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Hepatitis,epstein bar,discoid lupus,psoriatic breakout,steroid,inflammation

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Practicing since : 2001
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I am at a point where my family doc doesn't know what to do. Her comment last week was you know there is no cure. I know this. But I don't know whether to see immunologist, there has to be something else. I am 57,had hepatitis 10yrs ago.No ABC etc. just a very inflammed liver. Dx was epstein barr. I'm very suspicious of a discoid lupus or something such. Why, because, since my hospitalization, I have continued to have psoriatic like breakouts scalp, neck, ears etc. Always one place, same dermatones. Also my skin in general has changed. Yes I have gone thru menopause(boo) I've seen derm doc and all I get is you have dermatitis(duh!!) The long and short is no topical has been able to affect it at all rx or nonrx. Only oral steriod medrol dose packs. Problem is by 4th day it is totally gone. The inflammation, painful splits, insane itching, but by 10th day post tx it comes back with a fury! I know the pitfalls of continued use of steroids,but it has been the only thing that works. I asked doc if I could go on lower dose over longer period of time. We tried this, with very minimal results. Right now my ears,part of scalp and neck are very inflammed. I just finished a dose pack 4 days ago, am back to square 1. The splitting is what is so painful, hard to sleep at night. Ears feel like on fire. Blood on pillow in am. Can't hug my honey of 35yrs.,been thru neosporin, petroleum jelly, use benedryl spray,then jelly or neo. The problem with the ears has been going on now for 1 1/2 yrs. Continually getting worse. In fact these past 2 yrs have been worst yrs. for this problem. I have been wearing bandanas of late to protect and keep me from scratching and I love gardening,spending hours outside. Gnats love my ears! No tests have been done. No scraps etc. So, should I consult another derm doc or immuno doc?
Posted Wed, 25 Apr 2012 in Lupus
Answered by Dr. Rakhi Tayal 28 minutes later
Thanks for writing to us.
Your problem seems to be related to some autoimmune disorder. Since steroids are the strongest anti inflammatory agents, they are only able to provide you some relief. Consulting an immunologist will be best for you.
Till then you can follow some simple measures to help the improvement -
* Avoid scrubbing your skin.
* Use as little soap as possible. Use gentle cleansers instead.
* Avoid applying cosmetic lotions or ointments directly on the rash.
* Use warm (not hot) water for cleaning. XXXXXXX dry, don't rub.
* Eliminate any newly added cosmetics or lotions.
* Leave the affected area exposed to the air as much as possible.
* Try calamine medicated lotion.
* Hydrocortisone cream (1%) is available without a prescription and may soothe you.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.
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