My Dad Started Off Around The First Week In August

Posted on Sun, 27 Sep 2020

Question: My dad started off around the first week in August with little appetite and then about a week later one single spot (lesion) on his middle back, after which several spots kept appearing around his waistband, on his back, face (forehead, temples, chin), behind his ears, and on the back of his neck. We went to his doctor who said they looked like chigger bites but he always works in the yard and is very active and has never been bitten in his yard by chiggers. They itch, are crusty and burn. He has no other symptoms other than skin related, no fever, chills, night sweats, abdominal pain, nausea, vomiting, headache, sore throat, etc. Could this be something other than chigger bites, i.e. pityriasis rosea?

Follow up: Dr. Dr. Kakkar (17 minutes later)

I uploaded several pictures also.

Follow up: Dr. Dr. Kakkar (8 minutes later)

Also to note, he just started on the lisinopril 06/26/2020.

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Regarding itchy, eroded patches

Detailed Answer:
Hello and welcome to ask a doctor service. I have gone through your query and viewed the images.

No, this is certainly not Pityriasis Rosea (PR) which presents as dry, scaly patches predominantly on back and trunk, not so itchy and not eroded or crusty. This is most likely either some insect bites which has got infected or it could be Neurotic excoriations.

Hope I have answered your query. Let me know if you need any more assistance

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (1 hour later)

What is the best thing to do to get it to heal? He is using Neosporin on them and also taking penicillin?

Follow up: Dr. Dr. Kakkar (35 minutes later)

He does have a very grown up piece of property next door to him that is causing him to have a lot of bugs in his house. He has found many tiny black winged bugs but the bites itch so bad and ooze he is constantly cleaning them (not picking at them) and they are staying inflamed. His doctor only gave him the 1 shot of Kenalog which seemed to help and the cream. If you looked at the images, can you tell me what the single spot on his back looks like? That is not a bug bite and my thought was some type of skin cancer. It is photo 0000.jpg.

Answered by Dr. Dr. Kakkar (19 minutes later)

Brief Answer:
Regarding infected/ oozing spots

Detailed Answer:
hi.
The spot on back seems to have got infected, the reason this and other spots may have been oozing and crusting. I suggest him to take a week or 10 days of oral antibiotic e.g either Amoxicillin or Cephalexin. In addition he may use a topical antibiotic e.g either Neosporin ointment or Mupirocin ointment, twice daily. I would also suggest an oral antihistamine e.g either cetirizine 10mg tablet once a day and/ or hydroxyzine 25mg, 3-4 times a day to suppress itching. These medicines would require a prescription.
Take care.

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Above answer was peer-reviewed by : Dr. Nagamani Ng