Prescribed With Accutane For Skin. Suggestions

Posted on Mon, 2 Dec 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 2 Dec 2013 Answered on

Wed, 1 Jan 2014 Last reviewed on

Question : Hello, I'm finding it very hard for someone to tell me what is wrong with my skin. I tried a dermatologist and they wanted to put me on accutane which i declined as I don't think that is the problem. From your experience what does my skin look like to you? Its been this way for years. I appreciate any advice. Thank you, I will answer any questions

Answered by Dr. Sujoy Khan (10 hours later)

Brief Answer: Possible staph infection/urticaria overlap Detailed Answer: Hello, It appears to be an urticaria/staph infection on the skin. The intolerance to banana is usually a secondary allergy (if this is allergy) and the primary allergy is to grass pollen or latex. The asthma needs to be under control if you have symptoms of hay fever or grass pollen allergy. Mupirocin cream with long acting antihistamines such as fexofenadine 180mg should control the urticaria. In addition thyroid function, liver function test with hemogram may be required. Your treating doctor will know about the medication and tests. Hope this helps. Let me know if you need clarifications. Best Wishes

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sujoy Khan (28 minutes later)

Hello thanks for your reply dr Khan! My asthma is under control now for a few years, it very rarely pops up. I did a thyroid function blood test ( TSH only though, which I heard can be unreliable?). I am going today for the last of my blood tests which include: Calcium adjusted, C-reactive protein (CRP), Ferritin and a Liver profile. thank you!

Answered by Dr. Sujoy Khan (15 minutes later)

Brief Answer: Results of tests to be reviewed Detailed Answer: Thanks for informing me. If the TSH is normal, it suggests that the thyroid is working fine. Thyroid antibodies (Anti-TPO or TG) may still be positive and I only check it when the urticaria gets very difficult to control with standard treatments. I would like to review the results of these tests, so do upload them when you have the reports.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Sujoy Khan (4 hours later)

Ok I had the blood test and should get the results in a week, I will close this chat for now and reopen it when I have the results to keep you informed. Thanks Dr XXXXXXX

Answered by Dr. Sujoy Khan (2 days later)

Brief Answer: Fine Detailed Answer: ok, we can proceed once the results are ready.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sujoy Khan (9 days later)

sorry for being late with the results here they are: Blood Haematinic levels: Ferritin 120.000 ug/L Liver function test: Serum total protein 74.000g g/L Serum albumin 44.000 g/L Serum globulin 30.000 g/L Serum bilirubin level 14.000 umol/L Serum alkaline phosphatase 66.000 iu/L Serum ALT level 35.000 iu/L Serum Calcium 2.400 mmol/L Corrected serum calcium level 2.320 ol/L Serum C reactive protein level 1.000mg/L

Answered by Dr. Sujoy Khan (7 hours later)

Brief Answer: Reports normal, thyroid antibodies required Detailed Answer: Many thanks for uploading the results. Ferritin, liver function tests, CRP and calcium are normal, suggesting further investigation such as ultrasound abdomen are not required. Anti-TPO, TG are however still awaited (if already done). This is because antithyroid antibodies can be positive with normal TSH. No changes in medication required at this stage. Best Wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar