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Have Large Rash On Leg. Scared Of HIV And HSV Infections. Suggestions

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Posted on Wed, 5 Jun 2013
Question: I have a rather large rash on my right leg, which appears to be folliculitis from pictures I've seen. But my PCP mentioned molluscum. However, the rash and postules have started to significantly resolve (after 6 days). That sounds more like folliculitis to me. I'm very, very concerned about HSV, or HZ and HIV. I also started feeling something happening to my left eye (somewhat irritated, feels heavy/swollen), but nothing wrong is visible (at least to me) -- but I've been so stressed for 3 days and haven't been eating because of it. My PCP ordered blood and urine tests but I won't hear results for 2 more days. I have no other symptoms.....no fever, lymph nodes are normal, etc. my PCP seemed convinced upon visual inspection that the rash was viral, not bacterial. The attached pic is from 4 days ago. Is there anything you can tell me?

I have a picture of my left eye. There does seem to be some redness in the inside near the nose, but mostly visible when I look to the left.

I'm sorry, one more important piece of info: the rash has never been painful or itched.
doctor
Answered by Dr. Achuo Ascensius (4 hours later)
Hello XXXXXX,
thanks for the query.

It would have been a lot more easier to comment had you posted a picture of the rash. However, from the information you have given; i understand there is a rash, covering a large space, with pustules, does not pain nor itch and on the right thigh.

Molluscum contagiosum is a viral infection of the skin that begins as a small painless skin elevation ranging in size from a pinhead to a pencil eraser. Each usually has a dimple on it and when scratched, the lesions follow the scratch. Contamination is possible through direct contact or through contaminated towels or materials. In people with normal immune system, the rash eventually clears of on its own over a period of months or years where as in people with immune deficiency, the rash has a worsening course and treatment is done by surgery or freezing or other methods.

Given that the rash does not pain nor itch, it is less likely to be Herpes Zoster (Zona). Zona particularly occurs on one side of the body and presents with pains and fluid filled vessicles on the skin that will eventually rupture to form crouts. It is also less likely to a Herpes simplex give that the characteristic locations are the lips or genital area and it presents with pains.

Folliculitis is inflammation of hair follicles which may lead to furoncles ( small abscess of hair follicle) or carbuncle ( abscesses of hair follicles occurring in a cluster). Since you mentioned about pustules which are pus filled bumps, it is more likely that you have a carbuncle or a superifection of an underlying condition ( molluscum which does not pain or fungal infection etc). Drainage of the pus with regular dressing with antiseptic should be the primary care and then observe as the rash evolves. With folliculitis or carbuncle, drainage and dressing should suffix in most cases and recovery is fast.

Molluscum, Hs and Hz are common in HIV infected individuals. Getting an HIV test is thus important since you are concerned about these infections.

Concerning the eye, its defficult to say what is wrong but it is possible to be an irritation of hair or small foreign particle that might have entered the eye or a simple infection about to start. You should wash the eyes regularly with soapy water and if its an infection it would be cleared off.

Hope this answers your query. If you have further query, i will be glad to help.
Best regards


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Achuo Ascensius (16 minutes later)
I did attach a picture of the rash as well as my eye. I took a rapid HIV test at the 6 week XXXXXXX from possible exposure which was negative. I'll take another in 6 more weeks. I can't see how this rash could be molluscum as it is healing within the first week.
doctor
Answered by Dr. Achuo Ascensius (38 minutes later)
Hello XXXXXX,
thanks once more for the query.

It would appear you uploaded the same picture of the eye twice.
However, you are right in that it is less likely to be molluscum giving that its fast healing. That makes it more of a carbuncle or multiple furoncles which generally should improved fast as drainage is done.
It is interesting to know that your results came back negative for HIV thus making it less likely to be Hs nor Hz nor Molluscum.

Hope this answers your query. If you do not have more query, you could close the discussion and rate the answers.
Best regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Achuo Ascensius

General & Family Physician

Practicing since :2012

Answered : 1040 Questions

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Have Large Rash On Leg. Scared Of HIV And HSV Infections. Suggestions

Hello XXXXXX,
thanks for the query.

It would have been a lot more easier to comment had you posted a picture of the rash. However, from the information you have given; i understand there is a rash, covering a large space, with pustules, does not pain nor itch and on the right thigh.

Molluscum contagiosum is a viral infection of the skin that begins as a small painless skin elevation ranging in size from a pinhead to a pencil eraser. Each usually has a dimple on it and when scratched, the lesions follow the scratch. Contamination is possible through direct contact or through contaminated towels or materials. In people with normal immune system, the rash eventually clears of on its own over a period of months or years where as in people with immune deficiency, the rash has a worsening course and treatment is done by surgery or freezing or other methods.

Given that the rash does not pain nor itch, it is less likely to be Herpes Zoster (Zona). Zona particularly occurs on one side of the body and presents with pains and fluid filled vessicles on the skin that will eventually rupture to form crouts. It is also less likely to a Herpes simplex give that the characteristic locations are the lips or genital area and it presents with pains.

Folliculitis is inflammation of hair follicles which may lead to furoncles ( small abscess of hair follicle) or carbuncle ( abscesses of hair follicles occurring in a cluster). Since you mentioned about pustules which are pus filled bumps, it is more likely that you have a carbuncle or a superifection of an underlying condition ( molluscum which does not pain or fungal infection etc). Drainage of the pus with regular dressing with antiseptic should be the primary care and then observe as the rash evolves. With folliculitis or carbuncle, drainage and dressing should suffix in most cases and recovery is fast.

Molluscum, Hs and Hz are common in HIV infected individuals. Getting an HIV test is thus important since you are concerned about these infections.

Concerning the eye, its defficult to say what is wrong but it is possible to be an irritation of hair or small foreign particle that might have entered the eye or a simple infection about to start. You should wash the eyes regularly with soapy water and if its an infection it would be cleared off.

Hope this answers your query. If you have further query, i will be glad to help.
Best regards