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Suggest Treatment For Mouth Sores And Pimple Like Sores Throughout Body
Question: My son's lab rest results showed his mo% 7.4, eo% 16.4 and ba% 1.1. He has suffered with mouth sores and pimple like sores all over his body for the past month. His doctor just keeps giving him antibiotics. He has lost 20 lbs. Do you have ideas about what could be wrong or what kind of doctor he should see about this. He is 29.
Brief Answer:
Upload Images and Provide more details
Detailed Answer:
Hello. Thank you for writing to us
I have taken note of your query and I hope to help you regarding that..
His eosinophil percent count seems to be raised.
I would like to request you to upload a few digital Images of his skin lesions and mouth sores.
You may either upload them at "Reports Section"
Or else
You may also mail me the Images at YYYY@YYYY . Kindly mention the subject of this mail as Attn: Dr. Kakkar.
Also provide me more information regarding the query..
-Is there any history of fever? Or swollen neck glands?
-Is there any history of preceding drug intake prior to him developing skin lesions/oral ulcers?
-Is he sexually active?
Regards
Upload Images and Provide more details
Detailed Answer:
Hello. Thank you for writing to us
I have taken note of your query and I hope to help you regarding that..
His eosinophil percent count seems to be raised.
I would like to request you to upload a few digital Images of his skin lesions and mouth sores.
You may either upload them at "Reports Section"
Or else
You may also mail me the Images at YYYY@YYYY . Kindly mention the subject of this mail as Attn: Dr. Kakkar.
Also provide me more information regarding the query..
-Is there any history of fever? Or swollen neck glands?
-Is there any history of preceding drug intake prior to him developing skin lesions/oral ulcers?
-Is he sexually active?
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
No fever. I'm not sure about swollen glands. He has loss 25 lbs. He is tired but still manages to function. His internist says it is nothing. The oral surgeon said to stop all antibiotics. The allergist said to see an infectious disease doctor but made no recommendation for one, so on our own it will take about a month to get in to one. He was in Mexico when the first bout of mouth sores began. He went to a dermatologist at the time and began taking tetracycline. He did improve for a time but only for about 5 days.
He did not take any new medication and he is not sexually active. He is 48xxy and mildly developmentally delayed.
He did not take any new medication and he is not sexually active. He is 48xxy and mildly developmentally delayed.
Brief Answer:
Investigate for absolute eosinophil count.
Detailed Answer:
Hi.
I have reviewed the Image.. this looks like an aphthous ulcer on mucosal aspect of upper lip.
The points I can gather from the information provided are that he has mouth sores since past 1 month, feels tired, has lost significant amount of weight, his eosinophil percent count is raised and he is afebrile.
His raised eosinophil percent count should be investigated further.
I would suggest you to ask for an Absolute Eosinophil Count (AEC). This would tell his exact Eosinophil count whether it is a relative increase or it is an absolute increase.
After going through the history and symptoms and raised eosinophil percent count I would suggest a tentative diagnosis of Hypereosinophilic syndrome (HES) but this is pending his absolute eosinophilic count (AEC) report.
If AEC is above 1500 cells/cu. mm then Hypereosinophilic syndrome (HES) becomes a real possibility.
Regards
Investigate for absolute eosinophil count.
Detailed Answer:
Hi.
I have reviewed the Image.. this looks like an aphthous ulcer on mucosal aspect of upper lip.
The points I can gather from the information provided are that he has mouth sores since past 1 month, feels tired, has lost significant amount of weight, his eosinophil percent count is raised and he is afebrile.
His raised eosinophil percent count should be investigated further.
I would suggest you to ask for an Absolute Eosinophil Count (AEC). This would tell his exact Eosinophil count whether it is a relative increase or it is an absolute increase.
After going through the history and symptoms and raised eosinophil percent count I would suggest a tentative diagnosis of Hypereosinophilic syndrome (HES) but this is pending his absolute eosinophilic count (AEC) report.
If AEC is above 1500 cells/cu. mm then Hypereosinophilic syndrome (HES) becomes a real possibility.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What is HES? And, is a parasite infection possible? And, if so what would test, or rather what test would you suggest to rule out parasites? The oral surgeon will welcome suggestions. Thank you!
Brief Answer:
HES is just a possibility; Rule out parasitic infections if not already
Detailed Answer:
Hi.
HES is just a possibility. I just want your doctor to consider it.
I would also request you to upload an Image of the skin lesions that he has? Are they itchy? Does anyone else in the family has itchy skin lesions?
The raised eosinophil percentage should be investigated.
Of course it could be due to parasitic infections like intestinal worms Or it could be due to scabies, but how would that explain his Oral ulcers and weight loss and tiredness? unless it is a very severe worm infestation causing weight loss and oral ulcers.
Nevertheless, you can ask for a Stool test for Ova/ cyst..a test for intestinal worms.
Scabies can be ruled out by skin examination..
Once these are ruled out and if excluded, I would like to investigate further..I would suggest a total/ absolute eosinophil count/ AEC.
If AEC is raised above 1500 / cu. mm (normal count is less than 500/ cu. mm) and there is no feasible explanation for his recurrent oral ulcers and weight loss (as you say that previous doctors have not been able to find out the exact reason for his weight loss and oral sores) then the possibility of HES can be considered.
Basically HES is a diagnosis of exclusion i.e HES is a possibility only after these secondary causes(e.g worms and scabies) have been ruled out and it should be considered in a patient with generalized symptoms like fatigue, aches and pain; cutaneous symptoms like itchy rashes; Oral sores; cardiac and respiratory symptoms like breathlessness, cough etc when there is no plausible explanation for the symptoms.
Regards
HES is just a possibility; Rule out parasitic infections if not already
Detailed Answer:
Hi.
HES is just a possibility. I just want your doctor to consider it.
I would also request you to upload an Image of the skin lesions that he has? Are they itchy? Does anyone else in the family has itchy skin lesions?
The raised eosinophil percentage should be investigated.
Of course it could be due to parasitic infections like intestinal worms Or it could be due to scabies, but how would that explain his Oral ulcers and weight loss and tiredness? unless it is a very severe worm infestation causing weight loss and oral ulcers.
Nevertheless, you can ask for a Stool test for Ova/ cyst..a test for intestinal worms.
Scabies can be ruled out by skin examination..
Once these are ruled out and if excluded, I would like to investigate further..I would suggest a total/ absolute eosinophil count/ AEC.
If AEC is raised above 1500 / cu. mm (normal count is less than 500/ cu. mm) and there is no feasible explanation for his recurrent oral ulcers and weight loss (as you say that previous doctors have not been able to find out the exact reason for his weight loss and oral sores) then the possibility of HES can be considered.
Basically HES is a diagnosis of exclusion i.e HES is a possibility only after these secondary causes(e.g worms and scabies) have been ruled out and it should be considered in a patient with generalized symptoms like fatigue, aches and pain; cutaneous symptoms like itchy rashes; Oral sores; cardiac and respiratory symptoms like breathlessness, cough etc when there is no plausible explanation for the symptoms.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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