Itching

[alicejones]

For over 1 year, I have had extreme itching, mostly on my arms and back. Itchy,  Small white spots develop into open sores that bleed and leave scars. Antihistamines, cortisone lotions etc., make  condition worse. Only wet, cold cloths give any relief. Heat and dry air make itch and burning unbearable. Could I have an allergy to Cortef?  Can't sleep. Help!

[alicejones]

Recently, I went to another dermatologist, who ruled out herpes as the cause of the severe itching  and burning  on my arms that I have been suffering from for over a year.The lesions have now spread to my back as well.  He did, however, make a diagnosis that absolutely made sense to me :Brachioradial Pruritis, which causes extreme itching, due to nerve damage caused by over exposure to the sun and/or compression of nerves on the spine. Since I was a child, I spent summers at the beach at Cape Cod and now also winters in Florida. In addition, I have had herniated discs, an arthritic neck and spine and recent surgery for spinal stenosis and removal of a synovial cyst. At my next appointment the doctor will biopsy  some of the lesions and perform tests to confirm his diagnosis.  The bad news is that there is no cure!

[alicejones]

Thank you, Dr.Kaur. I will follow up on your suggestions.

[Bhupinder Kaur, MD]

Hello,
It is less likely to be toxin related problem and some specific disease needs to be ruled out. For this herpes needs to be ruled out first. For herpes Laboratory tests include: culture of the virus, direct fluorescent antibody (DFA) studies to detect virus, skin biopsy, and polymerase chain reaction (PCR) to test for presence of viral DNA can be done. I sincerely advise you to consult a dermatologist and get it ruled out.

Also a skin biopsy can be done to confirm the diagnosis as most skin diseases can be confirmed in diagnosis by skin biopsy.

I hope it helps. Take care and regards.

[alicejones]

   Thank you for your response, Dr. Kaur.
   However, dermatologists have been unable to make a proper diagnosis for my skin condition that includes white spots on my arms and back that itch, burn and later develop into  sores resembling mosquito bites that bleed,scab over and eventually leave scarring. Initially, topical antibiotics or  neomycin containing ointment seem to give some relief, but are of no real benefit. I use only hypo-allergenic lotions and soaps.  Antihistimines and topical cortisone ointments make the itching and burning unbearable and I seem to have developed an allergic reaction to them. Symptoms persisted even while taking  oral antibiotics that were prescribed to me following recent surgery.
Patch tests given by allergists showed only a  minor reaction to dust and mold. Liver tests were negative. Cortef, which I have been prescribed  for years due to an adrenal deficiency, has recently been replaced with dexamethason, though I show no improvement. Only ice and cool baths provide tempory relief. Could toxins be the problem? Would body detox be helpful? I'll try anything...

[Bhupinder Kaur, MD]

Hello,
These can be due to folliculitis or boils. Use an antibacterial soap or mild soap like dove. Avoid any kind of cosmetics. Topical antibiotics such as mupirocin or neomycin containing ointment are also useful. In case the symptoms persist then oral antibiotics may be needed. Please consult a dermatologist in that case. Also if they are painful bumps that tingle and scab over then herpes sores is an important possibility.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.