scabies or fungus?

[HayleyJane]

My first symptom was a 'C' shaped rash on my cheek which was itchy, red and burning.  It calmed with Canesten but as soon as I stopped applying it - it came back.  I then applied a homeopathic (well advertised) RX lotion, but unfortunately it seemed to spread across my face causing small circular rashes made up of little bumps which were also itchy.  I then started itchy irregular shaped lesions up my forearms.  I also noticed a pale purple lacy pattern on my wrists and around my knees which was much more noticeable at night.  I had one very bad night when I had a temperature and pounding heart and the lacy rash was very strong but I also had a 'sunburn' rash all over although not having been in the sun.  The lacy rash the next day was very bad.  I have since been unusually tired every evening.  The rashes on my face seem to have cleared (except for one on the bridge of my nose) with Tolnaftate cream but the ones on my arms are worse and some of them are now a mass of raised bumps (resembling excema).  The skin on the inside of my legs flared up very red after a shower and during the day the skin looks pale purple and dirty.  Recently a small patch of my left leg had marks like pale freckles and were very very itchy.  I shaved my legs and now I have a pinprick rash over a much larger area which itches like crazy and all the hair follicles seem raised.  HELP - DOES ANYONE HAVE A CLUE?

[Vanessa Lacuesta]

Hi.

One differential for this is a viral infection. Do you have any joint pains?

I suggest you get a referral with an infectious disease specialist and have this condition evaluated. This may be a case of parvovirus B19 infection which may affect both adults and children alike. This infection is also referred to as the "fifth disease"."Fifth disease is a mild rash illness that occurs most commonly in children. The ill child typically has a "slapped-cheek" rash on the face and a lacy red rash on the trunk and limbs. Occasionally, the rash may itch. An ill child may have a low-grade fever, malaise, or a "cold" a few days before the rash breaks out. The child is usually not very ill, and the rash resolves in 7 to 10 days." This infection also affects adults.

Source:http://www.cdc.gov/ncidod/dvrd/revb/respiratory/parvo_b19.htm

You may discuss this possible differential with your physician.

[HayleyJane]

Thank you very much for replying to my question.  I have carefully looked at the symptoms of the B19 Parvovirus and I really feel that this could be a possibility.  My doctor unfortunately dismissed the idea and refused to test me for the antibodies (even though he was sending me for various other blood tests).  The lacy rash comes and goes which fits in with fifth disease.  However I do have other symptoms not synonymous with fifth disease - itchy patches which were mostly on my face, including the nose, (some of which were circular) which did seem to heal up with anti-fungal cream. Also I had terrible nipping feelings in my scalp and a red creeping rash behind both ears.  The doc gave me itracnazole and then terbinafine and also ketaconazole shampoo.  (not that he definitely diagnosed a fungal infection - I think I suggested it and he went along with the idea, basically I think the family doctors just guess).   I also did not mention that my mum is going to through very similar symptoms.  We feel that she started first and that whatever she had she definitely gave it to me.  One strange symptom that we have both had is the skin on the inside of our thighs burns bright red at night especially after a shower  but during the day looks a dirty purple/black colour with pale purple rings on the knees and also the wrists.  My doc gave me coloidal oat cream for this but moisturizing seemed to make it worse but when I applied diluted cider vinegar on the legs morning and night and they definitely improved.
Is it possible to have a number of things going on at once? because I have been assured that a topical fungal rash would not have systemic symptoms and yet we have both experienced systemic symptoms.  My mum believes she can trace the start of this back to her staying at a friend's house in what she considered to be a very dirty bed.  The cats had used been all over this bed and there was a lot of old menstrual blood on the mattress.  My mum's friend was old and ill and my mum was too embarassed to make a fuss.  Could she have picked up B19 Parvovirus from the blood and then passed it to me? and maybe even picked up a fungal infection as well?  I know it sounds a bit far fetched and difficult to know without a team of CSI on the case!  Anyway thanks for reading this and taking an interest.

[Vanessa Lacuesta]

Hi.

This is quite a cornucopia of symptoms and I would like to think that these may be separate conditions. Going back to the facial rash, you have noted that the rash appears circular and may involve the nose as well. You have also noted some nipping feeling over the scalp. Is the rash scaly? The rash of fifth disease is circular and appears on the cheek hence the term "slapped cheek". If the rash appears to be more diffused, that involving the nose and the scalp, then we have to reconsider the differential of fifth disease or parvovirus. A fungal infection or seborrheic dermatitis may be likely here. And these skin conditions may be localized on the face and scalp or they may affect other areas of the body.

What is apparently not in line here is the rash that you have noted. These lacy rash may be viral in origin. Is the rash still present or has it disappeared?

[HayleyJane]

Hi again Vanessa
It does seem a bit confusing.  I have some photos of the rash on my legs.  It is much better now unless I have a warm bath then it can come back.  The skin in this area was not red all the time but during the day it was blotchy pinky purple - a bit dirty coloured but then at night it would go bright red and lacy.  I have some photos but not sure how to post them on this site.  One is a picture of when its enflamed and the other is a picture taken today.  I do have a bit of an itchy bumpy rash going on too on my arms - this is fairly new.  Not sure if its a bit of dermatitis due to slapping loads of different creams on.  Anyway thanks again.