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What Causes Redness Around Skin Lesions Despite Medication?

Posted on Wed, 5 Aug 2015

Question: Hi doctor pfa my pics .. I have using clotrimizolnfor 5 days now pleade tell me what you think .. I also want to ask you is this reddening any different from that caused by hiv? Another doctor also ruled this as an hiv symptom but obviousky i will still get tested.. Have respinded to your email looking forward to meeting you.. Anxiously waiting for response

Answered by Dr. Dr. Kakkar (12 hours later)

Brief Answer:
Continue with antifungal cream

Detailed Answer:
Hi.

I have reviewed the Images.

Skin lesions have almost resolved and it looks fine. I suggest you to continue with the topical antifungal cream for 2 more days.
I cant see much of redness. Minor redness is not a concern at all. It will resolve. I don't attribute minor redness to Hiv infection. Anyways, you can take an HIV test at 4 weeks for confirmation.
If there is too much of an anxiety I suggest that you take help from a psychiatrist.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (18 minutes later)

Ok doc.. Thanks but the redness does increase sonewgat the evening.. These pics were taken in the afternoon ..does that change anything ??

Answered by Dr. Dr. Kakkar (9 hours later)

Brief Answer:
Mild redness is nothing to worry

Detailed Answer:
Hi.

No it does'nt.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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

Ok sir and what about this pic pf my toenail..my toenail did break last year and new one grew but see this sir again does this indicate anything serious

Answered by Dr. Dr. Kakkar (12 hours later)

Brief Answer:
Toe nail Onychomycosis; I suggest a KOH nail clippog test to confirm

Detailed Answer:
Hi.

I have reviewed the Image. The nail appears discolored and friable. This is fungal infection of toe nail/ onychomycosis.
You could give a sample of nail i.e nail clipping and submit in a laboratory for KOH nail clipping test and they would tell you whether the nail clipping shows fungal elements or not.
If KOH nail clipping reveals fungal elements I would suggest an Oral antifungal e.g terbinafine tablet for 2-3 months and that should make it fine.

Dr. Kakkar.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (2 hours later)

Onychomycosis a symptom of hiv?

Answered by Dr. Dr. Kakkar (46 minutes later)

Brief Answer:
Only Proximal subungual onychomycosis is asociated with HIV

Detailed Answer:
Hi.

A particular type of onychomycosis i.e Proximal subungual onychomycosis (PSO) is associated with HIV and immunodeficiency. Not the one that you have. You have distal subungual onychomycosis (DSO)

DSO type of Onychomycosis is otherwise fairly common in general population and is not a clue to suspect HIV unless onychomycosis is of PSO Variety.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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

Thanks a lot sir i have gotten testing lined up after 2 week and 4 week mark. Just one question would the antigen abd antibody test detect both hiv 1 and 2? What tests to cover two types of virus

Answered by Dr. Dr. Kakkar (20 hours later)

Brief Answer:
Anitbody test for both Hiv- 1 & 2 at 4 weeks and repeat at 3 months

Detailed Answer:
Hi.

Hiv-2 is not included in the p24 antigen test. Antibody based test looks for both hiv 1 and 2 types. But p24 antigen only looks for HIV -1 type and not the HIV-2 type.

Since P 24 antigen test is the earliest to become positive at 2 weeks therefore in those who are infected with Hiv 2 may have a false negative p 24 antigen result at 2 weeks. Antibodies don't appear at this stage.
However those infected with Hiv-1 may show a positive result at this stage for P 24 antigen.

In most of Hiv infected individuals antibodies against Hiv appear by 4 weeks. Therefore it is important to test for both antibodies as well as p 24 antigen at 4 weeks to cover for both types of viruses.

However, In a very few number of Hiv infected individuals antibodies may not appear at 4 weeks. In these very few individuals antibody based tests may be false negative at 4 weeks.
However, in all of those infected antibodies appear by 12 weeks.
Therefore, a 12 week antibody based test is considered the most reliable in ruling out both Hiv 1 and 2 types.

You may take both P 24 antigen test at 2 weeks followed by P 24 antigen test and antibody test at 4 weeks and an antibody test at 12 weeks.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (3 days later)

Hi doctor i went to a prominent urologist in new XXXXXXX and he examined everything and told me not to worry and get off the internet. He also suggested i stop using the cream now since it is fine. I will get a test done after 3 months but hes put mevat ease. I am attaching a picture of my right foot i think ot was just some bites. The doctor said it was nothing to worry about just wanted to know your opinion specially from the point of view of any potential std

Answered by Dr. Dr. Kakkar (11 hours later)

Brief Answer:
Kindly upload again

Detailed Answer:
Hi.

Good. However I have not recieved the Image. Kindly upload again.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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

Hi sir pfa

Answered by Dr. Dr. Kakkar (12 hours later)

Brief Answer:
Insect Bite Hypersensitivity

Detailed Answer:
Hi.

I have reviewed Image. This seems like an Insect bite. Not related to an STD.

You may use a topical steroid cream e.g Betamethasone valerate 0.1%+Neomycin 0.5% cream, twice daily.

An Oral antihistamine e.g cetrizine 10 mg once daily for symptomatic relief from itching.

Regards

Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar