Facial Burning and VERY tiny Bumps

[complexderm1]

Dr. Rockoff,

I initially noticed very tiny bumps in center of face and exfoliated them away. --no problems for about a month
had a really bad illness with strep-throat symptoms
after I got a bit better, I noticed a slight burning sensation between nose and upper-lip
I was also not eating very well (mostly tea and coffee and carbs + fast food) [I have improvd my diet 1000%, since then]
at night before I went to bed I was craving sugar so I would eat a ton of sweets and chug water
three weeks later I still had the burning and noticed the upper lip area looked red
noticed some dryness and redness on a private portion of my anatomy as well
eventually my cheeks just adjacent to the red area started to feel "dry"
soon it burned to wash my face

went to derm, started on 3 month treatment for perioral dermatitis (doxycyclin + klaron)
I then noticed burning below my lower-lip + was getting little bumps again.
tried to moisturize my face one day and in the evening I noticed an itchy red patch on the left side of my nose

told derm about red patch, burning upper lip, and original diagnosis with perioral
started 8 weeks of minocy., noritate, moisturizing cleanser and SPF15 lotion
immediately noticed a lot of very tiny bumps in the same areas
sides of my nose began to feel VERY dry/raw + burn
same original symptoms + redness began to spread from above lip to my cheeks and my nose.

tried 2% tea-tree wash + born to be mild (pyrithione zinc) and klaron twice a day
noticed improvment in burning, redness, dryness
went to a diff. derm, told the whole story + that had redness in my bellybutton area
he said it was probably seb. derm all along.

told to use 2% ketacon. shampoo 2-3 times a week + klaron
the shampoo kind of stings when I first apply it, and i'm not sure if it really makes a difference


Do you agree with diagnosis?
Is burning typical in seb derm?
I have acne what can I do to improve both conditions?
What about psoriasis brought on by strep throat?

[Alan Rockoff, MD]

I think seborrheic dermatitis does sound like the most likely diagnosis, and the new treatment plan seems appropriate for that.  Acne is different and needs treatment with topical or oral antibiotics.  Your doctor can help you with that, although it may be best to wait till the seborrhea goes away, so as not to confuse the issue.  The fact that this rash affects your navel and privates seems to be making you anxious, but means nothing.  That may be why you're feeling burning sensations.  I do not think you are describing psoriasis, however.

Take care.

Dr. Rockoff

[complexderm1]

P.S.  

I've been getting the chills a lot (every day) this was something I first noticed along with some flu like symptoms before this all started.  In addition, I was noticing the dry/flaky appearance of my penis when I first noticd the redness between my nose and upper lip... (tried to put lotion on it and it only made it red in a few areas on the top side of the "head")

Also, I have noticed the undersides of my forearms also look pinkish and dry and I get some itching in various areas on my body, nothing crazy, but abnormal for me...

[complexderm1]

Thank you very much for your response, Dr. Rockoff.

I only experience the burning sensation above my upper lip, on the lower-left and right sides of my mouth, and a little on my cheeks near the nose.

The redness in my naval and genital area was only for a day during the two month treatment with antibiotics and noritate.  The dry genital area was only for a few days when I was first noticing the redness above my upper lip.  I have not given the two incidents much thought sense, but considered it important in the diagnosis.

The burning is definitely real and I am wondering if it is possibly what the original dermatologist diagnosed as perioral dermatitis??

-- or --

If some redness, burning, and itching at night around the mouth and cheek areas adjacent to the nose is a symptom in seborrheic dermatitis??  the lower part of my nose [near the tip] feels sort of rough too.

Please keep in mind a month after noticing the tiny bumps in the central areas of my face and not having them come back after exfoliating gently, my original symptom was intermittent burning above my upper lip.  This was a month before I noticed the redness in the same area. A month or so later I noticed my cheeks, adjacent to the area that was red, felt rather dry... subsequently burning when washing in the morning. I noted the areas that felt dry still looked oily.


P.S. In the areas that itch, I also have larger red bumps (1/3rd an eraser in diameter) that look a bit like old zits sometimes do, but these ones can itch a little and sometimes sting.  benzoyl peroxide doesn't seem to help on them + stings a bit. I will be coming up on 10 weeks of minocycline + a month of doxy before that, do you think these red bumps are a result of seb. derm?

Thanks Again!