Recurrent Skin Infections

[345medhelpFAN]

During Summer 2000 I spent several weeks at a lake.  I was also shaving my lower back as it was summer, etc.  I noticed several quarter size lesions on my lower back, penis, and thru out my swimsuit area.  Over the next few weeks small red bumps would appear on my wrist, feet, stomach, etc.  I went to the dermatologist - he said it was bacterial - gave me Keflex, Bactroban, and said wash with Hibiclens.  It went away, but about a month later reappeared in a milder form.  18 months later I still deal with it, but it is mild, but not gone.  Of course I stopped shaving as to reduce all trama to skin/hair, I wash with anitbacterial soap, and currently my Dr. is trying a long term course of bactroban nasal and an oral anitbiotic diocoxclin.  I have been on the bactroban nasal before, when I go off of it and other antibiotics, little infections return, almost always in the swimsuit area.

My Dr. says I got colonized and its just being stubborn.  I was wondering if there is something else I should try?  Also, will this eventually die off?  

Thank you for your input in advance.

[rubie]

Hi! this is more of an inquiry.  I've been having recurrent little red scaly circles on my thighs.  It started only as one tiny circle that got as big as less than 1cm.  They are red (sometimes itchy), flaky dots that turn brown (mocha) after sometime.  And they multiply rather fast.  Happen to know how to stop them? thanks! :)

[Alan Rockoff, MD]

It sounds as though your dermatologist has the situation correctly sized up.  Your condition sounds like folliculitis, inflammation of hair follicles with some bacterial involvement.  This is quite common, and in my expereince often does not correlate with heat, trauma, or any of the other usual suspects.

When the bumps are small and not painful or unsightly, I usually don't bother to treat, assuring people that sooner or later the follicles stop erupting (don't know why they come or go, but they do--both.)

Your initial attack was almost certainly a true bacterial infection.  What's happening now is most likley not a true consequence of the first episode, just a garden-variety folliculitis which treatment has little effect on.

If your regimen of bactroban and dicloxacillin seems to really help (diminish numbers of spots, etc.), then keep it up.  If, however, you can't really tell, you may do just as well waiting things out.

Best.

Dr. Rockoff