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Diagnosed with endometriosis. Noticed pimples with clear fluid on thighs and forearms. What is the cause?

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Practicing since : 2007
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I keep getting these recurrent cysts or mass. First one I had was on sept 16, 6 days after having a laparoscopy done and d&c diagnosing me with endometriosis. It was on my left labia minora in the fold. Caused pain, redness, swelling, fever. Whole left groin hurt and lymph glands were swollen and tender. I was admitted and started on IV antibiotics which they stopped Bc cultures were neg and mass didn't respond to meds. Eventually was dc home. It was solid not fluid according to sono. Next one I got was oct 11th, same thing, low fever, pain, swelling ect, but this one was up a little higher then last but in the Majora crease again. Current one I have appeared nov 11, but on the right minora close to clitoras. Tender and red again. All last week I was having bad pains in my knee and hips, stiffness, swelling in hands and feet in the am. Felt like I was in a car accident when I woke up, when I was able to sleep, saw my doc said it sounded like RA or arthritis. I was also having diahrrea all week too. Those both happen in different episodes or flare ups. Saw my OB, he did a punch biopsy and sent it off, has no idea what is is. They seem to occur the week before my cycle and the biopsy showed it being solid. I also have cysts or lypoma on my for arm about size of pea, thigh and also shoulder that one larger. Those never go away. I have keratosis on my arms and get bumps here and there on my thighs and forearms. Like pimples, but clear fluid comes out when popped, sometimes whitish. Have no idea why I keep getting these mass's and other symptoms. Please help.
Posted Wed, 4 Dec 2013 in Women's Health
Answered by Dr. Arif N Khan 16 hours later
Brief Answer: It could be labial abscess. Detailed Answer: Hi, After analyzing your symptoms I feel you might be having two different problems, the swelling in labia region could be labial abscess and endometriosis. Kindly answer few questions so that I can come to a conclusion: 1)what is the swelling size which is present in your labial region? Is it painful and tender/ hot? 2)what are the laparoscopy findings? what is the size of endometriotic cysts? 3)do you have painful menstruation? 2)have you undergone any blood investigation? what is your blood sugar levels? If possible please attach all your investigations/ discharge summary into the follow up question. Please ask if you have more questions, try to be as specific as possible when you are asking questions, and do write back with the answers so that I can guide you further. Awaiting your response. Regards Arif
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Follow-up: Diagnosed with endometriosis. Noticed pimples with clear fluid on thighs and forearms. What is the cause? 3 hours later
It started out small like a pea, normall they will get to the size of a kidney bean or larger. Yes, painful they always are, red and tender, warm as well. Yes painful periods, always have, and had significant pain in my right ovary, several cysts as well. Tried birth control for treatment didnt help much, IUD did help but during the laparoscopy, they found it perforated thru the cervic and into the uterus. Periods are very painful, heavy and long. The laparocopy was 5 hrs long, showing several adhesions on the right side as well as cysts in both ovaries and one of my fallopian tubes. OB told me the endometriosis was in my bowls, perineum, and ligaments. Stage"4", whatever that means. She didnt give my the actual size, but i do have pics they took. Ill try to upload them. Yesterday they did a biopsy and i have had alot of pain since, headache, temp started out 99 last night, now 100.7. Lower stomach hurts, cramping feels like contractions, sometimes i hurl over for a min or two bc i cant stand up and I break out into a sweat. This is similar to what happened with the first mass 6 days after the laparoscopy. What blood tests? They have tested my thyroid and hormone levels, both fine, CBC and cultures were fine in the hospital. Let me see how i can upload my last few hospital stays and surgery reports on here. They also did a CT after surgery when the mass appeared and all it showed was possible cellulitits, but the infectious disease disaggreed after nothing responded to the iv vanco and clyndo. I have no clue, i thought maybe they were endometriousis cysts but its solid inside and its not chocolate like the dr said it would be if that were the case. No STD, vaginal culture is neg too. My husband is an Internal med MD and clueless as well, though not his specialty anyways.
Answered by Dr. Arif N Khan 22 hours later
Brief Answer: Symptoms could be due to pelvic peritonitis. Detailed Answer: Hi, I apologize for the late response; I was away from my computer due to unavoidable reasons. Coming back to your question, I have gone through your uploaded discharge summary and there are no other reports other than your discharge summary. After analyzing your history and reports I feel you are presently suffering from PELVIC PERITONITIS, if I were your treating doctor, I would have advised few investigations like blood culture, urine culture, baseline LFT, RFT (liver function and renal function tests). I would have even advised aspiration of pelvic fluid for culture and sensitivity. Our main concern presently will be to treat the pelvic infection. Also there might be chances that you might require another operation. Depending on the culture reports antibiotics can be changed. Secondly for your endometriosis, as it is already stage 3 only option is hysterectomy and bilateral oophorectomy(removal of uterus and both ovaries), it depends on whether you have completed your family and your wishes. Kindly speak with your doctor regarding this. Please ask if you have more questions. If you are satisfied, please make sure that your ACCEPT my answer so that I receive credit. Good luck!!
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Follow-up: Diagnosed with endometriosis. Noticed pimples with clear fluid on thighs and forearms. What is the cause? 3 hours later
My OB did a urine culture and it was fine, did a punch biopsy tue still waiting on the results of that. They did not stitch the area, so now the skin must of stretched so it a big hole in that area. Very painful, i keep a clean panty liner on bc its drains some brownish stuff. When i had theis the first time, they did culture and labs, everything was fine. Wbc wasnt elevated LFT&RFT were fine. My liver enzymes go up and down from my GI issues. Cultures were neg, they had me keflex, vanco and clyno. Nothing responed, then they said it wasnt an infection. When he did the biopsy tue, he said it came out solid, no fluid and nothing that looked infectious. He called in bactrium yesterday to start since im having fevers. Dont have a clue what causes the pain in my pelvic area and unterus, goes into back at times. Feels like a contraction, then passes. But still achy, during the severe cramps, i get nausous. I have alot of bowl movements and feel the urge even when i dont need to go. But i do have Gi probs. SOD, papilary stinosis and pancreatic divisum, dont know if that adds to it. My liver is aching as well, prob bc i take lortab for the biopsy, it will take the edge off. Im concerned about the hole, and the pain. Not sure what to do besides just wait. As far as the endometriosis, they told me a hysterectomy is needed. Our youngest is 15 mo and oldest 5, soon we want another then thats it. Are my current issues from the endometriosis? What can i do? How do they know if its pelvic peritonosis and if there is fluid there? Will that cause they labia mass's to keep reacurre?
Answered by Dr. Arif N Khan 14 hours later
Brief Answer: Could be labial endometriosis. Detailed Answer: Hi, Sorry for the late reply. 1.Are my current issues from the endometriosis? Now, it looks like this could be due to endometriosis. But you need to be confirmed by biopsy. Kindly wait for the report. 2. What can i do? How do they know if its pelvic peritonosis and if there is fluid there? I suspected peritonitis because of recent history of surgery, high grade fever and scan/ CT showing fluid in the peritonium. Now when all blood counts and other test are normal, it could be just a mild infection, hope the injectable antibiotics will control the infection. 3. Will that cause they labia mass's to keep reacurre? If the mass are due to endometriosis, then it can recur. 4. Lastly about the hole, do not wory; it will take time to heal (hope it is not a sinus/ fistula), then definitely it will heal with time. Your bowl problems could be due to your GI prob. Please ask if you have more questions, I would be pleased to assist you. If you are satisfied, please make sure that your ACCEPT my answer so that I receive credit. Good luck!!
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