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Folliculitis on right leg.

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Hello, this is a follow up question based on the request of Dr Deepu Sebin Sebastian , Internal Medicine Specialist. He told me to check with your dermatologist as she will be in a better position to diagnose based on the images I sent. Reference 91332 . Please reference to Consultation ID: CS120520130403 for more details about my condition.

I attached 3 files, the right leg, left leg and back. You should know that I caused the big bumps on the right leg. I tried to squeeze them and they left big marks.

As you can see, the bumps on my back almost disappeared except for the marks they left.

I don't know if this is relevant, but I used to put my laptop on my lap for prolonged periods of time (5-6 hours and sometimes more). When I read that it's harmful about 6 months ago, I stopped putting it on my lap immediately.

Also, do you think the burning sensation on my thighs after an erection is related to the other symptoms knowing that about a year and a half ago, I didn't have any of these symptoms.

I'm really sorry for all of these details doctor. I just want to know that it's not a dangerous condition.


Patients is 27 male,
CBC- Normal,
Allergy test (skin prick with 11 allergens)- Negative,
HCV, HBV, HIV- Negative
LFTs - Normal
TFTs -Normal
Urinalysis -Normal
Chest Xray - Normal

Thank you very much.

Previous consult 1 -

Hello Doctor, I hope you're having a great day.

First of all, I wanted to thank you for your advice. Since I started steam inhalation as you suggested, I haven't gotten any sore throat whatsoever. You have no idea how grateful I am for this. It was a nightmare before each time I took a shower. Now I exercise regularly and shower without any problem, so thank you for that.

For the rest of the symptoms, I've been monitoring them to determine what's the cause. I realized that after a simple erection or even an ejaculation, my vision becomes blurry a little bit in addition to a very simple rash in my back or thighs that appears the next day (several small pink bumps + rarely a small blister). This rash starts to go away after 2-3 days, but sometimes it leaves marks. Also, each time I have and erection, even when I wake up in the morning, my thighs start to burn a little bit. Also, I go to the bathroom very often.

I've seen many Urologists before I contacted you the first time and they all told me the I have nothing + they gave me some antibiotics...etc.

You should know that I'm not married. I also don't get exposed to sun often because I work from home (I'm starting to change that because of the importance of vitamin D) + I get stressed easily so it's safe to say that I'm stressed most of the times.

I'm really confused about this. As you saw, All the tests came fine, so I don't really know what's the cause of this. I don't know if it's an infection, a hormonal problem or the exposure to Perchloroethylene or anything else. Please help me.

Thank you very much.

Category: Dermatologist

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Category: Cosmetic and Plastic Surgeon
 25 Doctors Online

Hello,

Thanks for posting your query at DoctorSpring.com. I can understand your concern.

It seems to be a case of folliculitis from the pictures, folliculitis is a bacterial infection of the hair follicles, which is leaving dark marks on healing.

Since you are getting recurrent episodes of the folliculitis, its more likely that you have a carriage of the bacteria called staphylococcus in your body folds and nostrils.

It will be important to eliminate this carriage by taking appropriate treatment.

For this i would recommend application of mupirocin cream in the body folds like groins, arm pits and between the buttocks and nostrils twice a day for a week every month for 6 months. It needs to be applied also on the bumps.

This is my opinion, I hope it helps. However, I am open to any doubts that you may have regarding the rash that you are getting.

Please let me know your queries.

Take care


Patient replied :

Hello doctor, thank you very much for the diagnosis. I noticed that each bump appears in the middle of a hair, so I believe that this reinforced the diagnosis of Folliculitis. However, what I don't understand is why they appear 1-3 days after each ejaculation? They are some how linked, but I don't know how.

Also, after each ejaculation, my thighs start burning, my vision becomes blurry a little bit after a while and the next day I feel some minor discomfort in my knees and elbows.

Another thing I noticed months ago is couple of purple lines in my thighs. I'm also exercising regularly for more than 4 months now, but I can't seem to lose weight no matter how hard I try (I'm going through the P90X training program, but with no results).

I'm trying to ignore these symptoms, but they don't seem like they're going away (it's been about a year now). I'm afraid that if I don't do something, my sexual and overall health will be ruined. The surprising thing is that all the tests that Dr Deepu Sebin Sebastian recommended came back fine. I just want peace of mind no matter what the diagnosis is.

Thank you for your help doctor. I really appreciate it.


Hello

Thanks for your reply.


I can understand your concern.

Folliculitis is surely a possibility, for which the treatment I suggested would be helpful.

It's possible that the folliculitis is related to an irritant or infection that is being acquired during the sexual activity.

For the symptoms you describe you get after ejaculation I would recommend that you visit a urologist who can help you better.

I would request you to send a picture of the purple lines that you mentioned. I could let you know what is it after having a look.

I would suggest you do not worry about your concern and it would surely be under control soon.

Please let me know if you have any queries.

Take care


Patient replied :

Thank you very much Doctor. I attached 3 pictures of the purple lines I told you about. I hope they're clear enough. Just for clarification, I'm not in any sexual activity right now and I haven't been for years now. Just some questions:

1- Can you explain a little further how can I apply the treatment you recommended. Does it mean that every month, I apply the cream for just one week (2 times a day) and wait 3 weeks without applying and then apply again in the first week of the second month...etc. Also, do I apply it and shower or is it ok if I keep it on my body.

2- Is Folliculitis contagious? I want to make sure that no one will catch it from me.

3- Another thing I forgot to mention is that even my head hair is falling. Is it because of the Folliculitis and do I need to apply the cream on my head as well?

4- Can you refer me to a Urologist here at DoctorSpring. I went to several Urologists here in my country and they all told me everything is fine. They gave me tons of medication (Antibiotics...etc) and nothing worked in removing these symptoms.

Thank you again doctor. I will never forget your help.


Hello

Thanks for your reply.

The picture suggests that these are telangiectasia. These are dilated capillaries of the skin. They are just aging changes in the skin. There also seem to be a few stretch marks.
I wouldn't recommend any treatment for it.

Folliculitis is not contagious. It won't lead to hair fall so I would advise you to not apply the same cream on the scalp.

You need to apply the cream for a week every month and nothing for next three weeks. You need to leave it on for a while.

I would recommend that you send a query for a urologist on doctorspring and your question will be directed to a qualified specialist by customer care.

Take care


Patient replied :

Thank you very much for your help Doctor!

I consulted with a Urologist here at Doctor Spring and he told me that most of the symptoms I'm experiencing are because of a condition called "Post-orgasmic illness syndrome". However, some of the other symptoms seem not related.

One quick question. My hair is falling, especially on both sides of the forehead and I would like to know about any effective treatment, medication, supplements or home remedies that will help restore it.

Thank you very much. I really appreciate your help Doctor!


Hello,

From your description this looks like a androgenic alopecia or male pattern of baldness. Well, there are few treatment options like Minoxidil, Finasteride etc but those are not without adverse effects. For now you can take a protein rich diet and a Vitamin B complex supplementation. If the hair loss persists and if that is bothering you, you can consider the above said treatment options.

Thank you


Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Experience: 
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
Dr. Kruti Jobanputra Banodkar and 4 other Medical Specialists are ready to help you

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