Does eczema leave chickenpox-like scars?

[Laura]

Since Feb. 1999 I have experienced an intensely itchy rash that started on my ankle, moved up and around my right leg to the knee in June, then also my left leg, thighs, stomach, and arms from the elbows down. It is a bumpy red rash, but at the beginning, my skin itched, then the bumps appeared.  At its peak, I itched the second I woke up, especially on my arms, but everyone says it is not scabies. I have seen my gp and two dermatologists who has prescribed: E-mycin, Bactroban, Psorcon-E .05%, Triamcinolone ointment .5%, Lubriderm with betamethansone valerate, and had two cortisone shots in August.  The cortisone shots were my only true relief, which lasted exactly two weeks.  I received 80 units of some sort.  The Psorcon-E helps, but the second dermatologist I saw thought it was two strong to keep using.  Now I have chickenpox-like scars on my legs and lesser scars on my arms.  My right leg is flaring up just like it did in Feb., so I am afraid the entire cycle is starting again, and I just started to get better in late Sept.  I have not had blisters, just itching which comes and goes, but I scratch until I bleed to relieve it.  The various diagnoses have been from "I don't know (nurse practitioner) to eczema, to I don't know, it's hivish - dermatologists.  I have searched through Dermatology textbooks and the internet, and I don't seem to find descriptions of anything that leaves these types of scars, unless it was just because mine became too infected?  I am 50 years old, premenopausal, and have had no skin problems except seborrheic dermatitis in my college years. I do not have hay fever or allergies.  I was not on any medications at the time this all started.   Any ideas?  I have asked my doctor for a referral to yet another dermatologist, but it will probably be a month or two until I get an appointment.  I am appalled that after all these doctor visits and medications, I still wound up with scars.  Of course, my scratching caused them I guess.  Can you suggest other useful medications to ask the dermatologist about, or other diagnoses to consider?  The dermatologist I have seen the most like to says that there is something magical about E-mycin and the skin, but it didn't seem to work for me!

[Alan Rockoff, MD]

Laura:

There are many ill-defined itchy conditions which make people miserable and respond poorly or erratically to treatment.  If scratched--and they usually are--they often leave scars which I suppose can be reminiscent of chickenpox, and I assume that is what you are describing.  Doctors sometimes refer to this as "prurigo nodularis," which more or less restates our ignorance in Latin.  Cause is unknown.  It does not go "in cycles;" in other worss, just because it recurs to some extent does not automatically mean that it will come back full-blast as it did before.

If Psorcon E helped, I would not be afraid to use it anywhere but the face, even long-term.  Another possible treatment is Doxepin, either topically or by mouth.  Antihistamines help sometimes too, but I'd stay away from injected cortisone, which as you probably know can cause significant side-effects if used repeatedly.  Topical anti-itch preparations like Sarna lotion, used continually can help suppress itch and scratching.  You can pick that up without a prescription while you wait for your next visit.

The good news is that with patience and perseverance, many cases can be brought under control long enough for the "scars" to recede or go away altogether.

Good luck.

Dr. R

[Dawn]

I too  have chicken pock like scars as a result of eczema.  These scars tend to itch alot at night and after form after scratching. Is there any sort of topical ointment that can be applied to these scars/raised areas to get rid of them?  They tend to be unsightly.

[Eileen]

