Circular Spots

[Tywais]

My wife asked me to look at her sister's arm for a diagnosis even though I keep telling her I'm not a medical doctor. She would like some idea of what it might be so she will be armed with some info when she takes her to the doctor tomorrow. It's on both arms and left leg.

The flash made it look redder then it really is, more darker brown. She says no discomfort, sometimes slight itching and dry. The annoying part is that she has had it for 4-5 months and never said anything. In the picture it looks somewhat like eczema but the spots are more brownish. Any ideas?

[whatsoever]

My wife asked me to look at her sister's arm for a diagnosis even though I keep telling her I'm not a medical doctor. She would like some idea of what it might be so she will be armed with some info when she takes her to the doctor tomorrow. It is only on the left arm and left leg.

The flash made it look redder then it really is, more darker brown. She says no discomfort, sometimes slight itching and dry. The annoying part is that she has had it for 4-5 months and never said anything. In the picture it looks somewhat like eczema but the spots are more brownish. Any ideas?

Ringworm (nothing to do with worms) its a fungal infection easily cured by a cream bought at any pharmacy

[retiredusn]

My wife asked me to look at her sister's arm for a diagnosis even though I keep telling her I'm not a medical doctor. She would like some idea of what it might be so she will be armed with some info when she takes her to the doctor tomorrow. It is only on the left arm and left leg.

The flash made it look redder then it really is, more darker brown. She says no discomfort, sometimes slight itching and dry. The annoying part is that she has had it for 4-5 months and never said anything. In the picture it looks somewhat like eczema but the spots are more brownish. Any ideas?

Ringworm (nothing to do with worms) its a fungal infection easily cured by a cream bought at any pharmacy

Any idea on what the name is of the best cream available??

[britmaveric]

Def parasite - ringworm does sound probable.

[imaneggspurt]

Crop circles ! . looks like ringworm to me,.

[Tywais]

Thanks for your responses, not something I would have thought of or ever seen.

[Who, me ?]

You can try Dermovate...Works wonders

[Sheryl]

Another vote for probable ringworm

Dermovate is a steroid and while effective for eczema would be contraindicated for ringworm.

Clotrimazole cream, available under many brand names, for 10 days

If no improvement consult a dermatologist

[Tywais]

If no improvement consult a dermatologist

Thanks for the responses. My wife is taking her right now to both a dermatologist and a GP that I know.

[LaoPo]

If no improvement consult a dermatologist

Thanks for the responses. My wife is taking her right now to both a dermatologist and a GP that I know.

I´ll bet Sheryl´s advise is cheaper

LaoPo

[bina]

voting ringworm, although u never kown....

ringwormmeans check the kids also (mostly scalp areas) and launder all sheets etc very well; and check the house hold pets (cats are non systematic carriers but dogs get it)....

if te cream doesnt work, they'll put her on the stuff via oral.... it takes weeks to go away, and does go away by itself eventually usually if a person's immune system is up to par... but is contagiuos the whole time...

bina

[eek]

Looks exactly like the circular spots that developed on my arm around a year ago here, and yes, was diagnosed as Ringworm and given a steroid cream. Cleared up pretty fast after using the cream (sorry cant remember the name). I guess the reason she has so many is because she has left it so long. When i got one small spot, i thought it was nothing and it would go away on its own (silly me i know). But over a little time it got a bit bigger and then another one developed, so realised it needed attention.

Definitely looks like ringworm as so many have said. Once she gets the cream, should clear up fast. Good luck.

Wonder how is ringworm 'caught'.. guess i will go google that one now..

[britmaveric]

Pets, undercooked meat for starters.

[Tywais]

She just returned from the clinic of the GP, didn't have time to see the dermatologist but will tomorrow. Not sure what's up because the doctor took a blood sample and sent it to a lab for testing. The results will be back Monday.

[bina]

wierd cause if he thought it was ringworm he would do a scraping ... but who knows....

now u got my curiosity up

and brit: u dont get ringworm from undercooked meat. ringworm is a fungus , mostly cats are carriers but also just lays around in the earth.... although u can get other nasty parasites from undercooked meat...

maybe u are thinkin of roundworm or tape worm....

[britmaveric]

Quite correct - confused tapeworm with ringworm

[Tywais]

An update on this. The sister in law will go tomorrow for results of the blood tests. However, after talking to my wife and digging deeper she said the doctor mentioned SL something and is an immune deficiency and that a popular Thai female folk singer died of it. Taking that information on my research hunt found Lupus or SLE (Systemic Lupus Erythematosus) appears to be what he is talking about. A version of it that exhibits skin conditions only is DLE and if it has to be lupus, hope it is this one which is generally non-fatal.

Needless to say, we are all very concerned at the moment.

[Who, me ?]

a friend of mine suffers from "the wolf" for years. She faces some flares from times to times, which brings skin rash, mood swings, menstruation troubles, headaches...she also feel the Need to rest, in a quiet dark room....When there is no flare, she lives a normal life.....

Hope your relative will be OK.....

[Tywais]

I know this is a 3 year old topic but wanted to bring it up to date. After all this time she still has this problem but worse. She has gone to more than one doctor including a highly regarded skin doctor in Chiang Mai and talking to my wife trying to get as much detail as I can from them so I know what we are dealing with this is what I gather. Some information I gleaned from them that was important to further my research was it is an immune system issue, about 10% of Thais have it in various degrees and it is a life long disease. This pointed to Psoriasis and based on the photos on the Internet shown to my wife pretty much verifies it. I'm waiting for actual doctor reports to be given me to evaluate.

