Extreamly itchy skin

[Deanne07]

I am having trouble getting a skin condition diagnosed.  4 doctors, 3 chemists, 1 naturopath and 1 skin specialist have all failed to make a diagnosis.  I have had explanations from scabies, bacterial skin infection, fungal skin infection and mosquito bites! ( I really didn't feel like paying the doctor that suggested mosquito bites!).  This is becoming terribly frustrating and I don't know where to turn.  This is the history so far... on the 17th of September 2007 I presented with symptoms of haemeroids and vaginal thrush, i attempted to treat this with haemeroid cream and an antifungal cream however the itching became severe and i broke skin scratching, the entire area (all the way up the back of my bottom and on my bottom cheeks) became intensely itchy.  I went to the doctor on the 21st of September and she prescribed antibiotics, advantan cream (to reduce inflamation (inflammation) and itching) and an antifungal cream. this settled the problem down.  Then on the 15th of November the problem returned (exactly the same way). again i went to the same doc who prescribed the same treatment.  On this time, approx 2 days later my lower legs became intensely itchy (with no rash or spots visable) i treated this with cold packs and calamine lotion.  then a day or so later my arms became itchy, then my stomach and upper legs, neck and back.  small pimple like bumps began to appear all over.  there were about half a dozen spots on my stomach, 30 or so on my right arm, half a dozen on my left arm, 4 or so on my upper chest, a dozen or more on each of my legs and several on my back. it's difficult to say what the spots would have looked like because they were intensely itchy and I scratched them before they got the chance to look like anything! i did notice that a couple of them looked like small clear- fluid filled pimples.  There were no burrow like tracks associated with any of the bumps.  On the 25th of november a different doctor diagnosed scabies and told me to use a scabies treatment from the chemist.  i did this (and my family - even though they did not present with any symptoms) and we all repeated the treatment 5 days later as instructed.  the itching did subside a little in the following 2-3 days and dissapeared altogether between the 12/12 and 15/12.  I should mention here just in case it's of any relevance that I had an extreamly stressful time just prior to the first itchy problem on the 17th of September and again (although over a different matter) on the morning of the 15/12.  (stress symptoms included dizziness and breathlessness.. I haven't been having a great time lately - but both situations are now both resolved and I no longer feel stressed).  So... on the evening of the 16/12 I became a little itchy, then on the 17/12 I had full-blown all over itchy skin again.  this time my palms of my hands and heels were intensely itchy and I could not even care for my two small children (my sister had to come over) as I spent the day applying ice packs and creams (I have tried 1% cortisone cream, calamine lotion, crotamiton cream, sandlewood oil... all to no avail).  I returned to the doctor who referred me to a well respected skin specialist.  He said it could be a bacterial skin infection but wasn’t sure, he prescribed an antibiotic, 2000mg of vitamin c per day and twice daily wipe downs with Ethanol.  I followed his instructions however was still intensely itchy and ended up with legs so bruised from scratching they looked black.   I returned to another doctor (I was now on holidays in Tasmania) who couldn’t believe I had been told to wipe down with ethanol twice a day and said I should stop this immediately as this would only exacerbate the problem (drying the skin out), he gave me a prescription for panafortelone (25mg 2 x daily for 10 days) to control the itching and told me to use eurax (crotamiton) cream to relieve any further itching and to moisturize with a mild cream such as dermaid.  The tablets worked and I woke the next morning with no itching and only occasionally over the next 10 days had a small itch somewhere… I thought I was getting better and my itching was a thing of the past… two days after I stopped the course of tablets on the 31st of December (on the 2nd Jan 2008) I started to itch again.. not as intensely as before but still an all over irritating itch.  I have noticed by now also that when I scratch at a spot many if not all of the spots contain a small (tiny) round ball (brown in colour). This led me to believe that the itchiness may have been caused by a skin parasite afterall as I thought this might have been some sort of egg or mite faeces? However I visited yet another doctor today who advised that what I had looked like a fungal skin infection and that scabies do not leave behind what I described.  This doctor prescribed cetirizine (hydrochloride 10mg) tablets to be taken one daily and a miconazole nitrate 2% / hydrocortisone 1% cream for my bottom / groin area.  Also, everytime I have a shower the spots sting quite sharply as the water runs over them (almost like an electric shock). I am currently taking 2000mg of vitamin c per day, a general multi-vitamin, 1 x certirizine (hydrochloride 10mg), 2 x inner health capsules (lactobacillus acidophilus and bifidobacterium) and using the miconazole nitrate 2% / hydrocortisone 1% to alleviate symptoms “down there” and eurax cream elsewhere on my body.  After that long winded explanation of my problem … my question is what could a differential diagnosis be? And should I be applying an antifungal cream all over? I read elsewhere on the internet that it is a good idea to use an antifungal shampoo such as nizoral or excel in the shower – to leave it on for 5 minutes then wash off).  Thanks, Deanne

[loiloi]

Stress can aggreviate skin problems, so if you are having a difficult time do think about seeing a counsellor or taking anti-anxiety drugs. Otherwise it turns into a circle of stress, skin problem, stress. Have you taken antihistamines during any of this? They will stop the itching if it is an allergy or chronic hives. Oral anti-histamines start to work within one hour. Hydrocortizone 1% cream is effective, but contra-indicated for long term use so you need to get this sorted. Thrush is extremely uncomfortable, if topical lotions haven't worked have you tried a pessary or oral treatment? The best products i can recommend generally for itchy skin are Oiltum, Aveeno and Eucerin. Were the doctors you saw general practioners or dermatologists? I really think you need to see a dermatologist. I am also concerned about the breathlessness you experienced with the rash. Although this may be anxiety related, rashes with swelling or difficulty breathing can be dangerous and you must go to the hospital if this happens again.  Good luck, Loiloi x

[Deanne07]

Thanks for your response Loiloi.  Much appreciated. I think I will revisit the doc today and get a prescription for advantan as that fixed the problem (downstairs) last time.  As for the itch everywhere else I think I will ask the doc to send away a skin scraping for analysis (I think 2 months is long enough for this problem to go on for). You are right about stress exacerbating the problem (my Mum said the same thing as she suffered from quite a severe stress rash once) but I don't think it's the "cause" of the problem.  Also, the breathlessness and dizziness I mentioned was due to receiving rather shocking news so I'm sure it wasn't a symptom derived from the itch.. more likely the other way around.  I am taking an oral antihistimine and using cortisone cream (I'm aware of the long term problems).  Thanks also for mentioning the other products for itchy skin.  (My chemist is getting some good business out of me lately!)
Thanks again, Deanne