What can cause pain and an associated red colored patch?

Question

Hi doctor,

It is about two months that I have pain in the L5/S1 region. I also have a red patch at this region. The picture of which I have attached. It is a localized pain. When I bend forward or sit down it increases. But when I bend backward, I do not have any problem. The red patch does not itch. I have frequent urination, burning sensation before or after urination and occasional pelvic pain. I do not know whether the two problems are related or not. Currently, I focused on my back pain problem. I am waiting for an MRI (magnetic resonance imaging) which will be one month later. I have some questions to you as an expert in the field. What is the red patch at L5/S1 region? What can be the cause? What could be the source of pain at L5/S1 region? I am pleased for your advice.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your query. I have seen the attached photographs (attachment removed to protect patient identity) also. I understand your concern. The possibilities for the red patch on your back are lichen simplex chronicus and tinea corporis. Lichen simplex chronicus is characterized by hyperpigmented patch with roughened skin. Tinea corporis is a fungal infection of skin and characterized by red colored scaly rash. Treatment depends on the diagnosis:

I prefer to advise topical steroid like Mometasone for lichen simplex chronicus.
For fungal infection of skin, oral and topical antifungals like Fluconazole and Clotrimazole cream is advised.

For back pain you visit an internal medicine specialist in person for physical evaluation.

Thank you for consulting me.

You can always reach me at icliniq.com.

Answer 2

Hi,

Welcome back to icliniq.com.

I read and understand your concern.

If you feel that the pain and rash are related then there is only one entity that fits into. In case of tubercular etiology specifically scrofuloderma there is involvement of skin in association with underlying bone involvement. Your MRI (magnetic resonance imaging) scan would help in confirmation of diagnosis. In atypical cases, skin biopsy is done to confirm the clinical diagnosis. You can share my opinion with your doctor.

Looking forward to your response in order to help you.

Thank you.