What could have caused this condition?

[Aknaten]

I have a female friend who is 33yrs old. I have known her for 2 yrs. The whole time I have known her she has suffereed continually from pimples all over her body but on a minor scale. She does constantly scratch them and this scratching seems to be some nervous response, I have seen her from time to time with red splotches in groups where there are no pimples. She did have a just horrible outbreak of these pimples that covered her whole body seemingly equally spaced  just before I met her. She showed me a photo of this outbreak and I was stunned at her appearance. She was grossly overweight at that time but I did not know her then. This skin condition, small pimples with pus were throughout her whole body. This condition apparently cleared up on its own over a period of time.
     She also complains frequently of back pain in her kidney areas, she does not seemed to have had any urniary infections in the 2 yrs. I have know her she has not seen a  Doctor in the 2 yrs. I have known her. She is an immigrant from Bosnia and has been diagnosed with extreme depression and PTSS as a result of the Bosnian /Serbian war and was a victim of Serbian atrocities including the witnessing of the murders of members of her family.
     Over the last 2yrs. that I have known her she has not been under any medication although before I knew her he had be prescribed medication for her nerves and depression. She was raised as a Moslem and apparently was brutually abused as a child.
     So briefly once again I think back about that horrific picture of this outbreak and wonder what could have caused this terrible condition. It looked like Smallpox but with no scarring. Could she possibly have picked up a vaginal infection because of the proxmity of the virgina to the anus? I hope you may be able to give me some insight! Thank you!

[Alan Rockoff, MD]

From what I can tell from your description, your friend mas a picking habit that is so severe it may amount to something like self-mutilation.  This no doubt reflects her psychological trauma and perhaps other difficulties.  The cure is to stop scratching, which is easier said than done.  She should see a dermatologist to confirm the diagnosis and a psychiatrist who specializes in treating OCD, obsessive-compulsive disorder.  She can definitely be helped, though of course she has to agree to be helped.

Take care.

Dr. Rockoff