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Pain and discomfort in face. Had dental work done. Yellow blotches on forearm. Taking penicillin. Professional opinion?

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General & Family Physician
Practicing since : 2005
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Hello. I put this query into the General Health category as it seems to effect multiple systems at this point and time. Based upon your professional opinion please forward to appropriate professional:
I am a 38 year old male, 6'4" with no notable medical history save starting a few months ago. I recently went into see an MD about general discomfort in the left side of my face (my left), he found a swollen gland or bump just below my skull where it meets the neck on my left side slightly below and behind my ear, but behind my mandible. After palpating the area and cleaning out my ears and no ear infection, and ruling out parotitis as that gland seems to be functioning normally and isn't the cause of the pain as we did the "sour test", he said it might be inflamed due to TMJ or some such, but I had doubts about this because I don't grind my teeth and the pain seems to be more nerve-based or XXXXXXX between throat and neck (the pain migrates from high, about the upper mid-molar, down to that swollen gland, then sometimes down underneath my lower jaw about mid-mandible - and repeats this migrations pattern). I have had dental work some months ago, upper left molar that never really felt right, that might be contributor. So, I went to the dentist five days ago, and he said indeed this tooth needs a root canal, but wasn't overly infected or notable, just based upon high temp and pressure sensitivity; but still I don't think that is all the problem, and to me doesn't explain how the pain radiates to different parts of my face and neck (by the way, on a 1-10 the pain is not constant and can go from a 0 to 1 to a 3 or 4, but never keeps me up at night, and comes and goes). And on the dentist's xray he said there wasn't notable or significant inflammation or infection in my sinus cavity above the tooth. Now, for the most recent manifestation, and main reason for this inquiry. The dentist put me on Penicillin pending the root canal (which I haven't scheduled due to insurance reasons) in case the tooth was the cause of the swollen gland or pain in my face, but the pain hasn't really abated, and now I am getting yellow blotches on my right forearm skin that seem to come and go - and changes in intensity of color (faded to yellow and hard to see in florescent light, but can see it better in natural or sunlight). I am not sure if there are a couple medical problems conspiring coincidentally at the same time (tooth meets infection meets problem with penicillin in my body meets inner organs or something more serious) or if you have an idea on what might connect these dots. I was not concerned until I saw the yellow blotches (perhaps 5 or 6 distinct, 2-4 centimeter blotches on my forearm skin, in random patterns). I am currently taking penicillin every 6 hours for the last four days. The yellowing on my forearm is limited to my right forearm skin (the part that gets the most sun) and seems to not migrate into the less-damaged or baby-skin in the inner arm or upper arm. My left arm has no yellowing. Also the yellowing does not itch or hurt. the gland in the back of my neck also hasn't shrank, nor has the discomfort in the area abated. Also, I just noticed a small yellow, about 2 mm) blotch, on my upper bicep skin of my right arm. Thank you so much for your opinion and candor. - XXXXXXX
Posted Mon, 23 Apr 2012 in Brain and Spine
Answered by Dr. Radhika 14 hours later

Thanks for posting the query.

I understand your health concern. I appreciate your efforts to write in detail about your symptoms.

You have mentioned about swelling behind the ear and below the skull area. It might most probably be swelling in Lymph nodes of the neck swollen from infection, inflammatory conditions, an abscess, or cancer. The most common cause of swollen lymph nodes is infection.

When swelling appears suddenly and is painful, it is usually caused by injury or an infection. Enlargement that comes on gradually and painlessly may, in some cases, result from cancer or a tumor.

The various causes include:

-Abscessed or impacted tooth
-Ear infection
-Colds, flu, and other infections
-Mouth sores
-Sexually transmitted diseases
-Skin infections

If your lymph node do not get smaller after several weeks or continue to get larger, if they are red and tender, or feel hard, irregular, or fixed in place, if you have fever, or unexplained weight loss then you will need to get it tested by your Physician.

You will need to undergo a physical examination, blood tests ( including liver function tests, kidney function tests, and CBC ), lymph node biopsy, chest x-ray.

You have mentioned previous history of skin tumor on left side of cheek and on left forearm. So you will definitely need to consult a Physician regarding your present symptoms.

UV exposure causes thickening and thinning of the skin. Thick skin is found in coarse wrinkles especially on the back of the neck, forearm (areas exposed to sun) that do not disappear when the skin is stretched. Solar elastosis causes thickening of skin, coarse wrinkling and yellow discoloration of the skin. It may also be seen in premalignant lesions.

Hope I have answered your query. I will be available for follow up queries, if any.


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