Recurrent Skin Infection

Skin History: I am a 25 yr. old female. I dealt with acne when I was about 12-14 years old and now again for about the last 2 years, since I turned 23. A month and a half ago I woke up with a huge swollen neck and went to the emergency room (it was a Saturday morning). The doctor said it was an abscess and attempted to drain it with no luck. I went to another doctor at a health center and he determined it was an infected lymph node and put me on Keflex and it went away. As soon as I finished the antibiotics my neck swelled right back up. I was put on Sulfam Sulfameth and it slowly went back down, though I still have a knot under my skin in my neck that doesn't feel like its going to go away. The doctor at the health center wants me to have it excised. I feel that is a bit extreme.  I described the issue with my neck in case it might be related at all to what's going on with my face. As I previously mentioned, I've dealt with acne before (and maybe currently) and I'm not sure the infection on my face right now is acne. I've had these sores for a few weeks now that won't heal and are looking worse & worse. They bleed excessively. I woke up 2 mornings ago and I looked like I'd been punched. One sore on my cheek was huge- my whole cheek & eye had swollen up and (I probably shouldn't have) I was able to drain a lot of it out. Does this sound like acne or something else? Why do I keep getting these skin infections? Any advise?

[Vanessa Lacuesta]

Hi

You have a previous history of a neck abscess and at this point this does not sound related to your facial condition. However, we have to ascertain what could be causing the neck infection. If it was a bacterial or fungal infection, then the infection could have affected the face. However, you have not mentioned of any open wound on the neck or any reason which could have facilitated the spread of the infection. Differentials at this point will be severe forms of acne, rosacea and a bacterial or fungal infection. I suggest that a swab be done over the affected skin of the face. The swab may be cultured and the organisms involved may be identified. This will help aid treatment. An ophthalmologic consult is necessary here if the eye is involved. You may need oral antibiotics and an infectious disease referral for this.