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Skin rashes for a patient with Pernicious anemia - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Blood Disorders
Answered by

General & Family Physician
Practicing since : 2009
Answered : 352 Questions
User :   Hi doctor im a 24 year old female who suffers from hypothyrodism and pernicious anaemia. I am currently taking 125mcg levothyroxine and 3monthly b12 injections. Ive had bloods taken recently and everything is stable. But 4 days ago i woke up in a rash starting from behind my ears travelling down my neck, chest, back,stomach and i do have a few red pimples on my arms and top of legs. The rash is red and a pimple like texture it is widespread. It manucpapular kind of rash (dont think that spelt right). Do you have any idea what this is? thanks
Doctor :   let me read ur query
User :   Hi wondered if you could help me :-) thanks
Doctor :   based on your history of pernicious anemia, the presentation of the rash could be due to low platelets
User :   ok i had a fbc done 4 weeks ago and everything was ok
Doctor :   when was the blood tests done ?
Doctor :   have u recenttly had any colds or flu ?
User :   and i had tft, ferritin,folate,b12 1 weeks ago everyhting was good
User :   no but i have been a tad under the weather
User :   tired
Doctor :   do u have any itching, or pain in the rash areas ?
User :   yes itching
User :   but im trying not to itch it
Doctor :   was a complete blood count done ?
User :   no just fbc
User :   i went to my GP yesterday who said it appears to be viral rash
Doctor :   was the blood counts normal ?
Doctor :   ok
User :   yes everything was normal
Doctor :   tiredness, is the most common and early symptoms of viral fever
Doctor :   rash can be due to viral associated skin damage, or due to weakness of the skin blood cappilaries ,
User :   its spreading down my body
User :   started behind the ears
User :   but i do feel ok in myself
Doctor :   you might benefit by blood test to check your platelet counts , just to make sure
Doctor :   the viral infections that present in this way include rubella, measles, and chicken pox
User :   it feels warm to touch
Doctor :   and most of these do go away within a weeks time, with symptomatic medications
Doctor :   yes, that is indicative of viral infection
User :   this is day 4
User :   seems to be getting worse
Doctor :   have u taken any medications ?
User :   yes antihistamines and paracetamol
Doctor :   have they helped ?
User :   the antihistamines helps me not to scratch but at night time i seems to be worse
Doctor :   in that case, try to take the antihistamines at night time
Doctor :   apply cold packs to the skin to sooth it
User :   thanks :-) should i use calamine?
Doctor :   and apply betamethasone cream , to the skin
Doctor :   calamine can be used too '
User :   i was worrying i got acne over night all over my body
User :   is that possible ?
Doctor :   if the lesions appear like acne, then they are most probably chicken pox
User :   they havent got heads on them
Doctor :   acne do not appear all over the body within a few days
User :   they are like red pimples
User :   some small small big
Doctor :   but they may change as the days progress
User :   ive had acne roscea in the past its not like that
Doctor :   have u had them on your body as well ( acne rosacea i mean ) ?
User :   no never
User :   just few on cheeks nose and forehead
Doctor :   ok , that is fine,
User :   it cant be that over night could it?
Doctor :   actually viral infections and acne are not similar
Doctor :   and acne do not present over the skin of the body
Doctor :   if they do, they are folliculitis ( infection of hair follicles), which may worsen to form furuncles
User :   ive actually got these pimples on my breast and nipples my family think it measles
User :   i do work in a doctors surgery so do have a lot of contact with ill patients
Doctor :   ok
Doctor :   that could be the way, u might have got the infection
Doctor :   have u ever had measles as a child
User :   unsure?
Doctor :   or have u been immunised ?
User :   yes been immunised
User :   mmr
Doctor :   ok
Doctor :   in that case, the chances of measles would be less
User :   it prob viral
User :   how long will it last?
User :   does it get worse before better?
Doctor :   yes it is definitely viral
Doctor :   it will last for 1-2 weeks
User :   how long should i be off work
Doctor :   by the end of 1 week, it will peak in severity
Doctor :   and then it will resolve
Doctor :   1 week rest and off work might be necessary
User :   ok
User :   how will i know if it contagious
User :   as i worrying about going back to work with poorly patients
User :   also i have only got a few on arms literally about 15- 20 pimples
User :   will this get worse?
Doctor :   if the lesions increase in no, and have purulent tops, they will indicate infectivity
User :   what is purulent tops like?
Doctor :   once the tops form the scabs, the infectiviity will reduce , and this will occur in the second week
Doctor :   its like yellowish tips of the pimple like lesions
User :   blimey there not many with scabs
User :   i must have 1000 pimples
Doctor :   they will be seen in the 2nd week
Doctor :   not in the first week
User :   do u think these will still spreak
User :   spread
Doctor :   yes they will spread, but only until the end of 1st week
User :   as i only have about 15 -20 on each arm and about 40 on each thigh none on the lower leg or feet or hands
Doctor :   the lesions will peak , by the end of the first week
Doctor :   and then they will reduce
User :   ok so ive not to worry that they are getting worse
Doctor :   yes
User :   and is it normal for heat to irritate them
Doctor :   they will improve soon
Doctor :   and yes, it is normal for heat to irritate them
User :   ok thanks for your time
Doctor :   you are most welcome
Doctor :   take care, and hope you have a speedy recovery
Doctor :   bye for now
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