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Q. I have Asperger syndrome, OCD, anxiety, and depression. Kindly help.

Answered by
Dr. Shanza Ikram
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Jul 23, 2019 and last reviewed on: Jul 29, 2019

Hello doctor,

I am 30 years old male. Weight is 107 kg, and height is 5'9. Not under any medications. (Not been on any medication for over a year previous medications include numerous mental health medications, various SSRIs, Clomipramine, and several anti-psychotics, most recently Olanzapine). I tried Lymecycline a couple of years ago and multiple creams for acne in the past.

I have a history of mental health problems. I have a diagnosis of Asperger syndrome, OCD, anxiety, and depression. My anxiety levels have been chronic for many years due to the severity of my obsessive thoughts and compulsions etc. I think that my poor mental state has impacted on my health. I have had severe skin problems since I was about 17 or so. I get huge cysts that often recur in the same place with large boils. I have some large permanent cysts. I seem to break out at certain times.

I also have a condition known as a functional neurological disorder. I will be seeing a neurologist here in the at a movement disorders clinic to deal with this in the near future. I also developed eyelash ptosis, where my eyelash in my right eye keeps growing long. My Ophthalmologist told me that it needs to be trimmed regularly with scissors or that I have to use curlers, as it can impair my visual field. The neurological or psychological aspects may be affecting my other conditions.

I have had athlete's foot for the past year. Due to my mental or neurological problems and depression, I have been housebound for most of the last year. I tend not to shower much or brush my teeth due to this (but I am trying to change my life with the help and change this). I walk around in my bare feet in the house most of the time, and when I do go out, I tend to wear crocs.The athlete's foot has become more itchy or burning recently. Also, for the past year or two, I have two fungal nails. My big toes on both feet are very yellow looking at the front of the pins (I have ingrown nails in the past). What I am concerned about is my fingernail.

I do not know how I did this? About two weeks ago, I noticed that my middle finger on my right hand was very painful when I touched it. I cannot remember if I pulled the nail, and this has caused some infection, or if it is related in some way to the fungal nail infections on my toes or my athlete's foot.I will show you some pictures, and I would like your advice on what to do next. Due to my mental state, I have not taken good care of my body, but I am trying to address this.

My athlete's foot is entirely wrong. If I start treating this with cream, I am likely to see an improvement. Also, what can I do about the fungal nails? I also have a pilonidal cyst on my tailbone. It was initially very painful to sit down (I am overweight, spend a lot of time sitting at my desk, etc.). This cyst is intermittent, but there are times when it can be very itchy. As you can see, I am not in the best shape, but I am trying to address both my mental health and my physical health by starting to take better care of myself, eat better, exercise, etc.The main concern is the fingernail. Do I have an infection? Can it be serious to blood flow/losing limbs, or is this my anxiety and the things I've read on Google. I am quite concerned. I cannot see a doctor for another week or two. I have had this fingernail problem for about two weeks, and it is very sore and very red.

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Hello,

Welcome to icliniq.com.

I have gone through your case and all treatments which you have taken so far. It is good that you have explained all your medical history as every doctor should know it in detail. However, your finger infection is not related to history. It is a new event. Regarding your finger, you need nothing to worry as it is an infection of the skin, and your finger will not go away. In my opinion, this is not a fungal infection. It is a bacterial infection. I can very well understand that it must be very painful for you as it is entirely red. You need some oral medication for its treatment.

1. Take capsule Amoxil 500 mg three times a day for seven days.

2. Take tablet Ibuprofen 400 mg two times a day for seven days.

3. Apply Pyodine solution or Fucidin acid cream two times a day for seven days.

Thank you doctor,

I imagine that I will be able to see a GP in the next week or so. In the meantime, while I am at home, is there any home remedies I can take. Will tea tree oil cream work? What about Daktacort (this is an old cream I was given in the past for something else)? Is it possible that the infection will heal on its own in time? Will soaking it in warm water help draw it out also is it safe to get a hot needle to pop it or will this make things worse? Is this like a hangnail infection maybe I bit my fingernail?

I should be able to see a doctor within the next five or six days. In the meantime, before I can access antibiotics, is there anything I can do at home to help myself? Are there any warning signs that I should look out for that might indicate any problems? What should I do about my athlete's foot and yellow toenails will Daktarin cream help the athlete's foot? How long will it take for athlete's foot to improve if I apply the cream?

#

Hello,

Welcome back to icliniq.com.

Please do not apply Daktacort on your this infection as it is meant for something else. As a home remedy, Povidone solution is antiseptic and readily available everywhere as an over-the-counter medicine. Please apply it with cotton on it. Regarding warning sign, this looks if the size of lesion increases rapidly.

Thank you doctor,

Could this be paronychia? If so, is this infection likely to cease, or can it last for a long time without treatment? Is it possible that my doctor or hospital might perform an incision and drainage or is this usually not necessary? Is the worst-case scenario that one could lose their nail? Do I not need to be worried about blood flow issues or missing limbs, or is this my health anxiety or OCD worries? This is my final question. Thank you very much for all of your great help.

#

Hello,

Welcome back to icliniq.com.

Well, it is acute paronychia and requires oral antibiotics as early as possible. The pyodine solution will help you a lot in case you do not get antibiotics in your country. Apply it two to three times a day. The good point is that most of the time, acute infections like paronychia heals without any loss or any damage.

Do not panic by word paronychia as paronching is just a medical term for nail fold infections. Do not worry about flow to your limb. Paronychia does not obliterate the blood flow. Regarding incision and drainage yes, it can be done if the infection starts spreading.


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