Brief Answer:
Please answer and post the photos

Detailed Answer:
Hi XXXXXXX,

You said that you have skin lesions at various parts of the body. The lesions are itchy. The scrotal skin is involved,it is red and swollen. The disease is for two weeks. Your itching is not stopped.

With this much history, I feel that you may be having prurigo simplex. But still, I would like to ask few questions.

- what are doing? Study or else.

- do you have any other skin disease or systemic disease?

- Family history of skin disease or systemic disease?

- past history of similar or other disease?

- any treatment you are taking?

Please answer and post the photos of affected parts of the body, so that I can help you in better ways.

You may take antihistaminic like levocetirizine 5 mg thrice a day to relieve itching.

Waiting for your answer.

Thanks.

Dr. Ilyas Patel MD

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Brief Answer:
Prurigo simplex

Detailed Answer:
Hi,

Welcome back,

It seems that you may be having prurigo simplex. It is a disease characterised by symmetrically distributed, small, intensely itchy, dome-shaped papules. Sometimes there may be tiny vesicles. They are most numerous on the outer aspects of the limbs and buttocks, but may occur anywhere on head and neck, trunk and limbs.It is generally considered a sensitivity reaction to insect bites and stings, fleas, mosquitoes and bedbugs being most commonly responsible for it. You consult dermatologist for firm diagnosis.

Most treatments are somewhat disappointing in their lone efficacy and a trial of several treatments may be needed in individual patients; use of combination therapy may improve outcome in individual cases.

I would like to advise following treatment if you were my patient...

1) Apply Emollients to cool and soothe itchy skin; menthol may be added to supplement this effect.
2) Steroid cream like mometasone cream may be used to decrease inflammation and pruritus and to soften and smooth nodules.Response is often variable.
3) Phenol and local anaesthetic creams have also been found to be helpful.
4)Calcipotriol ointment is sometimes more effective than topical steroids.
5)Capsaicin cream induces itching and burning and ultimately may stop itch. It requires repeated applications 4-6 times daily.

Systemic drugs may be taken as below..

1) antihistaminics like levocetirizine
2) steroid like methyl prednesolone in tappering dose
3) retunoids like actretin
4) gabapentin in severe itching, it may cause sedation.
5) anxiolytic drugs like fluoxetin or antidepressant like amytriptyline or doxepin

Avoid soap bath, you may use dettol for bath. Please relax, avoid stress and anxiety,you will be alright after thorough and proper treatment.

I advise you to consult dermatologist and have firm diagnosis and perfect treatment.

I hope this answer would be helpful to you.

Thanks.

Dr. Ilyas Patel MD

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