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Having scalp abscess. Scalp open up several layers with lesions and sores after wash. Using hibclense. Advise?

DOCTOR OF THE MONTH - Dec 2013
Dec 2013
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Dermatologist
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i have had a on going problem with my scalp now for 11 months several dx recent bx shows scalp abscess without staph. when i wash my hair my scalp open up several layers with lesions and sores all over it. have been using hibclense and dial liquid antibacial to wash it in. i can feel a lot of fluid around the crown of my scalp and have a big circle in two different area.
Posted Sat, 1 Jun 2013 in Skin Hair and Nails
 
 
Answered by Dr. Sanjay Kumar Kanodia 1 hour later
Hello,
Welcome and thanks for posting your query to Healthcare Magic.My self Dr S K Kanodia and will try to provide you the best of information regarding your query.
After reading your brief query I can make out the possibility of "Pityriasis capitis" with secondary infection of scalp. It is a common condition of the scalp where due excessive flakiness the skin becomes red and inflammed followed by oozing or discharge with irritation over the same. Before I proceed any further I would like to ask you certain related questions:
1. How much of the itching is present in the scalp.
2. Is the condition becomes alright in between and then recurs back or is continuous in nature
3. Do you have similar type of problem any where else in body
3. Have you checked for any pediculosis mite infection
4. Do you have any sort of systemic disease
You have a feature to upload images by yourself at the right side of the query page, please utilize that so that I can answer your queries better. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia)
I hope you would not be bothered to reply above. Waiting for your reply so that I can guide you further.
Regards.
Dr Sanjay Kumar Kanodia
MD (Dermatology & STD)
Above answer was peer-reviewed by
 
Follow-up: Having scalp abscess. Scalp open up several layers with lesions and sores after wash. Using hibclense. Advise? 38 minutes later
I have a low immune system have had 2 mild strokes and a head injury. i had a recent boil inside my thigh next to my groin that i put some antibotic ontiment on and it ruptured. i have not been checked for pediclosis mite infection. the itching does come and go. my scalp did lift up at one time around the area that has the circle and a large amount of green and yellow drainage came out about 9 months ago with a very foul ordor while i was working outside in the heat, and reattached itself. i am very concerned that their is deep abscesses that have formed pockets that need to be drained while my white blood count is around 8 thousand right now. i have been nausea and have had diarrhrea off and on for 5 months but it has subsided with using probotics and active yogurt as i do have ibs. i am bipolar, pts, depression and anxiety, which the dermo i am seeing now said this is anxiety but my phys dr said this is no so this led to the bx on may 2 i have been put on lamsil back in nov 2012 after taking it my scalp went out of control getting even worse. i am allergic to all suflur drugs.
 
 
Answered by Dr. Sanjay Kumar Kanodia 6 hours later
Hi,

Welcome again.

Thanks for your prompt and detailed reply. It will definitely lead us to the closest possibility of the problem. As mentioned earlier about “pityriasis capitis” there are two more possibilities in addition to it. The one as I asked about “pediculosis infection” and (or) the second of “neurodermatitis”.

Now to differentiate above it is really very much important to get your scalp skin checked thoroughly for any kind of infestation by pediculosis or related mite or any other arthropod infestation.

It is a meticulous job so ask your dermatologist to rule out the rarest of rare possibility of anything related to infestation.

In pediculosis there is itching and then secondary infection due to mite, leading to multiple boils and recurrent infections. If this part is ruled out the only thing remains is that of neurodermatitis where the patient has intense desire to itch leading to more of excoriations and then secondary infection of the area. Neurodermatitis itself is a simple entity where the patient have itch- scratch and itch cycle.

As per your history also you have bipolar tendency, so during the phase of depression and anxiety the itch response is too much high leading to intense desire to itch. It also leads to a thinking of having deep abscess or something crawling in the scalp leading to further aggravation of the situation.

For the management part it is again requested to go for through check up of scalp. You can take second opinion from another dermatologist. If the infestation part is ruled out then for neurodermatitis part can be further guided by the dermatologist and at least you would be reassured by the part that nothing serious is present inside or over the skin.

Meanwhile clean your scalp daily, keep your nails trimmed, do not scratch any area and lastly give your self positive suggestions.

Hope I have answered your query. If you have any further questions, I will be happy to help or if you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health.

Regards,
Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
 
Follow-up: Having scalp abscess. Scalp open up several layers with lesions and sores after wash. Using hibclense. Advise? 20 hours later
i just returned from seeing my plastic sx to have a place restitched that did not heal that was done on my face over 6 months ago. he looked at my head and said my skin did not look good and i did not look good. suggested that i be referred to uab dermo. i went by and got my medical records also on biposy report it list culture wound non surigcal sq.epi's few gram + cocci my primary care is getting me a referring asap to uab in birmingham, alabama. thank you for you medical advise.
 
 
Answered by Dr. Sanjay Kumar Kanodia 28 minutes later
Hi,

Welcome again,

It’s really nice to discuss with you. We are highly thankful to God for providing us the opportunity to guide you for the right direction by the help of this forum.

It’s really so kind of you for following the advice, taking the opinion and to give further follow up to us. You rest assured; you will be alright by further thorough check up by the dermatologist at Birmingham. Please do clear all your doubts and possibilities to take the best treatment. Do give us a follow-up regarding your good health. If you have any further questions, I will be happy to help or if you do not have any clarifications, you can close the discussion and rate the answer.

Wish you good health.

Regards,
Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)
Above answer was peer-reviewed by
 
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