Brief Answer:
A clinical assessment and investigations needed for diagnosis

Detailed Answer:
Hi! Good morning. I am Dr Shareef, a general surgeon answering your query.

From your history, it seems to be a chronic infection of the sweat glands of the arm pit. Many times the infection is deep seated and is difficult to eradicate by the usual antibiotics.

If I were your doctor, after a clinical assessment I would advise you to get some routine blood tests like CBC, ESR and a blood sugar and also a cytological, gram-staining, and a culture sensitivity of the discharge from the infection in the arm pit. Depending on the reports I would advise you with an anti inflammatory along with a proton pump inhibitor and a broad spectrum antibiotic.

In case of no response, I would next go for some special investigations to rule out a chronic granulomatous condition, and if need be go for a small piece of biopsy from the edge of the lesion to have a histological diagnosis to proceed further. In this part of subcontinent, for this kind of chronic non healing infection I would have investigated the patient for tuberculosis as well, which might not be the case in the part you leave in.

If all the investigations do not point to any kind of specific diagnosis of a chronic infection, I would refer you to to a general surgeon who might advise you for the complete removal of the lesion by a surgery followed by a skin grafting of the area. This might give you a complete relief from this problem.

I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts.

Thanks for choosing health care magic to clear doubts on your health problems. I wish you an early recovery. Dr Shareef.

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