Question: Hi Dr Sawhney,

We had a consult a few months ago and you gave me very solid advice and direction. I’ve been able to get part of the recommendation work-up. I have still been unable to get a biopsy, due to COVID-19. But since then, I did the gold TB test, that was negative, I did a leishmaniasis antibody that was negative (however, Its my understanding that cutaneous disease does not produce the antibody, but not clear on that), my chest x-ray was negative for TB, but does show slight crowding of the vessels with minimal linear densities in the right lower lobe, consistent with atelectasis. I have a microbacteria urine culture pending and am consulting with the Jewish TB foundation to rule that Non TB Micro-bacteria. I tested negative for fungitell 1-3 B-D glucan assay, which from my understanding reduces the likelihood of sporotrichosis (but unsure). I am also negative for Valley Fever and cryptococcus. Since our last consult, I had a few new symptoms. First, the skin on my fingertips bubbled and then the top layers of skin pealed off all my fingers, except my pinky. I scrubbed my hands with surgical scrub and cut a piece off with clean scissors and sent them to EMSL lab on a SDA culture stick. It was identified as Rhizopus. That is consistent with the negative fungitell test, but I don’t know if it has any other clinical clues or value.

I had one new large lesion open up on my knee. I got it to close after 6 weeks but a white crust keeps forming and then shedding parts down my leg.

I still continue to feel something land on my back, upper arms thigh and tops of my feet. Basically any exposed skin seems to develop symptom. I also feel pops in those areas, followed by wetness. This is most obvious on my clothing. The liquid seems to dry on my skin and then leave a clear plaque that blocks the pores. I have excessive sweating/wetness in any heat above 74 degrees. Excessive wetness areas are my scalp, vaginal/but area and feet. It’s beyond normal sweat. At its peek, It’s so much that when walking I leave a dripping trail of liquid. Sometimes it’s clear, sometimes white and sometimes black gum like goop, but there always seems to be a hair or string in the liquid. Yesterday, the same string/hair like structures were on my hands. Initially they were flat and not even visible, but when I did notice, I felt a small poke feeling and the string was standing up with only a millimeter or two imbedded under the skin. Please see the attached pictures and reports.

Does this change your clinical recommendations? Do you have any other suggestions based off the new information?

Best Regards,
XXXXXXX Wood

I will upload the new pics and docs in the consult, I don’t see an option to do it here.

I should also add that these string type things are also in my vaginal region and I see the same structure when I wipe. I have also noticed them on my feet and on my scalp or hair. On one of the closer pictures, you will notice the tip is slightly larger than the rest of the structure. It’s always the same.

I added a few more pictures. The other open sore that has similar symptoms, just above my female genitalia, in the crease. The second is from hair on my scalp. It can look like a bug at first glance, but it is just more balled up string-like substance. Sometimes clear, sometimes white and sometimes black.