Why do I have new, raised, itchy bumps at age 69?

Question

Hello doctor,

I am a 69-year-old female, I weigh 152 pounds, and my height is 5 feet 9 inches. I was diagnosed with atopic eczema two months ago and was treated with steroid cream. This has improved, but I have had two bouts of athlete's foot, one of which was infected, and I had antibiotics.

Now, I have some small raised areas on my legs, arms, shoulders, and hands. It was not itchy initially, but now it is. It does not seem the same as the previous eczema.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can read and understand your concern.

It appears to be erosive pemphigus foliaceous.

Please answer the questions below to arrive at a definitive diagnosis:

Do you have a fever?
What is your drug history?
Do you have difficulty breathing?
Do you have oozing?

Kindly revert with the answers.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I have read your query and can understand your concern.

Differential diagnoses are atopic dermatitis, scabies, and vesiculobullous disorder (an autoimmune disorder) with a secondary bacterial infection.

I would suggest you clean the area with a Povidone-iodine solution and a cotton gauze piece twice daily for two weeks.

Do not worry, it is a benign condition of long duration. Supportive therapy is needed, and local skin care of lesions is of utmost importance.

Daily bathing with Ketoconazole Cetrimide soap or Permethrin soap is essential to maintain proper hygiene.
Apply Fluticasone Propionate and Mupirocin ointment twice daily for two weeks.

Consult your specialist doctor, discuss with him or her, and take the medicines with their consent.

Additionally, do not scratch or rub the lesions. Keep checking on sugar levels, monitor pulse rate and blood pressure, and get routine blood workups done. Also, answer the questions below for further treatment details.

What are the possible triggers? Stress, heat, sun, or certain harsh topical creams?
Since when did it appear?
Was there any similar episode in the past?
Are there any similar complaints in the family or with the partner?
Is there night aggravation of itching?
Is it tender to touch?
Is itching present?
What is your occupation?
Are you a known case of diabetes?

Kindly revert in case of any other doubts.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Thank you for the follow-up query.

As per your above-mentioned history, it appears to be scabies in clean. The presence of acute onset, pruritus usually sparing the face in adults with nocturnal exacerbation, similar complaints in close contacts, and typical distribution of excoriated papules suggests a diagnosis of scabies with a papular urticarial rash.

I would suggest you take the following measures:

Apply Betamethasone and Fusidic acid cream at night for seven days (on lesions).
Use Cetrimide soap or Permethrin soap for a bath for two months.
Keep fingernails short.
Wear loose, comfortable, thin cotton clothes.
Use an air conditioner in summer.
Showering or bathing in cool and lukewarm water, as hot water can be drying.
Do not scratch or rub the lesion.
Apply five percent Permethrin cream on day one and day seven (repeat next week).
Take tablet Ivermectin 12 mg once a week for two weeks.
Maintain proper hygiene, as hygiene plays a very important role in avoiding recurrence or remission and Relapse.

I hope this helps you.

Please let me know if you have any other concerns.

Thank you.