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Dr. David
Dr. David, Board Certified Physician
Category: Dermatology
Satisfied Customers: 44815
Experience:  Experienced Physician trained in New York City. I'm ready to help.
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Potential ringworm/fungal question. I do have pictures. This

Customer Question

Potential ringworm/fungal question. I do have pictures. This started over a month ago with a spot on my chest, that I was able to clear up. It started well small, and grew to almost an inch during treatment. I did see Urgent Care to get an opinion, then a Dermatologist. After a month, the spot went away by using Lotrimin Ringworm cream.
About two weeks ago another spot appeared on my right buttocks that I have been treating, it has grown since treatment began. I do have images of this spot in its early stages. Now I have 2-3 more spots, one on my right hip that has been there for about a week, and one on my right bicep that I just noticed last night. There may be a small spot behind my right knee as well, but am unsure on that one.
I did see a new dermatologist again today, but she was not convinced they were fungal. She thought perhaps they could be folliculitis. At their current stages, they are too small to tell she said, the image I showed her was too blurry since I printed it from my computer and brought it in. But she did prescribe a different cream. Im just looking for a second opinion on this so I know if Im treating fungal or something else.
Submitted: 8 months ago.
Category: Dermatology
Expert:  khagihara replied 8 months ago.

Can you attach the photos here? Did the doctor take a sample and examine it under the microscope? How tall are you? How much do you weigh? Any medical problems? Any surgeries? Any other medications including over-the-counter pills and herbs? Any family medical history?

Customer: replied 8 months ago.
I have attached three photos for you. The first two named Aug8a and Aug9b are the spot on my right buttocks from Aug 8 and 9. The dry inner ring of skin is gone, now it is a wider red patch. The third picture named Aug16rightsidea is a spot on my right hip from Aug 16. The dry/dead skin looking portion is no longer there and the spot itself is a little flatter and has not grown from what I can tell. When shining a light on it at an angle, you can see these spots are definitely raised. They do itch from time to time as well. The doctor did not take any samples, she just examined by eye. Height 5 foot 9 inches. Weight 140 pounds. I dont have any medical problems, or surgeries. The only medications I have used are the topical azole creams. Today I was prescribed Lotrisone. No family medical history.
Customer: replied 8 months ago.
I have attached three photos for you. The first two named Aug8a and Aug9b are the spot on my right buttocks from Aug 8 and 9. The dry inner ring of skin is gone, now it is a wider red patch. The third picture named Aug16rightsidea is a spot on my right hip from Aug 16. The dry/dead skin looking portion is no longer there and the spot itself is a little flatter and has not grown from what I can tell. When shining a light on it at an angle, you can see these spots are definitely raised. They do itch from time to time as well. The doctor did not take any samples, she just examined by eye. Height 5 foot 9 inches. Weight 140 pounds. I dont have any medical problems, or surgeries. The only medications I have used are the topical azole creams. Today I was prescribed Lotrisone. No family medical history..
Expert:  khagihara replied 8 months ago.

They don't seem to be fungal infection. They seem to be bacteria infection. Your doctor should take some samples and examine under the microscope to see if it is fungal infection or not. If the medication doesn't help, your doctor should take some samples.

Customer: replied 8 months ago.
Can you please give me an idea of what makes you feel its bacteria? And if it could be that what would the condition be called so I can do more research on my end as well. Also, what types of treatments over the counter are available if it is bacterial? Do you have any stock photos/medical photos showing similar spots that I can compare to?
Expert:  khagihara replied 8 months ago.

If it is fungal infection, it doesn't become a bump. The bumps have hairs. It seems to be folliculitis. Usually folliculitis is bacteria infection although there is fungal infection called hot tub folliculitis. But folliculitis usually has white head. Yours are not typical. Use Neosporin with the Lotorisone.

Customer: replied 8 months ago.
To be honest, when I signed up for this, it first offered me a doctor with over 4000 reviews. That is what it pictured and I expected. Definitely no offense to you, Im sure you are wonderful and well educated, but when you received the case I felt a little mislead from what doctor was advertised as being available. That could be something on Justanswer, and not yourself, perhaps they false advertised on purpose to get someone like myself to commit to the purchase. I would like the opinion of someone a bit more experiences if you dont mind.I would like to go into further detail and describe better what these spots were/are so I can stop playing the guessing game and wondering how I should treat them. Im looking for detail, I can find simple answers on the internet already. The two I pictured do not represent all of them. The original spot was not in an area with hair (unfortunately no picture of that one). It never had a whitehead of any resemblance to a pimple. Can it be coincidence that I have fungal and folliculitis at the same time, sure, but I have never had either in my entire life that I know of or have treated, and for both to pop up at once seems strange. Which leads me to believe they are related and one or the other.Does Folliculitis spread itself into a ringworm looking shape about 1 inch in size? And how long do Follicultis spots take to clear up on their own? Or does Folliculitis stay small, as its own bump only and does not spread? Me knowing the clear symptoms of each potential issue will help me better understand what this may be.The first spot that started on my chest that stayed for about a month started small, and spread to an oval shape almost 1 inch in size and was raised, but flat if that makes sense, also light pink in color. Not a "bump" at all. Then on the outer edges when it would spread, there would be a small bump or two that it connected with, and those flattened out as well. Lotrimin ringworm treatment cleared this up.
Expert:  Dr. David replied 8 months ago.

This is Dr. David

it looks like the other expert opted out.

I am glad you have seen several dermatologist face to face already.

I agree with your new dermatologist that this doesn't look to be fungal either.

what cream did your second dermatologist give you?

the spot on your chest could have been fungal or bacterial

you can have both fungal and bacterial infections on your skin at the same time.

every patients folliculitis and fungal skin infections can be different.

fungal infections tend to be itchy and stay flatter and tend to take longer to resolve with antifungal creams. and fungus tend to like to grow in dark warm moist environments.

just because a lesion on your chest cleared up with lotramin doesn't necessarily mean it was fungal. it could have cleared up on its own, even without the cream.

and you don't have a photo of that spot on your chest and your doctor's didn't see it either, correct?

ringworm skin fungal infections tend to be flat and itchy and sometimes scaly. none of the pictures you are uploading look like fungal skin ringworm infection.

the photos you have uploaded tend to look more like focal dermatitis or possibly a steroid dermatoses condition, possibly from local blocked skin pores.

excessive heat, blocked skin pores, lack of daily showering and exfoliation, new detergents or soaps, could cause these blocked skin pores on your body.

did your doctor give you a steroid cream to try?