Dear Laura,
Boy, do I ever understand your feelings of frustration!  Since Sept/Oct of 1998, my 15 yr.old developed this round reddish rash on her arms and legs only.  The 1rst derm. we saw prescribed very strong cremes and ointments that literally dried her skin out to the point of extreme irritation and made the rash spread. He also had us wrap her ams and legs in gauze, which further irritated these bumps to the extent that they became raw, oozy, and infected. Then he accused her of picking at the rash thru the gauze. The next derm we saw, treated her with zithromax initially, cortezone shots, bactraban and temovate ointments, and something like an x-ray machine. It's been a year now of watching my child be nothing more than a pin cushion.  We have noticed that when she gets sick, the rash flares up, as it does in the winter. During the summer, the UV rays of the sun help it go way. We've also eliminated all detergents & soaps with perfumes and dyes, and no longer use fabric softeners. We're now on our 3rd derm, an allergist and another biopsy. Any other biopsy and blood tests proved inconclusive, other than "she has sensitive skin".  Well, gee, duh. The 3rd derm suggested to discontinue the shots and x-rays, and have put my daughter on Dioxpin 10mg. at night. After all this, we still have no idea what the rash is, what causes it and how to cure it. If anyone else has any ideas, please feel free to chime in.

[Sharon T.]

Since March or April of 1999, I started to developing rashes out of nowhere.  It started with my palms and then it would be on my legs and arms, stomach, everywhere but my face.  This was not all at once...another words there was no consistency to the rashes at all.  I also went through the scratching where I also scarred my legs and arms.  I thought it would just pass but it did not.  About two months later, I saw my primary physician and he thought it may be nerves because I had a car accident in March.  I asked him if the airbag gases could have gotten into my blood stream, since I had been cut during the accident.  He said no.  Anyway, he thought I should take an antidepressant but I declined.  I was fine mentally.  As an alternative, he prescribed zyrtec which is an antihistamine and referred me to a dermatologist, who wanted me to continue to take the antihistimine and then we would determine if I needed to have a skin biopsy.  Meanwhile, I had contacted my primary doctor and asked if it could be allergies.  Prior to my appointment with the allergist I had to stay off the antihistamines for three days which I did.  At the time of my appointment, they did the scratch test and detected no allergies.  However, they had given me a paper johnnie to wear and after 15 minutes of wearing that I had a rash from my neck to my stomach...it looked like the measles.  My allergist determined that I was dermatographic which basically means that you can write on my skin and it will turn red.  Basically, anything I come in contact with other than cotton makes my skin break out in a rash, particulary, metal (hangers, tools,) plastic, wool, carpet, just about anything.  The zyrtec has relieved a lot of the itching, but I can tell when I have a rash because I feel itchy and sure enough, when I look there it is.  Sometimes it's in the form of a patch, sometimes straight lines, or diagonal etc.  It's very artistic.
(Prior to the zyrtec I was on claritin but that was not as effective)

I have not been able to find a lot about this condition and they have told me that sometimes it just goes away.  It's been almost a year... I don't know if any of this applies to your situation, but for just the relief of the itching I would take some kind of oral antihistimine...speaking from only my own experience with the itching.  One last point, mine seems to be worse in the warm humid weather...I don't know if any of this will help you but if I find out anything further, I will let you know.   Good Luck

[Angel T]

Over the last 4 or 5 months I have developed these little bumps that itch like crazy.  Once scratched they leave scars.  They seem to form on my back and left arm only for some reason.  I do have a problem with acne on my face, but I have never experienced this type of itching.  The Dermatologist prescribed
erythromicine, but I have not really noticed a change.  She seems to believe it is acne, but it does not look like acne to me.  Just because of the tiny scabs that form on top of the bumps
they almost seem like little sores. The scars that these bumps are leaving are very irritating and even the old bumps itch on occasion    I don't think it would be an allergic because it is not all over.

[Sandy]

