Missdirected
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Just looked at your new pics... Go to the doc! That stuff does not look right. Where are you that you are so hesitant? Just wondering, do those things hurt if squeeze them?
Strange Bumps After Scape on a Wreck Dive
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They do hurt a bit if you press on them. Last month with round one I used a needle to release whatever it was inside and then they ceased to cause any pain. They also appeared to completely heal week after puncturing them until they came back two days ago.
I'm in Buenos Aires. I'm not hesistant I was just too lazy to find a dermatologist here knowing that like last time they'll probably heal by themselves shortly. I'll make an effort to try to see one Monday or Tuesday if I can arrange it. It still would be nice to have an idea of what they might be before going in.
I'm in Buenos Aires. I'm not hesistant I was just too lazy to find a dermatologist here knowing that like last time they'll probably heal by themselves shortly. I'll make an effort to try to see one Monday or Tuesday if I can arrange it. It still would be nice to have an idea of what they might be before going in.
Missdirected
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enortham:
Just go lazy bones :winky: Something is running through your system - get rid of it - that looks nasty
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Hi fisherdvm,
In his latest post, Eric says of his skin lesions, "They do hurt a bit if you press on them. Last month with round one I used a needle to release whatever it was inside and then they ceased to cause any pain. They also appeared to completely heal week after puncturing them until they came back two days ago."
As I'm not especially savvy in cutaneous HPV infections, I wonder if you could educate me regarding what type(s) of these warts contain vesicles or pustules that can be drained with promptly ensuing resolution (albeit with recrudescence a month later)?
Thanks,
DocVikingo
In his latest post, Eric says of his skin lesions, "They do hurt a bit if you press on them. Last month with round one I used a needle to release whatever it was inside and then they ceased to cause any pain. They also appeared to completely heal week after puncturing them until they came back two days ago."
As I'm not especially savvy in cutaneous HPV infections, I wonder if you could educate me regarding what type(s) of these warts contain vesicles or pustules that can be drained with promptly ensuing resolution (albeit with recrudescence a month later)?
Thanks,
DocVikingo
fisherdvm
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If he released "what ever inside them" and it is fluid, then HPV is not the cause. I mentioned it just because photos can be deceptive, as you can not determine depth as well as a dermatoscope.
No warts would contain pustules nor vesicles, but again, my question is in regard to the first photo. The second is suggestive of inflammatory vesicles and pustules.
My number one diagnosis at this time is herpes simplex virus. With the recurrence after remission, I think I would do a Tzanck smear in my office, and check for giant cells. A direct smear for flourescent is requested by some lab, but most will do a DFA on a scraping submitted in viral culture medium.
I think if we just focus envenomation.... we might miss HSV, which might have gotten in via other method... And the ocean injury might just have allowed a point of entry.
If the HSV smear is negative, I would push for the biopsy, and mycobacterium culture.
Again, my initial suspicion for HPV is based on a poor photo... Photos can be very misleading, so I rely on a scalpel to pare down the lesion or a dermatoscope....
No warts would contain pustules nor vesicles, but again, my question is in regard to the first photo. The second is suggestive of inflammatory vesicles and pustules.
My number one diagnosis at this time is herpes simplex virus. With the recurrence after remission, I think I would do a Tzanck smear in my office, and check for giant cells. A direct smear for flourescent is requested by some lab, but most will do a DFA on a scraping submitted in viral culture medium.
I think if we just focus envenomation.... we might miss HSV, which might have gotten in via other method... And the ocean injury might just have allowed a point of entry.
If the HSV smear is negative, I would push for the biopsy, and mycobacterium culture.
Again, my initial suspicion for HPV is based on a poor photo... Photos can be very misleading, so I rely on a scalpel to pare down the lesion or a dermatoscope....
fisherdvm
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Grouped recurrent vesicles equals herpetic whitlow....
I just don't know why I didn't think of it at first.
Suggest this to your doctor, so he'll get the right test... Herpetic whitlow occurs when your finger touches a herpetic sore on someone's lip, or genital, or your own coldsore lesion. It needs a wound to enter, so it might be from the original injury.
Treatment is with a pill. Famvir, Acyclovir, or Valtrex. If it keeps on coming back, a one time dose of 1500 mg of FAmvir (tough on your stomach) is enough to treat an early infection. For an established infection, I would go with 250 mg twice a day for 5 to 7 days.
I just don't know why I didn't think of it at first.
Suggest this to your doctor, so he'll get the right test... Herpetic whitlow occurs when your finger touches a herpetic sore on someone's lip, or genital, or your own coldsore lesion. It needs a wound to enter, so it might be from the original injury.
Treatment is with a pill. Famvir, Acyclovir, or Valtrex. If it keeps on coming back, a one time dose of 1500 mg of FAmvir (tough on your stomach) is enough to treat an early infection. For an established infection, I would go with 250 mg twice a day for 5 to 7 days.
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Hi fisherdvm,
"Grouped recurrent vesicles equals herpetic whitlow.... I just don't know why I didn't think of it at first."
Now we seem to be talking slightly more sensibily.
Is it common that unroofing such lesions leads to a cessation of discomfort and speedy healing, only to be followed by return two days after apparent resolution?
Thanks,
DocVikingo
"Grouped recurrent vesicles equals herpetic whitlow.... I just don't know why I didn't think of it at first."
Now we seem to be talking slightly more sensibily.
Is it common that unroofing such lesions leads to a cessation of discomfort and speedy healing, only to be followed by return two days after apparent resolution?
Thanks,
DocVikingo
fisherdvm
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DocVikingo:
I've heard of it being done by other dermatologists, shaving the vesicles off. Perhaps letting the inflammatory exudates extrude, the skin heal faster???
My preference is still oral antiviral. I find the one time dose not as good for established infection, as the standard (FDA approved) 5 to 7 days treatment.
I finally went to the doctor the other day but wasn't to convinced with her assesment. She first said that in the current state it looked fine, wasn't contagious, and gave me a little tube of aloe vera to clear up the rest. I then mentioned this post and how you recommended I get a biopsy of the bumps, which had more or less flattened out, in order to determine if was herpetic whitlow. I managed to get her to take a quick glance at the post but she couldn't of read more than one or two sentences in the time she looked at it and then prescribed me what I can best make out as Peutavir. I think now I'm just going to not do anything and just see if they come back and then go somewhere else to get a biopsy.
Please let me know if you have any other suggestions. Thanks for all the responses.
Please let me know if you have any other suggestions. Thanks for all the responses.
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Hi Eric,
It seems that your recent exam was cursory at best and it's uncertain how far you've advanced your search for a diagnosis and treatment. Very little, I suspect.
In any event, while I am not familiar with "Peutavir," it very likely is one of a class of medications that interfere with the replication of an offending virus. If so, you have little to lose by taking it as prescribed. It may decrease discomfort and speed healing to some degree, but don't expect any miracles.
Since the lesions seems to be spontaneously resolving yet again, your plan to see if they come back and then go somewhere else to get a proper evaluation seems a reasonable one.
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.
Regards,
DocVikingo
It seems that your recent exam was cursory at best and it's uncertain how far you've advanced your search for a diagnosis and treatment. Very little, I suspect.
In any event, while I am not familiar with "Peutavir," it very likely is one of a class of medications that interfere with the replication of an offending virus. If so, you have little to lose by taking it as prescribed. It may decrease discomfort and speed healing to some degree, but don't expect any miracles.
Since the lesions seems to be spontaneously resolving yet again, your plan to see if they come back and then go somewhere else to get a proper evaluation seems a reasonable one.
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.
Regards,
DocVikingo
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