Brief Answer:
Possible causes explained and advises given

Detailed Answer:
Hello,
Thank you for asking at healthcaremagic.

I carefully read your question and understand your concern.

The ear lobule being red and feeling hot might be due to 3 possible causes:
1. The exposure to cold, normally this would have caused symptoms in both ears and should settle in a couple of hours. If the ear is still having the symptoms than probably as you say it is less likely to be due to cold temperature exposure
2. infection of the lobule- in this case you would have the swelling, rendess and pain also other than feeling warm. You might also develop fever if you develop infection of the ear lobule. In case you have pain (infection should cause pain- if no pain than infection is less likely at the moment) than you will need to talk with your doctor and get the treatment on time as infection in the lobule can easily spread in the cartilage of the ear and cause damage of it.
3. if there is some itchiness other than the swelling and local warmth than eczema or similar conditions might be considered. Just keep the area moisturised in this case and watch it. In case of not being improved in a couple of days or early if any worsening you will need to see your doctor.

So to conclude:
- if you have pain other than the swelling and you have redness and local heat and especially if you are developing fever than these are typicall symptoms of ear cellulitis and you will need oral antibiotics (example augmentine if you are not allergic to it)
- if no pain and no fever but just mild swelling and local warmth than you can just watch it for a while and see a doctor if no improvement in a couple of days or earlier if any new symptoms or worsening.
- if local warmth, swelling and itchiness is present without pain or fever than keep the area well moisturized and watch it.

I hope this is helpful and answers to your question but please feel free to reply in case anymore clarification is needed on this.

Kind regards,
Antoneta Zotaj, MD

---

Brief Answer:
Pictures seem to not have been uploaded... please try again.

Detailed Answer:
Hello,
Thank you for the reply.

I noticed that again the pictures are not uploaded as i can't see them.
Can you try to upload them again so i can access them?
You can also send them at YYYY@YYYY and address it to my name: Dr Antoneta Zotaj.

Waiting for your reply with the uploads.

Regards

Antoneta Zotaj, MD

---

Brief Answer:
Pictures show local swelling so no need to rush and have any treatment at the moment but watch it

Detailed Answer:
Hello,

By what I can see in the picture it is a localized swelling at the lobule and the rest of the ear doesn't seem to have been affected. This is very good and in a way does give you some time to just watch it.

I would not do anything at the moment but just watch, please don't pick it either.
If the swelling spreads or gets painful than you will very likely need antibiotics.

So, I would say just relax at the moment and no intervention, very likely it will go away in the next 2 days on its own, otherwise, a medical examination is needed.

I hope this is helpful and answers your question but please feel free to contact me in case any questions related to this.

Regards

Antoneta Zotaj, MD

---

Brief Answer:
Please see the answers under each question

Detailed Answer:
Hello again,

Thank you for your reply. Please find the answers under your question:
1. Do I still need to apply Betaderm, Fucidin?
As long as you take clindamycin oral than you are safe to use steroid on the arm (steroids might worsen bacterial infections as they reduce body reaction to the bacteria but if you are getting clindamycin orally than that is taking care of the possible infections and steroids will help reduce the swelling and rash)
2. Do I still need Benadryl?
I don't think benadryl is helping unless you have intense itchiness locally at the arm. It still does not help a lot with that either and might make you drowsy.
3. Can I moisturize the rashes so they don't crack,winter almost?
4. Would Clindamycin, if it works, correct rashes on left forearm And left Ear? Or just one of them?
Clindamycine is a very good antibiotic for skin infection and will cover very well both the arm and the ear if there is bacterial infection in them.
5. I have been eating plain Yogurt exclusively, is that bad? What else should I take to avoid AB side effects?
It is good you are taking yogurt, it has a great effect for the bowel while you are on antibiotics.
To avoid the side effects of the antibiotic (clindamycine can kill the bowel bacteria also and cause diarrhea and the worse scenario would be colitis due to antibiotics so taking yogurt and some oral probiotics might be advisable. You can take 1-2 bottles of probiotics (lactobacilli) a day while you are on oral antibiotic and a couple of days after that.
6. Any other advise you can give me is appreciated:
I agree with your doctor that if no improvement in 48 hours of starting the antibiotic you will need to go to have another visit with your doctor or ER. If any worsening or new symptoms, especially if you start problems with bowel, please see the doctor earlier (as soon as possible).

Because you are having a long history of infections that seem to be hard to resolve you might need to consider having a general check to see how you are doing. These general health checks would be: CBC, ERS, glucose levels, lipids, liver tests (ALT, AST, Bilirubine), kidney tests (creatinine, electrolytes), HIV, HepB, syphilis, and if you think you have been exposed to sexually transmitted disease risk i would also recommend being checked for chlamydia and gonorrhea. The doctor might alter this list by adding or removing some tests to it but it is important that you discuss it with him.

I hope this is helpful and answers to your question but please feel free to contact us in case anymore clarification is needed on this.

Kind regards,
Antoneta Zotaj, MD

---

Brief Answer:
Questions answered one by one- see below for details

Detailed Answer:
Hello,

Please see the answers after the questions:

1. To make sure, by 48h it means 8 Clindamycin pill? I'm making sure I'm taking one every 6h.
48 hours means, 48 hours from the start of the first pill which by calculations means when it is time to take the 8-th pill.

2. If it works will the rash be noticibly smaller on its own, without using the betaderm, within 48h. It sounds like the betaderm might have caused an infection to spread. And if not taking it is safer...
I am nor sure the betaderm is helping, i probably would not have prescribed it, on the other hand i feel a bit relaxed as you are already using the antibiotic to help with bacterial infection.

3. Is moisturizing the rashes counterproductive?
if the area is moist, you don't need to moisturize it. If the area gets dry and scaly maybe keeping it a little moist is helpful to not cause the skin to break due to being dry


4.The pharmacist told me to eat yogurt 2h after taking Clindamycin. Is this agreeable? Having yogurt every day is good, no necessarily directly after clindamycine.

5. Can you give me an example product of a single use probiotic in bottle form? I saw a lot of products labeled probiotic but most of them are in big jars of pills.
Lactobacilli (probiotics) come in different brand names. In some places they can come with small bottles single use. I would say it is ok to take pills of probiotics or the big bottles if these are the only ones available in your country and ask the pharmacist on the dose. They have the same effect as the single use small bottles i mentioned.

6. How long normally would a side effect, if any, be noticeable after the first dose? It's been 3 dose so far, 18h, and I think I'm not feeling any so far.
Generally you would not see an effect the first 24 hours but after the first 24 fours and within 48 hours (it is ok not to see an effect within the first 24 hours but should notice it within 48 hours. You should not get worse within the first 24 hours though)

I hope this is helpful and answers to you but please feel free to let us know for any concerns related to this.

Kind regards,

Antoneta Zotaj, MD

---

Brief Answer:
Go on with the antibiotics please, explanation provided

Detailed Answer:
Hello,

If you noticed that the rash is a lot thinner and less painful than before than this is a good improvement and means that antibiotic is helping. Because you don't have side effects from the antibiotic you need to go on using it and take the full-length treatment prescribed.

You have noticed some improvement within 2 days (as you should) but total healing takes at least one more week. As you already mentioned, after the infection, the damages to the skin need their own time to heal.

If you think the ears are not improving it is a good idea to see your doctor about that especially if it is painful other than red and swollen.

As for the fatigue, I think is not directly related to the antibiotic, some stress or even the infection itself and Benadryl, all combined can add to feeling fatigued.

So go on with the treatment full length (generally 7-10 days) and see your doctor as already planned especially if your ear lobule is painful.

I hope this addresses your concerns but please feel free to contact us if you have any further questions related to this.

Kind regards,

Antoneta Zotaj, MD

---