weird skin irritation

[bob]

During the last few months I have developed a very weird symptom that my doctor does not understand.
A few months ago I could not exercise for a few weeks due to work load. (I am a self-employed seminar instructor usually with no stress from my work. I rather have a relaxed lifestyle.)
When I resumed exercise I began to feel a very mild itching sensation first in my legs then throughout the body, but not really itching, when I began to perspire. It then went away in a minute or so when I was perspiring more. It continued on a regular basis and then gradually gotten worse and worse over the last few months. It now itches quite a bit, but still only at the beginning of perspiration and then stops when I perspire more or do not perspire at all. Now it happens, not just when I exercise, but whenever I perspire. Like when I drink a cup of hot tea or any other hot food. Please note that it itches only at the beginning of perspiration, never afterwards or any other time or activity.
I am a 54 year old healthy male who suffered from hepatitis A (infectious hepatitis) in India in 1978 when I was 32 years old. I had never been sick since then except for occasional colds. I never took any medicine or drugs, not even a Tylenol, during the last 22 years. But I have been taking a multi-vitamin and mineral supplement for last couple of years. Recently I got some blood tests done through the non-profit Life Extension Foundation: CBC/Chemistry Profile, TSH and DHEA-Sulfate.
Everything came normal except Total Bilirubin which is 1.8. I wonder if it had anything to do with my hepatitis of 22 years ago.
Some other test results are as follows: SGOT:39; SGPT:38; Serum Albumin:4.5; Serum Iron: 155; RDW: 11.5
Most of the other numbers are almost in the middle of the normal range as reported by the lab.
My TSH reads 1.13 and DHEA-S: 162
My father was obese and had diabetes and low blood pressure. My mother had a stroke and has high blood pressure. My blood pressure is always in the lower range. Sometimes I feel dizzy if I suddenly stand up from a sitting position. But only occasionally.
I do moderate exercise more or less regularly and eat a little carefully. I am 5'6" tall and weigh 133 pounds with a waist of 32/33 inches. I never touched alcohol and never smoke in my life.
My body temperature and pulse rate have always been below most people's from as far back as I can remember. My resting temperature is usually around 97 or less and resting pulse rate varies from early to mid sixties. My toes feel cold, but my fingers not as cold. But at night under the blanket my palms get very warm most of the nights and so do the bottom of my feet. They become uncomfortably warm. So much so that often I keep my feet and hands outside the blanket. Sometimes I wake up in the morning with a mild headache (usually when I sleep longer than normal) that goes away after some time.
For the last one year or  more I often, but not always, felt lethargic while jogging and did not feel as energetic as I used to be (while jogging only). At other times and in normal day to day activities I did not notice much of a difference.
When I walk or jog in the cold, my nose starts to run. Then it stops when I am back home. I have had this experience for many years although I did not catch regular colds as many times as most other people. But recently I have noticed that my nose begins to run mildly even at home when I drink a glass of water. On the other hand I don't feel colder than other people. We have been keeping our indoor temperature in the mid-sixties in winter (I live in Ohio with my happy family) for many years now without any problem.
These were some of the reasons that I ordered for TSH test.
When my doctor, who is very experienced and seems to be better than average, suggested that my problem may be psychological, I consulted a psychitrist who found nothing wrong. Then I consulted a psychotherapist who also did not find anything wrong. In fact, both of them indicated that I am one of the most psychologically healthy persons they ever met. I meditate more or less regularly and try to follow a rather spiritual lifestyle.
I would be grateful if you advise me in this situation. Thanks.
-bob

[optimuz21]

My skin problem is similar to that of Bob's "weird skin irritation."

Since I got arrived here in Southern California 3 weeks ago, I periodically experienced itching that has a stinging sensation usually on my feet and hands, and sometimes, all over my body. I initially suspected that my skin was only adapting to the California weather as against the tropical humidity in Southeast Asia. But 3 weeks have already passed but this irritaion is not going away. I have even tried the strongest varieties of moisturizing lotions (Jergens and Lubriderm) in the market to no avail.

My observation is that I get itchy when I get tired from doing something; when it's hot inside the car; or even when I feel a sudden gush of blood due to excitement or anxiety. Normally, I would sweat under these circumstances but I also noticed the absence of sweating, except at my armpits. Incidentally, my armpits do not itch at all.

To further confirm my suspicion, I jogged around the house for 15 minutes then turned up the disco music at home and danced for another 30 minutes. I should have sweat like a hog doing all these but only my armpits sweat. I thought that the absence of sweat from my head, back, chest and legs is quite alarming.

For the first 10 minutes of that streinous exercise, I felt itchy all over my body, my face, chest, back and everything else turned red like very much irritated. I also noticed my pores to swell - I dont know if that's the right term to describe it. But my skin became red and individual pores could be felt (like swelling).

My conclusion is that the itchy and burning sensation that I experience is caused by the sweat that cannot go out of my skin, that it is a result of the pressure of sweat that want to get out of my body. But my skin is too dry and maybe the pores closed up, thereby preventing my sweat to get out.

I am 25 years old and I was here last year during the last days of the spring and until the first week of the fall. I did not have this weird irritation back then. For whatever its worth, while I was in Asia from October 2000 til February 2001, I had recurring pimples which they dried up and went away when I got here.

Does the winter have anything to do with it? What should I do?

Thanks.  Rick

[Alan Rockoff, MD]

Bob:

Your symptom does not call to mind any skin or other disease of which I am aware.  I doubt that the bilirubin of 1.8 is relevant, though you may want to ask your doctor about it.  (As you know, your other liver enzymes are quite normal.)

Your extraordinarily detailed description of bodily appearance and senations does not strike me as lilely to be helpful to your physical and psychological well-being.  Now that you have done due diligence to rule out significant systemic problems, I suggest that you take the position that some symptoms are not worth thinking about.  If parts of your skin itch, put some Sarna lotion or Benadryl cream on (both OTC), and just get on with it.  Sometimes, itches just happen, and the more you think about them, the more they itch.

Other than having your regular doctor check you out again in a few months overall, I have no other suggestions.

Best.

Dr. Rockoff