel as if the skin disease doesn't like the UV rays + salt water and it actually gets better as the weather gets better (it completely vanishes in the summer months here in the Northwest). But just like clockwork, it comes back once late fall/winter hits.

I have had a biopsy, and the result was "spongiotic dermatitis", which I guess is pretty vague/general. However, I did get a skin scraping and another derm. said it was tinea versicolor. I have my suspicions though.

Interestingly enough...

I decided to give a "gluten-free" diet an experimental trial, and within 1 week, the rash has completely "died." I also took 25 mg of Dapsone once a day for 4 days.

Another doctor I talked to suggested I might have a Vitamin D deficiency during the winter months as my skin does not receive as much sunlight. I might try adding Vitamin D supplements to my diet, while in-taking gluten, to experiment if that will allow me to eat gluten during the winter months (since I can eat whatever I want to in the summer months).