i too have had these  same frustrating, insanely, itchy areas, which first started on my left palm, i've had that for months.... its a bit different than the bumbs i get on my legs... but my palm is getting better. at first it just started iching. then i got some bumbs. it gets real dry and started like it was peeling. from the beginning, i've put all kinds of lotions on it. it'd help, i'd get some relief but it never went away. after a while i thought it must be some form of eczema. my mom had giving me a book on remedies and cures, it had relief for psoriasis. which said it was "itchy redness of the skin". the article suggested using a "vitamin d3 cream". this cream had better results after 8 weeks of use than with a corticosteroid cream. this vitamin d cream is available by prescription under the name dovonex. which went on to say not to be confused with vitamin a and d ointment.this books' copyright of 1997. anyway, i went to the store a week later or so. and i went to buy some vitamins. i couldn't remember which vitamin they said to get. well, i ended up buying vitamin b. i went home and started taking it. only to find out later that i bought the wrong stuff. but my palm got noticeably better within a couple days. to my surprise. it got better but has not gone away. i also bought some eczema ointment which has vitimin a and d in it which the cream did not.  it is getting better, as long as i keep moisturizing it. i am 40 years old and my palm looks old with dry tight skin in that area.  i have gotten a couple spots... bumps, on my right palm but thats about it. now, my legs.... they are driving me crazy. red with white bumps that arise, many tiny bumps that just burn with only relief of itching which itch and burn more and then start bleeding after itching many times during the day and lots at night. it did start around my ankles and has worked its way up too my thighs. every winter my legs do get dried out and i itch and they bleed. but this year it is a bit different and a lot worse. and i need to find some relief, like yourselves. i have not seen a doctor yet.  the eczema ointment seems to only have made  it worse. the petrolatum in it didn't seem to help. the film almost made it itch more after awhile. so now, i'm on-line trying to figure out what this is and how i get rid of it. this morning i took a long hot bath with moisturizing bath salts and lotioned up a vitamin e lotion and i have been good most of the day. the hot water did make me itch my legs but it did give me and my legs relief being in the water and with the burning sensation, the hot water, gave me relief without itching as much. and like i said it helped and was much more manageable today and this evening. tonight i will try it again. hopefully i will get the relief i need as i also itch during the night and first thing in the morning. the uv rays also has helped me. i have noticed that in the past when i start tanning my legs have always gotten better. good luck to us all. thank you for your in put.

[Tim]

I'm a 47 year old white male living in the Virgin Islands.  For the past 8 years I have suffered reoccurring skin lesions.  They would begin for no apparent reason.  Severe itching in the middle of the night.  Apparently scratching in my sleep, until I woke up, in misery.  The hair follicle enlarges and becomes (if I understand the definition) a "vesico pustula". Secondary infection set in, along with scaliness of the skin, resulting in lumps approximately 5 mm. in diameter (some larger)sporaticly distributed over mylower arms and legs (rarely above the knees or elbows).  Over a period of time they gradually heal, leaving a scar, either in being depressed, or in color (darker or lighter).
In 8 years I have seen almost as many Doctors.  I will not go in to some of the disasters of some of the local dermatoligist's diagnosis.  Most of the doctors I think treated me appropriately with short oral doses of Prendisone, and Keflex for secondary infection.  But none of them could tell me what disease/allergy/disorder I was afflicted.
Recently (2 weeks) I decided to surf the net I see if I (having the time and the inclination, which understandably my doctors did not)could identify my condition.
I think I know what my skin problem is, and when presented with the information available from sites, my present doctor felt that the evidence was convincing.  It appears that I have Prurigo Nodularis.
So here are the questions:
How can I confirm diagnosis?  Biopsy? and if so by whom? (testing lab)
What other tests should be conducted to determine if this is a symptom of an underly disease.  Some of the literature suggests AIDS/HIV (I was tested negative about 5 years ago, re-test?), one of the hepatitus (hepatitis) strains, tuburculosis, renal failure, and allergic contact with a dog mite ([Cheyletiella], I have a dog).
Is the general consenses that this is an auto-immune disease?
I have a mono-zygotic twin brother who does not exhibit these symptoms.  I live in the sunny Caribbean, he lives near DC. (he also has dogs).  Can it be related to sun, temperature, or other external influences, or a subtle deviation in our genetic make ups?
Is there effective treatment?  Or is it best to just accept that the disorder can be to some degree be managed, but forever will be a chronic occurance?
If you have any answers, suggestions or whatever, I would appreciate your comments.