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Dermatology  (Expert Forum)
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Assistance required
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.

Assistance required

by warwick, Jul 04, 2004 12:00AM
Can anyone help.

For four years i have had a progressive skin disorder which has had inconclusive biopsies and the label of being self induced.

I t seems to be a cross between pilonidal sinus and folliculitis.

Hair follicle enlarge and cause pain.Linear swellings,possibly lymph vessels, are evident from the exterior.This seams to transmit the effect across the neck mostly just under the jaw line.

Groups of hairs grow in one place .These have swollen roots.Some white some dark.

Thin hair like structures are physically evident and are excruciatingly painful if pulled on.

One long hair 2.5inches has been extracted.

Hypertophic scarring is evident along the centre of the linear disturbance.

No creams or pills have had an effect.

The width of the effect is 6 inches across the front of the neck.

Any ideas?

by Alan Rockoff, MD, Jul 04, 2004 12:00AM
Hair roots do not cause pain under the skin that radiates.  They can cause pain if you pull them out, which you say you are doing.  However, you do not need to pull them out, and in fact should not do so.  Instead, you should look into having them removed.  Laser hair removal is by now a simple and inexpensive therapy.  If your hair is dark and your skin is light enough (the dermatologist can tell), you should look into this.



If you cannot bring yourself to stop pulling out your hair by your roots, you may have a variant of OCD (obsessive-compulsive disorder.)  Dermatology patients usually stoutly resist taking this possibility seriously and following through on it, which is a shame, because medical therapy is available and effective.



Basically, you need to stop pulling out your hairs by their roots.  You can do this by removing the hair and/or by removing your need to pull it out.  Please take advantage of any means necessary.



Best.



Dr. Rockoff
Member Comments (3)

by warwick, Jul 04, 2004 12:00AM
To: Dr Rockoff
Dr Rockoff.

Further to your advice,which I thank you, the problem I experience is that the pain builds under the skin and is relieved by their removal.If left the pain is so great I am in tears.I left this condition for 5 months in order to qualify this.It was most distressing.

Enduring your advice may very well be ideal but in reality I get so low it cosumes me and the visible effects expand.

Four operations have been cancelled at the last moment which makes me feel there was some arguement for limited excision.

You have to beleive me that if left to develope under the skin the pain is just so great, and this is a guy who successfully put in four stitches in his own hand whilst camping.

Regards.

Warwick

by warwick, Jul 05, 2004 12:00AM
To: Dr Rockoff.
On thinking of your response to me, I have to ask if anyone has considered the fact that some cases diagnosed with OCD may not have had an adequate understanding of the nature of the problem.

Could there not be room to accept a differing or additional way ahead.

If I leave the area to develope on its own it will make me suicidal.Your comment of OCD I understand but then what?



The condition started when I used MDF and a manmade fire board.The conection was not linked to my condition but the fine dust was irritating.Coupled with inconclusive biopsies OCD may well be a convinient label but not cotaining information to control it.

Would any dermatologist care to give me tests and monitor the development of what is going on? Could this not be a chance to improve the knowledge about similar conditions that I have seen on the Net which visibly result in what I think is hypertrophic scarring?

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