Rash
Unidentified, Itchy, Widespread
December 3, 2016
Patient in Texas reports having late stage Lyme, Babesiosis and Bartonella. Gluten sensitivity. Currently in treatment for infections. Had been on HBOT treatments, recently discontinued.
Current medications include: Doxycycline, artimisinim, cryptolepis, mepron, Malarone, glutathione IV pushes, Zyrtec, gabapentin, Wellbutrin, cymbalta, lamictal, klonipin, omeprozole, diflucan. Recently- IV clindamycin and oral flagyl, Claritin, mucinex.
Patient's out-of-state Lyme treating doctor instructed patient to see a local dermatologist. She did. The dermatologist had no clue what this could be and as some uninformed health care "professionals" can be in that sort of situation, he was unpleasant.
Patient works indoors. Claims it is not chiggers or poison ivy, no exposure. No new soaps, laundry products, or contact with any new substances.
Prescribed eurax, which helps reduce itching.
Symptoms- States the itching is unbearable. Many small bumps. When scratched more bumps appear and skin becomes raw and bleeds. Patient reports having a few small patches of a rash like this before, but nothing this widespread. Said… “When I itch it more bumps appear quickly and they are pretty close together.”
Stated… "The rash is all over my arms and patches on my legs, about 2 inches above my knee all the way to my ankles. It's on my chest too. I've itched myself bloody."
Rash as it first appears, before affected by too much scratching.
Scratching due to intense itching caused bumps to open and bleed.
Scabs forming.
Ask The Experts
EV- Most likely bartonella. Topical lidocaine may control the itching.
LD- Reading recently published Morgellons book it sounds like a possibility. Wonder if hbot stirred up the pot in a bad way with Babesia or bartonella (Dr. M has a point there) or if it's crud coming out. We have seen that here.
When Dr. S had us challenge with Zhang's artemesia, he told me my relative would have some really really itchy ankles and that he did. I never saw if there were any bumps, but my hands are full 24/7. Hope GS finds this to reply.
LC- Bed bugs?
RR- Larva migrans of some kind? They are itchy. I saw something similar, but not as widespread, that responded to albendazole (which has to be compounded). It took 3 months to clear it, but responded well even initially. I prescribed 400mg BID 4 weeks on, 2 weeks off, for 3 cycles. A few years later it recurred, exposure to worms again, and it cleared again with same treatment. That particular patient was round worm, but I saw another patient with similarity who also responded and we never new the particular "bug" on testing.
JBE- It almost looks like they are in lines and blister like. I wonder if there is a contact dermatitis on top of bites? You get lines with poison ivy from scratching. Perhaps something on her finger nails or hands that she is reacting to, my 2 cents.
CC- Could be Morgellons. Has she looked for fibers with hand held scope at 60-100 X magnification? History and presentation fits. She should look at her skin with a 60-100 X hand held scope. [Scope can be purchased online for approximately $10.00. Sample scope- click here.]
Dr. S- Somewhat similar to the bites from rat mites due to the unrecognized presence of raccoons in the house at night? I think that rat mites carry most of the TBDs, especially in some cases bartonellosis.
UPDATE from patient 12/26/16- Roughly a week after the initial onset of the rash, patient saw a local dermatologist. He took four biopsies and recommended she stay off the IV clindamycin she had recently been on for 7 days.
The biopsy report came back stating the diagnosis as "dermatitis," likely due to an insect bite or reaction to an insect bite.
After the patient continued to politely question the dermatologist's to better understand the situation, he put her on ivermectin even though he stated she didn't have scabies or a parasite. The patient felt as though he did this in an attempt to try to placate her since his answers didn't make sense.
The rash eventually began to subside with no new outbreaks. The patient resumed IV clindamycin after seven days. A few days into IV clindamycin, patient began to get the symptoms that preceded the first rash- welts and itching. She decided to stop the clindamycin around December 14th as she now suspected this may be the cause of the rash.
She saw her Lyme treating physician roughly a week later, and the patient and doctor both believe the IV clindamycin was likely the cause of the rash outbreak.
Since stopping the clindamycin, the patient reports she has not had any rashes appear.
Ask The Experts- The above comments were provided by health care professionals with experience treating Lyme patients, and volunteer patient advocates and support group leaders who have also been assisting Lyme and tick borne disease patients. Thanks to all of them for contributing to this project in an effort to help educate others and relieve the suffering.
*This is not to be considered medical advise. Please contact your own health care professional if you have questions about any health issues.
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