Fungus Infection or other zoonotic disease?

[rook_pup]

Hello Dr. Rockoff,

My son has a round skin rash on his face and one on his back that we can not get rid of.

Background: About 8 weeks ago we were caring for a stay cat and her kittens (they no longer live with us). About 4 weeks ago My son and I both came down with a rash. My rash was on my arm and started small and started to grow outwards. I went to my doctor and she stated it was ring worm and gave me Ketoconazole 2%. I applied it once a day for 10 days and it cleared up.

My son went to his doctor and she thought it was ring worm also. His rash looks a little different then mine. Mine started small and then started to grow larger (outwardly from the middle). His is the size of a half dollar (start and still is), however it's round in shape. She put him on Lotrimin AF for 10 days. After just 7 days it started to get worst (started to grow). So, I took him last week and she took a culture and put him on Econazole cream once a day for 10 days. It started to work at first then it started to get worst. The rash is still the same size, but it's really red and flaky and it's not getting at better. So, after 7 days (no improvement) I took him back again today. The lab results just came back and it was negative for fungus, however the doctor thinks it might be a mistake, so she took another lab culture and wants him to use some over the counter anti inflammatory and go back on lotrimin. My aunt mentioned another skin disease you can get from cats, but I can not think of the name (I think it starts with an I). But, the doctor did not think it was that.

Here are my questions.

1) Since the culture was negative for ring worm, any thought on what it can be. He's been on many anti-fungal medication.

2) If it is fungus, can he use the Ketoconazole cream on his face? When I mentioned it to his doctor a few weeks ago, she didn't think it was a good idea and put him on Econazole.
Ketoconazole worked well on my arm.

3) When he was using the Econazole, I was putting it on pretty heavy after his bath at night. Could I have been putting to much on? Plus, could this cause the condition to look worst (really red, dry and flaky)? Should I try this again, instead of the Ketoconazole?

4) Could pool water aggravate this? He's been swimming in a hotel pool and the pool at school. I'm keeping him out of the pool until clears.

5) Anything else I should have tested for? The doctors are only testing for fungus infections.

Any advise you can give will be much appreciated.

The dermatologist is booked out to mid September and his two doctors don't know what this is.

Sorry this is so long. Thanks for your advise.

Rook
  

[Alan Rockoff, MD]

1) Since the culture was negative for ring worm, any thought on what it can be. He's been on many anti-fungal medication.
Yes, it may not be fungus at all--it may be eczema, which would not respond to an antifungal cream but would respond to a steroid cream.  It may be that the cat has nothing to do with his rash.  Another possibility is that it is a fungus, but one that creams aren't strong enough for, which would require some oral medicine.  Microscopic examination, repeat culture, or even skin biopsy may be needed to clarify things.  Your doctors will be able to sort them out.

2) If it is fungus, can he use the Ketoconazole cream on his face? When I mentioned it to his doctor a few weeks ago, she didn't think it was a good idea and put him on Econazole.
Ketoconazole worked well on my arm.
Yes, it's safe.

3) When he was using the Econazole, I was putting it on pretty heavy after his bath at night. Could I have been putting to much on? Plus, could this cause the condition to look worst (really red, dry and flaky)? Should I try this again, instead of the Ketoconazole?
No.  I'd stick with econazole.

4) Could pool water aggravate this? He's been swimming in a hotel pool and the pool at school. I'm keeping him out of the pool until clears.
No.
5) Anything else I should have tested for? The doctors are only testing for fungus infections.
Not that I can think of.

Best.

Dr. Rockoff

[desperate for help]

I have had a spot on my left cheek that will open up into a sore like spot. It gets red and swollen. I have been experiencing this for about a year and a half. I went to 11 different doctors, was put on every medicine known to man, given shots, had 4 biopsies, been cut on and everything. All of these tests turned up NOTHING. Finally I found a dermatologist that tried Duo Derm patches. I wore this at night and sure enough, the spot cleared up within a month. It has been gone for about 6 months and suddenly re-appeared 2 days ago. Does anyone have any ideas that 11 doctors may have missed?

[bixnij6]

I have the same thing. I have had it on my arm, cheek, upper lip and now on the back of my neck. I put some cream on the first one ( prescription) and it did nothing to it. I have been dealing with it for about a year. I think it came from Florida when I was there on vacation. Derm. did not explain what it was either.
It is the size of a half dollar oval shape, itchy, raised and flat. It gets bigger if I itch it. I think it is some sort of fungus, but the doc says no.

I put pro clear anti fungus on it and it clears up in about 3 or 4 days.
I still have no idea what it is or how to keep it from coming back again and again. I just cant have things growing on my face. I am affraid to touch my face at all in fear of bringing on another rash. Crappy thing to think about.

Any help would be great.I had blood work done and everthing came back ok...

Please help if you can.

Thanks