Brief Answer:
Kindly upload an image

Detailed Answer:
Hi
Thank you for writing to us at healthcaremagic.
Kindly upload any image for better evaluation.
To upload an image go to report section
or
you can also mail at YYYY@YYYY with subject line as attention Dr. Kakkar.
Regards

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Brief Answer:
Possibility of body lice infestation

Detailed Answer:
Hi.

I have reviewed the Images.
I have noted that the lesions are distributed on your arms, shoulders and torso. I have also noted that you have already been treated with permethrin with no improvement.
Even I would have kept my first diagnosis as scabies after looking at the Images.
My second differential diagnosis would be pediculosis corporis

Based on the history I will like to rule out a possibility of 'Pediculosis corporis' or body lice infestation. The organism usually resides in the seams of clothing. At night the lice moves out to feed on to the skin and therefore just applying permethrin 5% is not enough unless all your clothing, bedding, and towels are laundered using hot water (at least 54 °C) and machine dried using the hot cycle.

You may reapply 5% permethrin once more to the whole body, below neck with special attention to flexures like axilla, groin. Keep it over night for 8 hours and bath next day.

If I was the treating doctor I would have also suggested a moderately potent topical steroid+topical antibiotic combination ointment (e.g fluticasone propionate0.05%+2% mupirocin ointment), to be applied twice daily at the red, crusted spots.

I would also suggest an OTC oral antihistamine e.g cetrizine 10 mg once daily for itching, if any.

The mole like brown spots could well be body lice which you describe as moving dots.

I strongly feel this is a body lice infestation.
I suggest you to wash all your sheets, clothings and towels as well using hot water (at least 54 °C).

Regards

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Brief Answer:
I suggest symptomatic treatment

Detailed Answer:
Hi.

Fine.

The mite or lice can cause hypersensitivity which can persist for a few days even after treatment, therefore, I suggest you to continue using a topical steroid+antibiotic combination ointment for the spots, twice daily.

I would also like to add an OTC oral antihistamine e.g cetrizine 10 mg once daily for a few days.

Should resolve in another 5-7 days.

Pay special attention to washing all your clothing and sheets etc as suggested.

Maintain utmost cleanliness and hygiene.

Regards

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Brief Answer:
I suggest a possibility of Razor burn Or Pseudofolliculitis

Detailed Answer:
Hi.

I have reviewed the Image

This looks like a razor burn. I can also see red, bumps specially around the hair follicles.
This is not related to scabies.
Most likely it is a razor burn Or pseudofolliculitis. It can happen from shaving with an old blade Or shaving too closely against the grain.

Did you shave against the grain?

Measures to avoid it include shaving during a hot shower after you have properly softening them up with a shaving cream/gel

I suggest you to use a topical steroid+antibiotic ointment, twice daily over this area as well.

Regards

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