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Dermatology (Expert Forum)
Rash
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
Welcome to the DERMATOLOGY FORUM! Questions in this forum are answered by Dermatologists from St. Luke's Roosevelt Hospital, under the direction of Andrew Alexis, M.D., M.P.H.
Rash
by beantown, Aug 26, 2002 12:00AM
About a year ago, I had a cold sore. I accidentally cut it open on the way to a doctors visit. After the visit, 2 days, I developed Impetigo. I went on a whole slew of different penicillins over the next 6 months to kill off whatever was on my face, which then went to my buttocks.
A throat culture then determined "Overgrowth of C. Albicans",
but no symptoms were present i.e. thrush, etc except ring-worm
in the buttocks area. That resolved mostly after several bouts of diflucan. I was tested negative for HIV three times.
To this day, I tend to have slight facial outbreaks on the
flares of my nose, the crease of my chin, and the left side
of my face. It usually happens after I go on a few day coughing
and sneezing jag. I have an appointment with a crack dermatologist, but this is driving me nuts. What the heck could
this be? No fever. No weight loss. I saw a Fungal specialist and
he looked at me and did a cursory examination and didn't feel
it was a fungus problem and didn't do any testing. No symptoms
according to him. He blamed it on the swab culture and said it
was a poor way to diagnose fungal infections especially on
someone who had as much penicillin as me.
-cold sore 03/01
-impetigo 04/01
Peniclillin -> 5 mos (amox, cipro, keflex, and some others)
- "ringworm" in buttocks area 09/01
- Creams to treat
- Diflucan <helped ringworm> 01/02
- More diflucan to further resolve 03/02
- 95% gone
- slight redness chin, cheek, nose flares
- slight itch in buttock area
- comes and goes. Always better after a night sleep.
- Shaving aggravates sometimes
- Shaving helps sometimes??? <-- weird
What the heck could this be if it isn't fungus?
A throat culture then determined "Overgrowth of C. Albicans",
but no symptoms were present i.e. thrush, etc except ring-worm
in the buttocks area. That resolved mostly after several bouts of diflucan. I was tested negative for HIV three times.
To this day, I tend to have slight facial outbreaks on the
flares of my nose, the crease of my chin, and the left side
of my face. It usually happens after I go on a few day coughing
and sneezing jag. I have an appointment with a crack dermatologist, but this is driving me nuts. What the heck could
this be? No fever. No weight loss. I saw a Fungal specialist and
he looked at me and did a cursory examination and didn't feel
it was a fungus problem and didn't do any testing. No symptoms
according to him. He blamed it on the swab culture and said it
was a poor way to diagnose fungal infections especially on
someone who had as much penicillin as me.
-cold sore 03/01
-impetigo 04/01
Peniclillin -> 5 mos (amox, cipro, keflex, and some others)
- "ringworm" in buttocks area 09/01
- Creams to treat
- Diflucan <helped ringworm> 01/02
- More diflucan to further resolve 03/02
- 95% gone
- slight redness chin, cheek, nose flares
- slight itch in buttock area
- comes and goes. Always better after a night sleep.
- Shaving aggravates sometimes
- Shaving helps sometimes??? <-- weird
What the heck could this be if it isn't fungus?
Doctor's Answer
by Alan Rockoff, MD, Aug 26, 2002 12:00AM
, Aug 26, 2002 12:00AM
I agree with the fungal specialist that a culture of Candida albicans doesn't mean much by itself. The fact that it took so long and so much therapy to clear up strongly suggests that yeast (Candida) wasn't the main problem.
You ask what you have now. Yet the symptoms you say you now have are:
"To this day, I tend to have slight facial outbreaks on the
flares of my nose, the crease of my chin, and the left side
of my face."
Why do you think that "slight facial outbreaks" represent a disease, much less a continuation of the original problem? Lots of people have mild facial otbreaks (heat rashes, folliculitis, whatever) which they just ignore and watch disappear. You go on:
"- slight itch in buttock area
- comes and goes. Always better after a night sleep.
- Shaving aggravates sometimes"
What does that add? Not a whole lot.
I suspect trhe dermatologist you consult will tell you to separate the issues in your mind and use as little therapy as possible.
Take care.
Dr. Rockoff
You ask what you have now. Yet the symptoms you say you now have are:
"To this day, I tend to have slight facial outbreaks on the
flares of my nose, the crease of my chin, and the left side
of my face."
Why do you think that "slight facial outbreaks" represent a disease, much less a continuation of the original problem? Lots of people have mild facial otbreaks (heat rashes, folliculitis, whatever) which they just ignore and watch disappear. You go on:
"- slight itch in buttock area
- comes and goes. Always better after a night sleep.
- Shaving aggravates sometimes"
What does that add? Not a whole lot.
I suspect trhe dermatologist you consult will tell you to separate the issues in your mind and use as little therapy as possible.
Take care.
Dr. Rockoff
Skin tags developed in arm pits, itchy!
Right eye has that "sleepy feeling" when things are going on
At the age of 17 atleast 2 to 3 times a year I developed huge cyst or boils under my facial area (cheek,forehead,& chin)...
I must have went to 6 different Dermintologist from 17 to 21 year old... They kept cutting, draining, & giving me medication for the next 5 years... No one can say why!! Some of the doctors felt it was just something I would outgrow and maybe they were right.. At the age of 22 I never had another HUGH CYST out break.. But I honestly feel the Impetigo infection stayed in my blood.. Just my personal info!! This cyst would get so big my EYE would shut or my face would look deformed.. It was crazy! After 3 days of medication it would go down and leave nice amount of fluid... I hope this helps!! I still never got a good answer..
They may well be individual issues. You're the first one
to say so. The reason I believe they are all associated
is because it's all in the same area that was terribly
inflamed. Prior to the impetigo, my skin had been fine sice
I was a teenager. From that point on, my face, eyes, nose,
and mouth have not been the same. I may be understating
"slight". Compared to what it was seeing in March of 2002,
they are slight. I'm definately linking the coughing
and sneezing, but I'm an engineer, not a Doctor, so it
probably works against me a bit. I've done some research
which may be working against me.
I have an appointment at the end of October. Earliest one I could
get. I believe the Dr. I will see is fine(BUMC), but I'm fairly
frustrated since it's affected my well being and quality of life. If you'd like to take a look at me, I am insured, BCBS
Elect, and in Boston. It'd be nice if someone would give it a diagnosis, including psychosematic.
All The Best,
BeanTown