Folliculitis, Skin Issues - What can this be? Never had before...

[sotiredofthis]

Doc,

I need your help. I am at the end of my rope. OK - here's my story:

May '06 - Moving family to east coast from west (packing, driving truck, etc) I developed first case of Tinea Cruris I'd hever had... both sides of groin, Very painful. I am 35, white male - no drink/smoke and no history of any medical issues.

June '06 - (and here's the kicker) I had VERY brief protected vagial sex with So. American sex worker while on business. Never before, never again. Regret and grief is beyond words. however... I immediately fell ill right afterword with flu-like/cold-like symptoms on flight back to US. Been pretty much sick off and on since then - and worried.

Symptoms: dry mouth, folliculitis, pains in mouth/apthous ulcers, pain under right rib, odd skin burning (like dry skin, red - transient on arms and thighs), scalp pimples, lost some weight but gained it back, light diarreha, odd node pain in arms and groin ... massive anxiety.

From July 06 to present - I have had multiple HIV 1&2 EIA and PCR, Urine, HSV I&II, Hep, Syph, Chlamid, Ghon and CBC Blood work/liver work every month. All negative, normal. I've seen 2 dermatologists, 2 GPs and an infections disease doc. All said I am fine. Throughout, I had persistent stubborn folliculitis and rashes on neck/cowl, forearms and thighs (also came back from east coast to DRY midwestern weather during this time). I had been diagnosed with everything from Folliculitis to Keratosis Polaris. Tried creams, hibiclens, clyndamicin, bactroban in nose, etc -- even 2 rounds of Cephalexin. It keeps coming back.

So here I sit at 10 months -- still freaking out. My question is - can folliculitus (stated online as a "subtle" way early HIV can present as the immune system is slowly eroded -- i friggin hate how they word things like this) be a sign that HIV is fooling the tests and I still have it?  If not - WHAT IS THIS FOLLICULITIS FROM -- and how do I cure/solve it? Is such stubborn folliculitis normal in people without other immune issues? I am very frightened.

Much thanks - all the best.

[Alan Rockoff, MD]

Yes, folliculitis is very common in people who have nothing wrong with their immune systems.  I see it all the time, especially in dry weather (don't know why.)  It's often not even worth treating.  I think you've seen more than enough doctors and had more than enough tests to show that you didn't pick up HIV, which would be very unlikely in any case from a single protected exposure.  What you really do appear to need is psychological counseling to help you get past this.  Your folliculitis may well be real, but it doesn't seem to mean what you're worried it does.  Please get the help you need so you can get on with your life.

Best.

Dr. Rockoff

[Martin2007]

I have the same symptoms. I had posted before to Dr. Rockoff about the continuing folliculitis. Practically same symptoms, strong folliculitis all of a sudden, and was treated for demodex (without proof), then had a full course of Fucidin, came back. We did biopsies: eczema, bacterarial tests (staph aureus), even did tests for scabies (negative), did all tests on STDs and HIV... and nothing. went on a full course of Pristinamycin and 2 weeks later, it is back...

One reader of the forum (CindyNelson) suggested tests for thyroid and altho the TSH looked normal, we found anti-bodies (anti TPO) higher than normal. Given thyroid disfunction can cause skin dryness and itching, which in turn lead to folliculitis (staph aureus colonize scars from scatching), we are now down the thyroid dysfunction path.

I saw 2 dermatologists, 1 infectious/tropical diseases expert, 2 GPs, and now an endocrinologist to see... My advice, check thyroid, if nothing, check for scabbies (common in tropical areas), also check for instestinal protozoa common in tropical areas (some lead to pruritic rashes), and if nothing, just wait it out... folliculitis takes a lot of time to treat...

[Strychninee]

I had the same symptoms only i thought it was a bite from a spider or tick...lime disease also has same symptoms, but i would feel my skin very sensitive and would feel as if i was being infested with nats all over my body...and i would get stings and actual bite looking marks, which i thought were from the initial bite of something that ruined my skin....but actually i kept noticing that it looked more like a burrow or some sort, i would pick till i got something out and i could never really distinguish it, although i would find only by magnification tiny tiny little bugs...i think it might have been from the bird feces outside some kind of parasite cause it seemed like a worm with an entrance and then would make another hole for its exit...AND the weird thing is out of 4 ppl in the house my partner and i were the only ones that realized we were bit , a 3rd got terribly sick lost alot of weight and coughed and had skin problems like brown marks everywhere and hairloss...lost his weight so fast...well my partner has multiple types of cancer and parasites arn't a rare thing to catch since the immune system has weakend...so i think i got it from him, who aquired it by some bite of something tat carried a disease...he refuses to go to doctor and i went and they hardly looked at me for 10 seconds and say...ummm...maybe scabies...i don't think correct since i had a deadly initial fever for only a short few hours in the night..i have delerious and in and out of conciousness..i really thought i was going to die...months ago...but now i have terrible symptoms much of what you discribe but worse ..i dont know...my marks seem bilateral and symmetrical....and they are flat with sometimes 2 beside each other and sometiems scar but then turn brown...OH and i also have found many new flat mole things..but some dissappear and they have a hair sticking out on both sides of it...so odd...