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dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 2851
Experience:  30 years practice in general and cosmetic dermatology
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60 something man with persistent discomfort, particularly on

Customer Question

60 something man with persistent discomfort, particularly on head/face. Pin prick sensations on limbs and trunk with tiny open skin penetrations where the pricking occurred.
It began in August when I initially thought it was prickly heat, possibly dry skin and also considered it might be a reaction to blood pressure medication. More recently I talked to a local pharmacist who amongst other suggestions raised the possibility of scabies. This worried me but I'm isure t's not that. There's no rash or tracks and only itching on head and face However, it prompted me to inspect skin more closely and I began to notice occasional blood specks appearing randomly in various places along with one or two raiised bumps on scalp and around face and neck.
I then decided to try permethrin 5% cream all over for 12 hours one week apart. I tried this treatment twice, the latest being over the last 2 weeks. Next day I picked several tiny dead bugs from my scalp and body. I was hoping the Permethrin would solve the problem, but although it reduced the severity of symptoms for a while I'm still getting pricking and new cuts appearing daily. I'd like to pursue the possibility of taking an oral medication such a vermectin as suspect there is some kind of life cycle going on that I can't eliminate with topical medication alone. I've got some 8x zoom pics. of tiny things that appear to be larvae removed either from the tiny cuts or from nearby skin. Also some slightly larger bugs or pupae which I found on me after the permethrin treatment.
These symptoms began during an extended time in the Scottish countryside in July/August. Lots of sheep, cattle, deer and biting insects in the vicinity. I also remember getting stung a several times in undergrowth whilst playing golf . Could this be the cause?
Assistant: How long have you been dealing with this? Do you notice any redness or scaling?
Customer: Since August. No rash just some bumps around face and neck and tiny cuts in skin elsewhere
Assistant: Anything else in your medical history you think the Doctor should know?
Customer: No. As part from A Fib and high blood pressure which m receiving treatment for
Submitted: 9 months ago.
Category: Dermatology
Expert:  the-good-doctor replied 9 months ago.

Hello. I'm The Good Dr., licensed and practicing physician. Excellent service is my goal.

Expert:  the-good-doctor replied 9 months ago.

still need help?

Customer: replied 9 months ago.
would like some advice please
Expert:  the-good-doctor replied 9 months ago.

can you list all your meds?

Customer: replied 9 months ago.
2x Apixaban 5mg
Bisoprolol 5mg
Ramapril 5mg
Amlodopine 5mg
Atorvastatin 10mg
Expert:  the-good-doctor replied 9 months ago.

could it be a med side effect?

Customer: replied 9 months ago.
Expert:  the-good-doctor replied 9 months ago.

could it be?

Customer: replied 9 months ago.
Thought about that but haven't had any new meds for over a year.
Customer: replied 9 months ago.
Hi, Are you still there?
Expert:  the-good-doctor replied 9 months ago.

I'm here

what is the main symptoms now?

Customer: replied 9 months ago.
Same as before. Mild but persistent irritation and random stinging with tiny cuts in skin. Some raised bumps on neck.
Expert:  the-good-doctor replied 9 months ago.

where is it located?

Customer: replied 9 months ago.
Holes are mostly on arms and legs. Scalp has some persistent tender lesions.
Customer: replied 9 months ago.
Apart from the Afib I've had no other issues till this happened
Customer: replied 9 months ago.
feel free to call if you can. I requested it earlier
Customer: replied 9 months ago.
From my initial description have you an ideas of what this could possibly be? It's a complete mystery to me and making me feel pretty depressed
Expert:  the-good-doctor replied 9 months ago.

do you have pics of the spots?

Customer: replied 9 months ago.
I've taken some of the spots plus some of what appears to be causing them.
Customer: replied 9 months ago.
How do I send them?
Customer: replied 9 months ago.
Sent 4.
1 showing ragged lesion with something half buried at bottom
1 showing a bump with what looks like tips of hooks protruding
1 showing tiny larvae on skin
1 after being removed with tweezers
Customer: replied 9 months ago.
Sounds crazy but Every time I examine a hole there is one of these things in it
Customer: replied 9 months ago.
Correction: not on skin but after removal from skin
Expert:  the-good-doctor replied 9 months ago.

I can't see the pics?