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Lesions appeared all over body. No relief from doxycylin. Is this due to tattoos?

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Practicing since : 2010
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i have skin problem. it started in 2009 and has continued pretty much non stop since. they are lesions that are circular with an outer ring of what seems to be scar tissue from the onset and an ulcerated center that is mostly at the site of a hair follicle. it has affected basically my entire body where hair exists. thighs, buttocks, lower back(spinal), stomach, shoulders, upper arms, forearms, back of hand, back of fingers, scalp, temples, mustache area, upper chin near corner of mouth, elbows, knees, ankles, feet. i have been to several doctors and several dermatologists and i have never been properly diagnosed, first i was told it was molluscum contagiosum, and later folliculitis that "is normal and you might just have it". i have been prescribed doxycyclin a few times, i took one course which did nothing so i passed the other times the doctor suggested it. I have had a culture for staph infection and blood tests for herpes all of which were negative. another thing that is relevant are my tattoos. they seem to be related to my tattoos as far as the timing and of how the tattoos were affected by the condition. i got several of the lesions within my tattoos and the ink is now gone in the spot the lesion was. also the lesions do not itch and they are not painful, they are just there.

from the photos i have seen and what i have read i believe that i have folliculitis possibly caused by herpes, or a gluten intolerance causing dermatitis herpetiformis. i guess my questions are,, what do you think i have, based on my short description and what do i need to do to get a proper diagnosis/treatment instead of the run around?
Posted Thu, 7 Mar 2013 in Skin Hair and Nails
Answered by Dr. Rahul Kumar 51 minutes later
Thanks for the query.

I would like to explain the condition and necessary action to be done in short.

1. All the lesions are related to follicle and are spreading so folliculitis can be considered but then there should be some pain or itch.
2. Circular lesions can also occur in fungal infection, these infections can be follicle centered and may not have symptoms.
3. There are few conditions called as gyrate erythema (circular erythema), these lesions persist for years and do not have any symptom other than the lesion.

Kindly send me a picture of a fresh lesion so I can comment in a better way. You have a feature to upload the reports by yourself on the right side of this query page. Please utilize it.

To know the exact diagnosis, biopsy from a fresh lesion is must.

I can comment specifically about biopsy only after seeing the lesion.

Wishing you a good health.

Thank you
Above answer was peer-reviewed by
Follow-up: Lesions appeared all over body. No relief from doxycylin. Is this due to tattoos? 21 hours later
i uploaded a few pictures. one is of my hand with multiple lesions. one is my right ring finger. the other is of my outer hip. one is fairly new and the other is older and has seemed to scar, but still looks similar to its original form. another thing that should be noted is that if i get a minor cut on my skin, it usually becomes a lesion just like the other ones that "spontaneously" appear.
Answered by Dr. Rahul Kumar 4 hours later

Thanks for the pictures.

With your details and clinical picture, I have the following differentials.
1. Papulo necrotic tuberculosis. (a mild form of cutaneous tuberculosis)
2. Homocysteinemia. Though presenting by birth but may present later in life.
3. Prolidase deficiency. It is an enzyme, deficiency of which leads to wide spread ulcers with scarring.
4. Behcet's disease. It has all symptoms what you have but along with that oral ulcer should also be there.

Here is my advice for you.
1. XXXXXXX a dermatologist and discuss the above given conditions with him in relation to your disease.
2. Get a mantoux test for tuberculosis done.
3. A biopsy from a fresh lesion is must to find a definite cause.

Hope my advice provides you bit help. Feel free to ask any further doubt.

Wishing you a good health.

Thank you .
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