I didn't realize Psoriasis could be that bad, I always thought of it as an occasional dry skin on the hands or scalp. She just went in for a battery of tests which includes blood panels, stool and urine exam, xrays and some others. The ointments & meds have not helped much and they want to try and determine a better prescription.

I've looked up homeopathic/home solutions to see what alternatives there are to traditional medications. A lot of places show people having good luck with apple cider vinegar with baking soda both internal and applied. Some talk about pure coconut oil and even Acupuncture. One treatment by western standards was light therapy and being in the sunlight more often can help.

Just wondering if anyone has or knows someone with this condition and if they have found solutions to reducing the symptoms. Apparently there is no cure as researchers are still not clear as to the exact cause of it.

Thanks.

//edit - symptoms are as shown in the photo but now the skin areas scale, itch and sometimes painful. Its on her neck, arms, legs and torso (that part my wife informed me).

[Sheryl]

I think you need to get the diagnosis pinned down first. Psoraiasis is common in Thailand but not I think to the point of 10%

Lupus is another possibility, there are dermal forms, and it is definitely an auto-immune disease and comparatively common in Thailand (although certainly not 10%, more like 1%).

Lupus and psoriasis as poles apart so need to be clear what you're dealing.

[Tywais]

I think you need to get the diagnosis pinned down first. Psoraiasis is common in Thailand but not I think to the point of 10%

When I showed my wife the Thai word for psoraiasis she lit up and said 'Yes, that's it!'. So believe that is the actual diagnosis from the doctors. My wife is going to give me the doctor's reports after the testing is completed. I saw that 7.5 million people in the US have it to certain degrees which is around 2% so perhaps the 10% was a misunderstanding or exaggeration.

Just found a research paper on it. So appears between 1% to 4%. http://www.eurojournals.com/AJSR_38_03.pdf

There are from six-hundred and sixty thousand to two million psoriasis

patients in Thailand and five thousand to fifteen thousand patients in Chanthaburi province (it was the

second most common skin disease found in Prapokklao hospital dermatological clinic in 2007).

[Sheryl]

Yes, it is comparatively common in Thailand.

it tendsw to affect skin that doesn't get much sun exposure so the Thai fondness for keeping the skin as white as possible may play a part.

In fact one of the oldest treatments for this is a combination of application of coal tar and sun exposure.

This is a good source of general info on the condition

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001470/

[Tywais]

Things just got seriously worse. The initial diagnosis for psoriasis was wrong and from what I've read it is a common misdiagnosis due to the similarities. A biopsy was performed and the diagnosis now is T cell lymphoma (specifically Mycosis Fungoides), in other words - cancer. This is about 3 1/2 years after first symptoms and seems about the time frame that doctors start considering it to be something else. I've researched about a dozen sites on this and it doesn't look good and there is no cure, just symptom relief and methods to try and stop/slow it down. Below is the pathology report of the sister which my wife wants me to explain to her. Her sister is 36 years old.

Difficult to pick out the prognosis from the various websites as there are many different forms and stages. Not sure if anyone can help interpret the report or have experience directly or indirectly.

[Sheryl]

The pending immunochemical histological studies will help confirm if it is indeed mycosis fungoides.

If this is what she has (and it likely is from the biopsy report) then it is a cutaneous type of T cell lymphoma. While certainly a serious disease, the prognosis is better than for non-cutaneous T-cell lymphomas, especially if there are no actual tumors present on the skin. Make sure anything you read refers to cutaneous T-cell lymphoma as the non-cutaneous types have a terrible prognosis.

What percent of her total body surface seems to be affected?

The Cutaneous Lymphoma Foundation is an excellent resource:

http://www.clfoundation.org/

In the last few years they have been some encouraging results with chemotherapy using the drug gemcitabine, although its use is usually eserved for those in the late stages of the disease. The Derm dept at Siriraj has the drug and cos experienced in its use. If possible try to consult them: I'll work on getting exact bnames of docs for you & send by PM.

[Tywais]

I've been focusing specifically on both cutaneous T-cell lymphoma and Mycosis Fungoides in my research. My wife says about 30-40% coverage, mostly starting at the very top of the thigh and up the back, sides and front. Some large blotches on her legs and smaller on her arms. The doctor has broached the subject of chemotherapy to them but guess is waiting for further tests. The last two blood and urine tests, last one a couple of weeks ago showed no abnormalities and another test just taken and waiting results. I've been studying up on CHOP therapy but not sure if that is available or if appropriate.

I showed my wife Google images of Mycosis Fungoides and the below is what she says it looks like on one shoulder (top image) about 5 cm surrounded by a ring of 10+cm blotches and raised. The other is the rest of her upper body but she says much more.

She was in Chon Buri last month and the red blotches on her legs and arms actually started drying up and getting better but that is also when the large raised one started showing up. I heard about UV therapy and asked my wife to see what the doctor thinks about that for the other areas.

[Sheryl]

From what you describe and also the biopsy results she may be at or near Stage IIB. At which point chemo with Gemcitabine is probably indicated. Localized radiation is also sometimes employed, also alfa interferon.

She is in for a tough time. Average survival at this stage is about 3-4 years but of course that is an average, some people live much longer.

Bone marrow transplants improve survival in some cases.

It would be worth consulting some of the doctors I sent you the names of for expert opinion and also to see if there are any new clinical trials underway in Thailand.