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I’ve had a 6 year skin problem on my face. I am a 60 yr

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I’ve had a 6...

I’ve had a 6 year skin problem on my face. I am a 60 yr young female in relatively good health. My skin develops leisons over night that quickly become quite large. There is often strings of bloody mucus to bleed out and if you enlarge the pic of these just using my iPhone you will see light white circles, many that quickly decide and grow with a dark brown center. It quickly becomes thick and bright white, almost neon, very bright. What I’ve observed over these years is that what has been growing under my top layer of skin almost weaving through my pores. When looking at the mucus and the lesions, you can see the white and brown weaving around each other making a huge mess on my face. You can also see white bright hairs growing out all over my face. I’ve been to a few Dermatologists and have given up. My GP just says he finds it interesting meanwhile my face is disfigured. I am a professional woman so you can imagine my insecurities when meeting with clients, etc. I did have a biopsy done 2 years ago and all that came back was very fibrous tissue. It has definitely improved over the 6 years but it will not go away. The worst area is where it started which is on the side of my nose near the nostril. I continually search it on the internet because I have a hard time accepting that they don’t know what it is and just throwing different medicated creams and antibiotics to it. Everything works great in the beginning but then stop and it regresses every time. HELP!!!

Doctor's Assistant: Are you keeping a personal medical record while dealing with this?

Yes I have over 30,000 pics, few videos and all my documents from my doctors. It

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I currently have adrenal insufficiency and fibromyalgia

Submitted: 4 months ago.Category: Dermatology
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Answered in 1 hour by:
3/13/2018
Dermatologist: Dr. Pravin, Dermatologist replied 4 months ago
Dr. Pravin
Dr. Pravin, Dermatologist
Category: Dermatology
Satisfied Customers: 2,973
Experience: Senior Consultant MBBS DNB (DVD)
Verified

Hello

Welcome and Thank you for your query posted.

My name is***** and being a Skin, Hair and Nail specialist I would be able to provide you with an appropriate solution to your concern.

Please note that my Goal is to provide you with an Excellent Service .

Before I answer your question I would like to get some more information:

Could you send me a photo of the condition at your convenience?

You can upload the photo on www.photobucket.com and send me the link

Other method of uploading photo or a file is:

1.Click the paperclip icon

2.Click the Browse icon

3.Click the Browse button

4.Select your file and click Open

5.Click OK

6.Click Insert

7.Click Save Changes on this page

Please note that the answer provided is for information purpose only and does not substitute a Doctor - Patient Consultation in Clinic

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Customer reply replied 4 months ago
I hope these photos came through. Not so good on computer and can’t find the paper clip anywhere. Have used it before but there isn’t any to use that I can see.
Dermatologist: Dr. Pravin, Dermatologist replied 4 months ago

Thank you for the images sent.

What blood tests have you done till date ?

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Customer reply replied 4 months ago
Hematology profile, PT-INR, Ferritin, Glucose, A1c, ACR, Lipid profile, Thyroid function, Sodium, Potassium, Albumin, Alk phos, ALT, Bilirubin, GGT, eGFR, Calcium, Cortisol, HCO3, CI, BUN, PTT, 25-OH-Vit D, Phosphate, Magnesium, Prealbumin, Vit B12 & A, Copper, Zinc, Selenium, Iron & transferrin saturation, RA, Antibodies for autoimmune. Please note that all the chemistry tests are done as a follow up to gastric Bypass surgery I had done in the fall. There are more so I will add to this list when I go through them tomorrow. Thank you.
Customer reply replied 4 months ago
Immunology, Serum Proteins, Muscle Enzymes, Lupus Antocoagulant, ESR, General Chemistry, Tumor Markers, CEA, Virology, Lyme Serology, Tissue Trans Ab, Adrenal Function, Urine Chemistry.
Dermatologist: Dr. Pravin, Dermatologist replied 4 months ago

What are the reports of these tests like ?

Are they all normal ?

Is there any autoimmune cause to your adrenal insufficiency ?

Have you taken any hormonal replacement therapy for your adrenal insufficiency ?

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Customer reply replied 4 months ago
Creatinine range jumping from normal to high since 2014,with eGFR low. Gamma GT consistently high which doctors feel is due to medications, RDW high in 2 tests over past 2 years otherwise normal, Iron Binding Capacity low, Ferritin low, Nuclear Ab A Equivical, titre 80, Pattern Speckled (only one test result) last year whereas others have been normal, Many other Immunology tests I do not have access to results but assume normal, Cortisol critically low since diagnosis of Adrenal Insufficiency, Urine Chemistry Leukocytes have shown trace to large over the past 4 years, WBC 1 - 30 (one reading only otherwise normal).
My Endocrinologist assumes my Adrenal Insufficiency is a result of chronic opioid use for pain management. I’ve had severe chronic pain for 10 years now which is a result of fibromyalgia and complex regional pain from an injury. (There hasn’t been any test results to prove this as all MRI, CT, X-rays have been normal)
I have been taking Cortef 20mg/day since 2013 for Adrenal Insufficiency.
Dermatologist: Dr. Pravin, Dermatologist replied 4 months ago

Thank you for the very valuable information provided.

What did the skin biopsy show ?

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Customer reply replied 4 months ago
Skin biopsy showed very fibrous tissue and light tan macule. Dermatologist said results showed
basically nothing. Suggested I treat it with photo therapy light which I did but stopped as it
Wasn’t making any difference.
Dermatologist: Dr. Pravin, Dermatologist replied 4 months ago

You need immunosuppressive medication for this like azathioprine. There is more than that meets the eye.

This is an autoimmune blistering disease.

I would suggest a repeat blood test to rule out desmoglein antibodies DSG 1 and DSG 3

I reckon that you would need this treatment for a period of 3 months.

Please do let me know if you have any further queries.

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Customer reply replied 4 months ago
I can’t thank you enough for taking the time to come to a solution for this dreadful disease. I have been so frustrated as I feel I’ve never been taking seriously as I was so quickly dismissed and no one had the time to really help me. All the doctors would only treat the symptoms and not find the underlying cause.
I am so excited to take this very valuable information to my doctor whereas she can order the suggested blood tests and prescribe the medication. Thank you so much.
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