sudden eruption?

[exoixx]

Hi I hope someone can help.

I wasn't sure whether to post this here or the rashes forum so apologies if its in the wrong place.

Two weeks ago I had a mild cold, and I got a couple of zits on my forehead as you do, however, once the cold subsided the spots didn't get any better. Then one day I woke up to find my entire forehead covered in spots. Over the last few days more have appeared and they have now spread to my chin and around my nose as well as a few sprinkled on my neck and back.

The spots are pink, at one point some of them looked like white heads but now they don't appear to have heads. They are a little itchy (but not very) and sore to touch. I do not suffer from acne as a rule. The only meds I'm on are fluexotine which I've taken for years. Haven't used any new make up or anything like that.

I've made an appointment to see my doctor next week but I'm getting worried now. I've also developed a sore tongue.

Here are some pics of the spots although the lighting isn't great the spots are angrier than they look in the pics. Has anyone got any idea what on earth this is? Thanks in advance!

http://i1228.photobucket.com/albums/ee447/pgemote/Guildford-20120208-00025.jpg

http://i1228.photobucket.com/albums/ee447/pgemote/Guildford-20120208-00026.jpg

http://i1228.photobucket.com/albums/ee447/pgemote/Guildford-20120208-00027.jpg

[vencasand]

you might have a viral infection. sometimes people get this after a cold. i am glad you made an appointment with your doctor. it is important to have a problem checked out.

[saiyan]

hi! though the picture u posted is not very clear, but according to history u have given and the nature of the lesion, it seems like the Pityrosporum Folliculitis to me, which presents as pruritic follicular papulopustular eruption. It is basically caused by overgrowth of yeast Malassezia furfur which is a normal flora of skin, but during certain favorable condition (decreased immunity eg. common cold) they seem to overgrow and cause the condition.

Usually simple tests can be performed with KOH preparation to confirm the case. Topical anti-fungal preparations or oral fungal medications are usually given to treat the condition. As antibiotic seem to deteriorate the condition, so it is best to avoid them. Still possibility of viral eruption and drug eruption cannot be completely excluded due to limited details online,i would still like to suggest you to see the dermatologist and after complete physical examination and tests go for the appropriate medication.

hope u keep us updated about your condition and progress.

[exoixx]

Thanks for the replies.

Apologies for the pictures not being clearer. Would this type of folliculitis you're
Talking about continue to spread? Since my last post more have developed on my chin and neck and one or two on my chest. Some of them appear to be in lines, some in groups of three and others in huge clusters. Would this be typical?

The itching is slighty worse, too. And there are few that are really sore :(

I'm seeing the doc tommorow I will let you know what they say

[saiyan]

the yeast is lipophilic and thrives in areas of skin with increased sebaceous gland(oil gland) activity as T zone of face,chest and back and also has tendency to spread.yes they seem to appear in clusters and is usually very itchy .we can use some over the counter antihistamines if its very itchy and bothers your sleep pattern, until u see the dermatologist.
anyway whatever your dermatologist diagnose do let us know,we will be happy to hear from you.

[exoixx]

Hi. Well I saw the doctor and he seemed clueless and gave me some antibiotics. The inflammation has gone down a bit and the spots have becomer drier but still there. Have an appt with dermatologist tommorow.
I've got a couple of better pics I thought I'd post.
http://i1228.photobucket.com/albums/ee447/pgemote/Guildford-20120211-00031.jpg
http://i1228.photobucket.com/albums/ee447/pgemote/Guildford-20120211-00030.jpg

[saiyan]

this picture u sent seem bit clear than the earlier ones.from this picture it also seem like allergic reaction to certain drugs or cosmetics u used recently.well u are visiting dermatologists shortly hope u come up with clear diagnosis and let us also inform about condition. good luck.

[exoixx]

UPDATE & another question:

Well, I saw a dermatologist who looked my face, thought for a moment and said "it's probably Acne here have some antibiotics." I pushed to have a swab though as it seemed silly not to make sure there was nothing else going on.

Swab was clear. Derm perscribed same antibiotics doc gave me which I have now been taking for just under 5 weeks.

Saw another derm as I didn't like the first's flippant attitude and this time they said it was an acne form rash but not necessarily acne (although it still could be) and that folliculitis was another possibility but again to continue with antibiotics.

She also said to use hydrocortisone cream provided I use it for no more than seven days and just dab a tiny amount on, which I did. This has reduced redness and inflammation considerably but they seem to be getting inflamed again now I'm no longer using the cream.

Someone suggested I use Nizoral to see if it makes any difference. I did this on one or two isolated spots (in case I had a reaction or something) a few nights ago and those spots are no longer inflammed. It almost looks like they have 'burst' - there is still a bump but it is now pale pink as opposed to red and far less inflammed. But there also appears to be a white circle on the edge of the pimple (still ON the pimple but sort of round where the sides would be if it was more inflammed) that sort of looks like dead skin, the sort of thing you have left when a blister on your foot goes down. Is this normal for acne? Its only like that on the spots where I used Nizoral. Could this indicate this is down to yeast or do acne spots respond in the same way to Nizoral? The spots I used the N on are also no longer itchy or sore but the rest are? Thanks!

[saiyan]

Nice to hear from you again.Sorry to hear that your rashes haven't improved yet. the medication you used Nizoral is an anti-fungal medication,if it seemed to improved your skin rashes, reduced inflammation and itching than it strongly suggest the yeast infection called Pityrosporum Folliculitis, which i have already mentioned you earlier.

The medication you used hydrocortisone cream is a steroid which suppress the inflammation but when you stop it your rashes flares up, which happens usually when you stop the steroid suddenly in cases of other microbial infection if it used alone.acne is bacterial infection caused by bacteria P.acne ,antibiotic is helpful for curing it.both steroid and antibiotic doesn't help to cure yeast infection Pityrosporum Folliculitis on contrary deteriorate it if they are used alone. so should be stopped immediately if your rashes gets worse.

So i suggest you to take simple fungal test with KOH or you can also go for culture.if the results comes positive than properly go for antifungal medication topical as well as oral.You can stop other medication until your diagnosis is confirmed. hope you will keep us informed about your condition.

[Deepak]

Acneiform eruptions like your eruption includes many skin disorders that resemble acne vulgaris and are sometimes misdiagnosed as acne vulgaris, drug eruption,folliculitis (bacterial) or others. As previously suggested by saiyan it sound like Pityrosporum Folliculitis( yeast) to me too (Reason: Acneiform eruptions+antibiotics not working + Nizoral working). Most widely used effective regimen consist of topical ketoconazole cream or shampoo with oral ketoconazole. ketoconazole cream or shampoo should be used even after lesion disappear to prevent the relapse as can be seen after discontinuing oral ketoconazole.

Being said that before starting oral medications its always good to perform liver function test and few other test and oral medications must always be taken after doctor prescription. I would suggest to visit a dermatologist and talk to be about Pityrosporum Folliculitis so he/she could inspect and suggest you further. Please do keep us update.

[exoixx]

Thanks both of you :) I have an appt with my GP today (as need another referral to see derm) and I've been told that the GP can take scrapings to be sent away to test for yeast infection in the meantime.

I will keep you posted, thanks again!

[saiyan]

Do let us know whatever your culture or test result comes.we are looking forward to hear from you.