Mysterious Rash? Break-Out?

[Josh0101]

I'm a 24 year old male, and have been struggling with a nearly full body skin problem for nearly 15 years.

It started small, but over the years the condition got worse- and it continued to spread over my entire body. Absolutely nothing the many, many doctors (whom all assumed it was acne) could give me showed any signs of improving the condition.

After several years break, I made an appointment with a Dermatologist that I hadn't tried before.  Right away she says that it wasn't acne.  She said that it was, I forgot the term she used- but it involved Staph and Foliculitis.

She prescribed to me: Mupirocin ointment 5 days mo. x12 mo.; Clindamycin Phosphate daily to affected areas; Hibiclins antiseptic/antimicrobial wash daily on body folds.  She told me that it would take an entire year for my case to clear completely.

So 3 months later, I return and show her that absolutely no progress had been made.  She was baffled.  She asked me if she could take some biopsy's and have them tested, so I did that. 1 week later, the results come back as 'Yeast'.  So I get a new prescription for Ketoconazole pills to take daily for 14 days.

It has been nearly 14 days now, and I see no progress, no lessening, or slowing of the breakout.  Nothing at all.

The breakout usually consists of small, red bumps- usually pustules, but not always.  Head to toe- minus hand/feet palms, almost always in an area with hair.  But not always limited to those restrictions.  The break-out seems to have a mind of it's own,  with the severity shifting from one area to another over a period of weeks. But although one area is worse, that is not to say that another is clear.  The entire body is always broken out to one degree or another.

Any help?

[dr_mom]

A related discussion, sudden rash was started.

[neetneets]

A related discussion, Rash Breakouts was started.

[Josh0101]

Well, from the pictures I've seen of Keratosis Pilaris- I'm certain that's not it at all.  I believe I have a widespread, untreated and misdiagnosed case of Candida Folliculitis.  And with my biopsy coming back as Yeast, it just adds fuel to that theory.  But my problem now is that I'm not responding to the Ketoconazole pill regimen.  So I'm at a loss as to what I need to do now.

[Alan Rockoff, MD]

I'm not sure whether my comment was posted.  I think you may well have keratosis pilaris, a genetic condition which manifests itself as bumps that can look like pustules.  The bumps contain keratin protein rather than any bacteria.  These bumps can be flattened a bit using exfoliating techniques, but frankly that is mostly more trouble than it's worth.  You've obviously lived with this condition for most of your life.  If you want to be sure, you'll need to ask a dermatologist to have a look, perhaps with this diagnosis in mind.  A skin biopsy might possibly be useful for clarifying the situation.

Take care.

Dr. Rockoff