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What Is The Cause And Treatment For Acne Vulgaris?

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Posted on Tue, 14 Oct 2014
Question: I am trying to figure out what is going on with a skin problem I am having. I have been to a dermatologist, twice, and am going to my GP, tomorrow, for a second opinion. Around the beginning of July, I had a sty on my eye. It ran the normal course and healed but left a hard knot under my eye. Then my face began breaking out and I had what seemed to be severe hormonal acne. Around this time, I also developed an abcess in the crack of my behind, which ran it's course and healed, too. Then, I began breaking out all over my body. I have bumps on my face, neck, chest, shoulders, arms, legs, and a few on my abdomen. It is terrible and there are numerous bumps. They seem to be small red or flesh colored bumps. I can't keep my hands off them and when I scratch or pick them, they turn into weeping "lesions" that crust or scab over. At that point, if I pick and remove a "scab", it leaves a hole/pit in my skin. These bumps become red, inflamed, and painful. The dermatologist told me it was nerves and I was basically picking at nothing and I needed to find a way to "chill out". I feel like it's an infection of some sort (viral or bacterial). I have also been very tired, weak, and nauseated and now, over the last few days, I've begun to have allergy and asthma symptoms. I also began taking Chantix around the time of this all over breakout. Please help me figure this out. It is confining me to my home, due to the horrible appearance of my skin, and it has been like this for almost 2 months now. Oh...and I AM in the perimenapausal stages. Thanks, in advance.
doctor
Answered by Dr. Suresh Heijebu (6 hours later)
Brief Answer:
Mostly Acne Vulgaris.

Detailed Answer:
Hi Madam,
I have carefully read your query, drug history and understand your concern.

You seem to have Severe/resistant form of Acne Vulgaris-Acne fulminans which is due to combination of hormonal factors and certainly unproven autoimmune factor.

Addition of topical ointments containing Benzoyl peroxide and Adaplene will help to work effectively.

Systemic therapy with Retinoic acid and Oral contraceptive pills(which can reduce the excess androgen secretion) should be the main stay in treating your resistant form of acne. Discuss about this your treating doctor.

These drugs should be taken under strict medical supervision.

An autoimmune screen mandate in your case to rule out any underlying autoimmune diseases.

This systemic therapy can offer excellent resolution of symptoms.

I hope this info is helpful to you,
Thank you

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Suresh Heijebu (37 hours later)
While what you suggested makes sense, acne doesn't seem to be the problem. I do have a couple of acne bumps but, like I said, a couple. Also, I HAVE been diagnosed with an autoimmune disorder but it hasn't been positively identified. Other than the couple of hormonal bumps I have, I have more than 100 "other" bumps all over my body. I finally got in to see my primary care doctor, yesterday, and he has diagnosed it as an infection, due to strep or staph bacteria (they "weep" and there is a yellowish to brown center, as they heal). He swabbed a few of the bumps and has sent them to the lab, for cultures. I should find out, Monday, what it is (he said possibly impetigo) and what antibiotic I need for treatment. Until then, he gave me a shot of Rocephan, steroid shot (I also have respiratory issues), and Omnicef to take orally. I thank you for your timely response and will update when I get the culture results. I wish there was an option to attach photos because adults need to be aware that this can happen to them. I have had this for 2 months, visited my dermatologist office twice, and I have finally gotten, what I believe to be, a correct diagnosis from my GP. I guess I should have gone to him first.
doctor
Answered by Dr. Suresh Heijebu (28 minutes later)
Brief Answer:
Review with culture sensitivity reports

Detailed Answer:
Hi,Madam
i understood your concern,swab for culture will be a safe option.
You have the option of uploading the photos on this forum.
A swab for culture can be ordered even by your dermatologist.
Yes certainly a GP would have been a better option first.
Lets await the reports of the culture to find out the exact antibiotic as needed to treat these crusted lesions.
Take care till then,
Thank you
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Suresh Heijebu (4 days later)
Hi. I finally got a diagnosis for this skin problem. It is a Acinetobacter Baumannii infection. I don't know how or where I contracted this bacteria, as I live in Alabama, USA. How long should this be contagious? I have read some articles on this bacteria but some are contradictory. Some say it's "highly contagious", while others say that "healthy" people should not get this infection. I'm also having shortness of breath and my chest is feeling very heavy. Should I be concerned about this? I am using a Dulera inhaler. Also, I have been taking Omnicef, as prescribed by my GP, but he told me to stop taking it and they have phoned in a different antibiotic. Is it safe for me to be around other people without contamination, as long as we don't touch, or should I stay "confined"? And for how long? Thanks for your assistance!!
doctor
Answered by Dr. Suresh Heijebu (13 hours later)
Brief Answer:
Non contagious

Detailed Answer:
HI,
welcome back.

You might have acquired this infection from the state of relative suppression of your immune system from the use steroidal drugs oral/inhalational.

This infection is not really contagious .

It can colonize the skin of healthy people,but will not cause infection.

Infection resolves once the course of antibiotics are finished.

You need not confine to isolation if you are on antibiotics.

Coming to the chest discomfort and breathlessness ,a noncontrast helical CT scan is needed to rule out interstitial lung disease in view of underlying autoimmunity.

In such case steroid sparing immunosuppresants are needed.

I hope this info is helpful to you
Thank you
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
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Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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What Is The Cause And Treatment For Acne Vulgaris?

Brief Answer: Mostly Acne Vulgaris. Detailed Answer: Hi Madam, I have carefully read your query, drug history and understand your concern. You seem to have Severe/resistant form of Acne Vulgaris-Acne fulminans which is due to combination of hormonal factors and certainly unproven autoimmune factor. Addition of topical ointments containing Benzoyl peroxide and Adaplene will help to work effectively. Systemic therapy with Retinoic acid and Oral contraceptive pills(which can reduce the excess androgen secretion) should be the main stay in treating your resistant form of acne. Discuss about this your treating doctor. These drugs should be taken under strict medical supervision. An autoimmune screen mandate in your case to rule out any underlying autoimmune diseases. This systemic therapy can offer excellent resolution of symptoms. I hope this info is helpful to you, Thank you