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What is the treatment for parasitic infection in my intestine and why is the flesh under my fingernail in purple color?

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Practicing since : 2006
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What is happening with my skin? I live a the southern hemisphere, it's averaging 31°C where I live, this is not duo to cold, also there are many symptoms, please I urge you to read it thoroughly as this skin condition could be a result of a more complex problem 3 months ago I noticed a few things about my skin and my nails, but before I delve into what I may have, I have to warn you that I have (likely) a parasitic infection in my intestine (possibly reached my liver), as of right now I'm waiting for the results of 2 biopics (from a colonoscopy, duo to 16th Jan), normal methods of detection have failed, I'll start a more severe treatment Monday (23rd) (despite not knowing what I have by name, the gastroenterologists are pretty sure it's a parasitic infection) A second warning would be that I have “Fatty liver” disease, or I used to have I guess, according to my latest ultrasound, my diet has ridden me of fat in the liver. Now with that out of the way, Symptoms: Blood Spots (low occurrence) Black birth mark-like spots (I'm white) (low occurrence) (some vanish with time, some get blacker and some get softer with time) The flesh under my fingernails has become somewhat blue/purple Blemishes appear, primarily on my right leg, like I was struck by something (dark blemishes, Grey and somewhat caramel colored around the edges), but I haven't, I also have them appear in other areas of the body like my left arm and my bum All of the symptoms seemed to cease once I took Flagyl (for 30 days treatment total, symptoms vanish on 5th day) (to combat the parasitic infection) and all of them came back once I stopped taking Flagyl, but correlation does not equal causation, and my 2 gastroenterologists said I should talk to a rheumatologist and a hematologist, thanks to the holidays I have no access to any of those so I'm posting here in the hopes of at least having an idea of what could possibly be the problem or what path to take to ensure I figure out what I have I stopped taking Flagyl on the 1st of this month 6 days ago, I was in the shower and I had this,“heat” sensation on my middle finger on the right hand, soon after it started to get purple, it stayed purple for a couple of days before vanishing (I do have pictures of it), it hurt at the time, and no I didn't hit anything with it at all, I was just showering! My doctor tested my my circulation (by pressing against my skin) to see if bad circulation was causing the issue with my nails, she said that my circulation appears to be really good, my hands and feet are usually warm, even when it's cold, it only starts to get cold at temperatures below 10 degrees (Celsius) My last blood test (few weeks ago) accused that my red blood cells are a bit high (54%), My uric acid is at 7.2mg (mildly high), and my TSH is 5,94 everything else is normal, I'll do another one shortly as the high TSH may be a result of using Flagyl (according to another doctor) So, there is a picture, but I believe that is all of the information I could possibly give, any inputs will be appreciated, I'll book appointments for the new years as soon as they're available Adding info: There are more black blemishes on my body, actually currently I have at least 3, and last week I topped at 5, in both of my legs and my left arm I get 3 to 0 blood spots a day The black marks, I get about 1 to 5 new ones a week, new old ones some times vanish on their own Took pictures of every issue, I'm sorry about my phone's picture quality, but I guess this can at least give you an idea of what I'm experiencing
Posted Tue, 21 Jan 2014 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 13 hours later
Brief Answer: details below Detailed Answer: Hi XXXXXXX Thanks for writing to me. As far as my clinical acumen goes, I do not think these skin manifestations might be due to parasitic infestation. I have seen all the pics attached Those blood spots are probably cherry angiomas. Cherry angiomas are common skin growths, seen commonly in normal population. Its number increases with age. Having few cherry angiomas over body is a normal finding. The black spots are blemishes are bruises. A bruise may occur due to trauma or sometimes in few individuals may occur spontaneously. If somebody develops bruise quite frequently, we advise certain blood investigations like absolute platelet count, clotting time, bleeding time etc to rule out any underlying cause for these lesions .As clotting factors are formed in liver, so any liver abnormality may cause formation of bruises or petechiae. As far as redness over your palms and bluish tinge of fingernails are concerned. It could be due to tissue hypoxia. In hypoxia red blood count as well as uric acid is increased too, So one should do a test to ascertain your oxygen level in blood. All in all, I would advise that you meet a qualified physician as whatever manifestations you are having may be due to some systemic abnormality that should be diagnosed by appropriate investigations. Hope this helped to some extent. should there be any other query, please write back. Take care
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Follow-up: What is the treatment for parasitic infection in my intestine and why is the flesh under my fingernail in purple color? 1 hour later
One thing left I suppose, the black birth mark like spots, I used to have a few of those on my body, their number has increased in the last year, could that help point out what the underlying issue is? Check the "Black Spots.jpg" file for instance, the mark near my wrist I always had, as the other one, but the small one near the top is brand new, it showed up on day, started as a very small black spot and grown larger and fainter with time, new ones pop up with a greater frequency as of late, and I'm concern it could be an indicator of a secondary issue, just hoping you could point me in the right direction! Thanks for the reply also As soon as the holidays are over I'll talk to my Dermatologist about this, she did insist for me to take an arterial gasometry test, but I declined, now the problems seem to have multiplied! I still find it odd that Flagyl seem to decrease all of those symptoms, I took it for about a month and in that month I had no skin issues, I had it before, and I had it after, but then again if the infection reached my liver that could be the root of the issues I supposed it might just be (based on the information I have it makes a high degree of logical sense), I'll take an MRI of my liver also to make sure no other issue is present (and that my fat levels are really as down the ultrasound says it is). One more question, sorry, I had to ask, how long does it take for the symptoms of hypoxia to subside? And does snoring or sleeping in a position that lock my airways to some degree can cause the symptoms? (I have a theory, and some really bad sleeping positions)
Answered by Dr. Kalpana Pathak 28 hours later
Brief Answer: details below Detailed Answer: Hi XXXXXXX Firstly please accept my apologies for delayed response. Those small black spots could either be freckles or acquired melanocytic nevi. Both of these are benign in nature and can be multiple in number. You need not worry about the same. Freckles are quite common in white skinned people and can be prevented by adequate sun protection and use of sunscreen. Symptoms of hypoxia would subside only if the underlying cause is treated. Firstly hypoxia should be confirmed. Once confirmed underlying cause should be ruled out. Snoring occurs due to block in breathing passage. There could be many causes for the same like stress, obesity, nasal blockade due to any allergy, smoking etc. Apart from these there is an alarming cause which is obstructive sleep apnoea. OSA is also associated with hypoxia. Now all these differentials are far fetched. Firstly diagnosis of hypoxia should be confirmed and then underlying cause should be looked for. In your case being slightly overweight and breathing passage blockade due to any allergy can lead to snoring too. So we have to rule out other causes before thinking of OSA as a possible cause. As advised please meet your doctor so that proper investigations can be advised for you. You need not worry about red and black spots( cherry angiomas and freckles/naevi) as these are completely benign and incidental findings. However cause for bruise and cyanosed nails should be ruled out. Hope this helped. Take care
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