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6 months ago began having dime sized lesions on face (only).

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6 months ago began having...
6 months ago began having dime sized facial lesions on face (only). Began only on forehead and now has moved down to cheeks and nose. Discharge from wound serosanguinous .. No odor present. Initially pcp Thought bacterial infection. Tried and failed - Kelflex Bactrim doxy clindamycin.. Also antivirals.. Acyclovir. Lesions very painful .. I have been to plastic surgeon, derm, and pcp and all have been "stumped" medications currently taking lisinopril adderall oral contraceptive and lexapro
JA: OK. The Doctor will need to help you with this. Is there anything else the Doctor should be aware of?
Customer: Not that I can think of
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Doctor about your situation and then connect you two.
Submitted: 1 year ago.Category: Health
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Customer reply replied 1 year ago
32 year old female - derm has ruled out any type of adult acne.
Customer reply replied 1 year ago
I do have pictures if it will be of any help.
Answered in 31 minutes by:
4/27/2016
Health Professional: Anthony Bray, MD, Doctor replied 1 year ago
Anthony Bray, MD
Category: Health
Satisfied Customers: 10,341
Experience: 14 years as clinician in the field of Family Practice
Verified

Hello !

Yes if you can load pictures of rash to page that would be helpful ....

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Health Professional: Anthony Bray, MD, Doctor replied 1 year ago

Also do these lesions itch ?

How long have you been on Adderall??

So the lesions have increased in number ?

Any insect bites that you know of ? Pets ? Travel ?

Anyone else affected ?

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Health Professional: Anthony Bray, MD, Doctor replied 1 year ago

From the specialists seen it sounds that the condition may need biopsy to help diagnosis ....

At times Adderall can cause dermatoses as a potential side effect....

I will be happy to get back with you after pics posted ...

Best regards ***** ***** !

Anthony Bray MD

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Customer reply replied 1 year ago
I've Been on adderall for about two years now. No they do not itch at all.. Just painful. I initially had one spot on forehead. It went away after a month.. As soon as it healed, it seemed to come right back in the same area. Again, if healed and hasn't returned but another place on the forehead occurred. Now Just within the last month.. I have one in the center of each cheek and on tip of nose. No pets or traveling outside of the US. No one else has any of these symptoms. I have thought Lyme dz, possibly autoimmune dz, I even checked my home for mold. No changes in any type of detergent, soap, makeup or dietPic#1: current pic of forehead lesion
#2: healed area on cheek
Customer reply replied 1 year ago
Pic #2
Customer reply replied 1 year ago
i know that vyvanse is an amphetamine as well, but would that medication potentially cause the dermatoses or is it most commonly w/adderall
Health Professional: Anthony Bray, MD, Doctor replied 1 year ago

Hello again,

Well a couple of possibles come to mind in reviewing your pics >> ?? Discoid lupus >> this type tend sto be sharply marginated, scaly, red plaques, more in exposed areas such as the face.. lesions may heal with scarring... affects females more than males and age is most in 20 to 45.. so many factors could fit that as a possible cause..

Sarcoidosis may present with skin lesions and that is more common in person taking an ACE inhibitor and you do >> Lisinopril... (Skin biopsy would be advised and checking for chest xray as well..)Blood tests to be considered..

Leishmaniasis which is a parasitic skin infection..related to a sandfly bite..

So I would recommend asking about these and other diagnostic possibilities.. I think some blood tests would be in order to check your blood counts/ ANA/ ANCA/ inflammatory markers/ ACE level /etc.. ?? I think a skin biopsy would be most helpful to nail down your diagnosis

I hope that this information is helpful for you.

Let me know if you have further questions or discussion. I will be happy to get back with you!

Best Regards,

Anthony Bray MD

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Customer reply replied 1 year ago
I'm sorry. I just have one last question. This is something no one else has really addressed .. Just thrown to the side. When I was first started on blood pressure medication my cardiologist ordered a CTA abdomen w/contrast. I know you can't say for sure if this would relate to what I have going on but it's always been a concern. My doctor didn't seem to think it was important but I think it's smart to get a second opinion in some cases. Thank you for all of your help
Health Professional: Anthony Bray, MD, Doctor replied 1 year ago

Hello again,

AS it looks that your doctor ordered the abdominal CT for evaluation of the hypertension I think he was mainly interested in looking at the renal arteries and these are not affected by renal artery stenosis >> so this was fine as to your renal arteries..

The study here does not reflect any problems of concern. I don't think that the study or contrast agent are related to the skin problem..

The starting on the ACE inhibitor Lisinopril COULD BE if the cause is related to sarcoidosis

I think that you need a skin biopsy and suportive studies to help nail down the diagnosis ...

I think it fine to see a dermatologist and discuss the above diagnoses..

I can't give you a specific diagnosis from the pics here alone either..

Hopefully this may help you to get closer to the correct diagnosis and treatment though..

Let me know if I may be of further help!

Best Regards,

Anthony Bray MD

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Customer reply replied 1 year ago
Thank you so much for your time
Health Professional: Anthony Bray, MD, Doctor replied 1 year ago
You are very welcome !
Good luck !
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Anthony Bray, MD
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