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Forum Name: Dermatology Topics

Question: Pimple cyst like forms back,neck,arms and chest


 flowrider - Wed Jun 30, 2010 11:18 am

Ok to start it off couple of month's back I shaved my hair completely bald using a norelco shaver this was done during winter season around February I was also using a warm cap that was my brothers it was kind of dirty but I didn't care I still used it to keep my head warm.

After 3 weeks of letting my hair grow back I noticed a pimple like form behind my neck mind you I have not had acne since a teenager I went ahead and popped it like a zit next morning i woke up with a cyst like acne right where I popped the pimple at i went ahead and tried to squeeze the lesion after not getting nothing out of the lesion I let it be thinking it would go away i was wrong next morning I woke up with 5 more pimples on my neck and a couple on my back and upper shoulders and arm i was asking my self why is this happening.

so i went ahead and bought some acne medicine to try and treat the pimple like lesions accordingly for 2 months boy was i wrong. thing where just getting worst i felt like bugs where crawling inside of my skin around my eyes hair intense itching and the pimples grew all over my top arms shoulder chest and back and also buttocks.


I said enough was enough and went ahead and made a appointment with a derm mind you I have no insurance and I had to basically pay out of pocket.

When i got to the derm he stated the acne like lesions where in fact folliculitis.
He did not do any kind of culture test the derm did not explain what kind of folliculitis it was all he did was prescribe me some doxycicline 150mg once a day for 12 days this made no difference, after the medication was over the folliculitis cleared and came back. I'm not sure if he even treated me correctly with out doing more research from what he stated to the looks of him it is bacteria not fungal. Can a dermatologist truly by looking at your skin condition really know that it is in fact bacteria and not fungal or even demodex infestation?

I went ahead and got blood tested for hiv and also blood work done for liver thyroid and so on everything came out perfectly fine. I asked the dr that treated me for the blood work what was these lesions and what do you think it is i asked him about staph from looking at it he said it doesn't look like staph so he prescribes me keflex (cephalexin) 250mg taken every 6 hours this was a 2 months and half ago

I still have not taken the medication because I just recently finished the doxycicline and I am scared about getting a gram negative infection.

I am here looking for some answers hopefully someone can be so kind and spread some knowledge on how i can go about this problem.

I did apply for charity care in a university hospital close by to see a derm but the appointment will not be for another 3 months and i cant wait that long.

I went ahead and went to the emergency room and they took me straight to see a specialist. I basically had to argue with the specialist to take a culture from one of my pimple like puss on my arm she did it anyways sent it to a lab last Thursday. got the result back month and when i got my result she told me to shoot straight to her office to prescribe me some meds..

the results came back as (rare quantity of staphylococcus capitis) (coagulase negative) I was prescribed clindamycin 300mg to be taken 4 times a day

can anyone define what this means does this mean I do have mrsa or a different strain of staph?

will this medication kill the bacteria growing?

I live with my mother and a brother should they get tested also for staph?

what would be the right requirements to go about my dr said it was nothing to worry about but I am still worried.

I have been doing some research about my case and need some questions answered please..

Staphylococcus Capitis I understand is part of everyone's normal flora when they did the culture test i also received a sensitivity report

susceptibility s capiti
cefazolin interp s
ceftriaxone interp s
clindamycin interp s
erythromycin interp s
gentamicin interp s
levofloxacin interp s
nafcillin interp s
penicillin interp s
rifampin interp s
tetracycline interp r
trimeth/sulfa interp s

Since i do have a eruption of folliculitis and Staphylococcus Capitis is part of the normal flora could I happen to have a infestation of demodex mites? I will be going to see a ID specialist on the first of next month

Should I ask the ID specialist for a skin scrape? do you think my ID doctor will do this if i ask? I have a high susceptibility I might have demodex mites
Itchy at night all around my face, arms, back, torso and legs.

Medication i have tried not doing anything to help it go away.

What do you expert advice.
 Dr.M.jagesh kamath - Wed Jul 14, 2010 9:23 pm

User avatar Hello,The association of itching and folliculitis and the areas involved being back,neck and chest,your age all would make one think of Pityrosporum Folliculitis.
Mallassezia(Pityrosporum) is a resident in our cutaneous flora but sometimes M.Furfur causes this pruritic folliculitis like papulopustules where the concentration of the organism is maximum ie back,chest,neck and upper arm.
The empheric therapy with antifungal cremes or internal antifungals would dramatically clear the lesions and would lend support to diagnosis.The presence of staph may be due to secondary infection.
Diagnosis is done under wood's light and would show bright blue florescence.
Do get your self examined and I am sure you will recover soon.
Cheers!
 flowrider - Thu Jul 15, 2010 7:45 pm

i went to see a infectious disease doctor and was stated that i might have scabies she prescribed me permethrin 5% and also ivermectin stromectol pills 3 mg told me to take 3 pills 9mg in one dose then repeat in 2weeks and to apply the permethrin head to toe then repeat in 7 days does this sound correct? i weight 141 pounds i thought the ivermectin should be at least 12mg for my weight

the reason she prescribed me the pills and cream is because when she asked me if i was getting any itchiness at night i told her yes i get extremely itchy she said it might be scabies and the folliculitis is a secondary infection what do you think?

here are some pics .

http://i45.tinypic.com/jrczty.jpg

http://i49.tinypic.com/24g6luf.jpg
 Dr.M.jagesh kamath - Sat Jul 17, 2010 10:43 am

User avatar Hello,Though 12mg is the dosage based on your weight,your doctor must have had other reasons to prescribe the current dosage.
Scabies involving the neck is rare.Generally you can idenify the contacts.Isolated scabies infections are unlikely.Ofcourse night itching is quite a characterestic of Scabies but it is shared with many other conditions.
Best wishes.
 flowrider - Wed Jul 21, 2010 11:05 pm

Hello doctor and thank you for the fast response.

you noted that it maybe a underlining problem possibly health issue well i have done all test's HIV, thyroid and so on next test will be a basic metabolic (calcium CO2, choloride,creatinine,glucose,potassium,sodium,urea nitrogen)
and also CBC with differential.......

As i stated above on my previous posts i do have folliculitis on my skin from the picture i provided do you think the itchiness on my entire body could possibly be having something to do with my shower!? (water contaminated) pseudomonas folliculitis or could this also be a possibility of a case of Pityrosporum folliculitis if either or what would be your diagnosis in this case how and what should i do to prevent this and what would be the treatment.
 Dr.M.jagesh kamath - Mon Jul 26, 2010 9:50 am

User avatar Hello,
Pseudomonas infections are generally contracted in bath tubs and swimming pools and i would have expected constitutional symptoms like fever and body pain, localisation mainly to the buttocks and culture growing the organism.
Ideally, in your case a biopsy may give a clue as to what you are suffering from. Scabies can last for weeks after the mite is dead due to delayed reactions. One other condition which needs to be ruled out would be dermatitis herpitiformis which is a itchy dermatitis of unknown etiology but a treatable condition. Wait and watch will be the best course for a couple of weeks.

Best Wishes.

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