Question: I have open lesions on my body. They seem to pustule, nodule and then ulcerate and do not heal. The few that have healed have left some awful scars. Upon reading, I ran across some articles and pictures leishmeniasis that have similarities to lesions. It also states that differential diagnosis can be Myiasis and sporotrichosis. Do any of my pictures seem consistent with any of the three diagnosis or some type of fungal infection? If not, do you have another diagnosis that I should investigate?

The lesions themselves are not painful but the surrounding area and swelling are very uncomfortable. I do seem to have a fungal component, but my dermaphyte culture in DTM adgar and blood fungal culture tests were negative. Can you let me know what you suggest as a next step?

Thanks!

Hi, Thank you for your further interest and quality ensuring your understanding. I do have other photos that are not so close, so I will upload a few of them.



Site of Lesions, Crown of scalp, left side of scalp just above my ear, the outer ear, breast, side of thigh, mouth, hands, top of feet, and outer vagina lip.



No prior trauma to any of the areas other than the crown of the scalp. I had a small lump after returning from travels (Cost Rico, Panama Canal, Belize, Bahamas, Cancun). It was painless and I would have not noticed if not for feeling the lump and some bloody oozing. It soon healed leaving a small bump and scar and I did not have any other problems associated, so I never sought medical attention. This was in 2014.

In 2019, the area started to get larger and was very hard and seem to have odd discharge. Sometimes liquid and sometimes more of a toilet paper-like substance. I went to the dermatologist and she said it was a sebaceous hyperplasia upon viewing it for 30 seconds and would not biopsy it. She could not account for the proliferation of substance from the lesion and further reading does not match the symptoms. It seems to go through a cycle, and it was in more of a closed nodule phase when she viewed it.



I have long suspected, but cannot be certain, that the other lesions are secondary to the first’s byproduct. Whether, bacteria, fungus or parasitic It can feel something landed on me or fell from the location on my back or arm, for instance, and the area would break into another lesion. Sometimes I can feel the lesions build pressure just before. Keeping areas covered with clothing has helped minimize the secondary lesions.



The symptoms seem to be worse in the summer or heat. There is a fever associated that reaches 100.8 and fluctuates to normal throughout the day. My normal waking temperature is 97.8. I have lost almost 30 lbs in 6 weeks and have not been dieting or not eating. I have disabling fatigue associated with the fevers. I get dizzy, my face flushes and my ears turn bright red and sometimes headaches are associated.

One of the other major symptoms is the bumps on my face that seem to go flat and then swell and migrate down my face or to the corner of my eyes. I will upload a picture of it happening. It absolutely drives me crazy because it feels 100X worse than it looks. Sometimes it causes something to temporarily get into my eye and one time it scratched my cornea. I attatched one photo of it in my eye.



Please look at the additional photos and let me know if you have more questions.