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Rash Around Legs, Under Arms. Diagnosed With Nummular Eczema Post Biopsy. Temporary Relief With Medicines. Was Biopsy Required?
Question: I have rash around legs and sometimes under the arms (mainly they appear to grow the area where no exposure to air among my body parts), which has developed for a while (at least 7-8 years).
When I visited a dermatologist , he suggested biopsy and went through; exam result was nummular eczema.
However, the symptom still comes back in the present time but lesser in warm weather. Applying body lotion is somehow helpful but never disappeared.
The 2 biopsy left 2 scars on the back of leg and I don't think the biopsy and prescribed ointment did not help to the full recovery. I had no itchiness, no bleeding but concerned it would grow deeper and bigger.
Was it necessary to do biopsy (2 of them with big bills)?
Was it normal to leave scars on the wound area?
The rash size is lesser than .5 inch (in diameter) in a circle shape (several appeared then dry out sometimes to form a sort of scalp).
When I visited a dermatologist , he suggested biopsy and went through; exam result was nummular eczema.
However, the symptom still comes back in the present time but lesser in warm weather. Applying body lotion is somehow helpful but never disappeared.
The 2 biopsy left 2 scars on the back of leg and I don't think the biopsy and prescribed ointment did not help to the full recovery. I had no itchiness, no bleeding but concerned it would grow deeper and bigger.
Was it necessary to do biopsy (2 of them with big bills)?
Was it normal to leave scars on the wound area?
The rash size is lesser than .5 inch (in diameter) in a circle shape (several appeared then dry out sometimes to form a sort of scalp).
Question 2.
I have another serious long-term problem; Hypertension condition for nearly 10 yrs and I cannot sleep at night lately. (e.g.. I slept from 11 pm ~ 1 am last nigh; about 2 hrs but I'm still working in the daytime). I try to sleep at the end morning but couldn't do it at all. What is the best way to handle the condition??
I'm puzzled because I still wake up to drive and work afterwards.
I do not take any caffeine (coffee not soda, not even tea at night) but I take some herbal supplementary pills (vitamins, acai, propolis, collagen, etc.).
I have another serious long-term problem; Hypertension condition for nearly 10 yrs and I cannot sleep at night lately. (e.g.. I slept from 11 pm ~ 1 am last nigh; about 2 hrs but I'm still working in the daytime). I try to sleep at the end morning but couldn't do it at all. What is the best way to handle the condition??
I'm puzzled because I still wake up to drive and work afterwards.
I do not take any caffeine (coffee not soda, not even tea at night) but I take some herbal supplementary pills (vitamins, acai, propolis, collagen, etc.).
Hi,
Thanks for writing to us.
I will answer your questions specifically
Your dermatologist was right in keeping a possibility of nummular eczema as you had dry itchy scaly round lesions with flare ups in dry cold weather. Sometimes psoriasis,CTCL or cutaneous T cell lymphoma, pityriasis rosea, tinea or fungal infection mimic nummular eczema and hence a biopsy is required to rule out these possibilities. Your dermatologist too wanted to rule out CTCL and tinea in your case as is mentioned in attached reports.
As biopsy is an invasive surgical procedure where a piece of your skin is excised( epidermis, dermis and subcutaneous tissue), it is bound to leave a scar. This scarring can be minimised by a proper technique and suturing the wound created post biopsy. However many prefer not to place sutures post skin biopsy.
To treat nummular eczema
Avoid hot water baths
Use mild soaps
Use moisturisers with urea and lactic acid as these hydrate skin effectively.
Apply mometasone or fluticasone based steroid creams to control eczema flare ups.
As far as your sleeping problem is concerned, it could be seen in hypertensives. It is better to consult your attending physician regarding the same. If required you may take mild sedatives for few days.
Hope that answered your query. Should there be any doubt, please write back.
Take care
Thanks for writing to us.
I will answer your questions specifically
Your dermatologist was right in keeping a possibility of nummular eczema as you had dry itchy scaly round lesions with flare ups in dry cold weather. Sometimes psoriasis,CTCL or cutaneous T cell lymphoma, pityriasis rosea, tinea or fungal infection mimic nummular eczema and hence a biopsy is required to rule out these possibilities. Your dermatologist too wanted to rule out CTCL and tinea in your case as is mentioned in attached reports.
As biopsy is an invasive surgical procedure where a piece of your skin is excised( epidermis, dermis and subcutaneous tissue), it is bound to leave a scar. This scarring can be minimised by a proper technique and suturing the wound created post biopsy. However many prefer not to place sutures post skin biopsy.
To treat nummular eczema
Avoid hot water baths
Use mild soaps
Use moisturisers with urea and lactic acid as these hydrate skin effectively.
Apply mometasone or fluticasone based steroid creams to control eczema flare ups.
As far as your sleeping problem is concerned, it could be seen in hypertensives. It is better to consult your attending physician regarding the same. If required you may take mild sedatives for few days.
Hope that answered your query. Should there be any doubt, please write back.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your kind and prompt reply.
I've already consulted with my primary physician last night, who suggested to do exercise more then come back in one month. I don't know what to do.
When I cannot sleep, how can I exercise since I don't feel much strength left and my head seems to be floating--light dizzy, too.
My last night blood pressure was 156/86. I've taken BLPRS pill for a while (amlodipine)
Is it really due to blood pressure? Then how come this serious sleeping problem comes lately (not throughout the past 10 yrs when I have had the hypertension issue?
As to the scar issue, some other doctor said it's does not occur all the time but some times.
I've already consulted with my primary physician last night, who suggested to do exercise more then come back in one month. I don't know what to do.
When I cannot sleep, how can I exercise since I don't feel much strength left and my head seems to be floating--light dizzy, too.
My last night blood pressure was 156/86. I've taken BLPRS pill for a while (amlodipine)
Is it really due to blood pressure? Then how come this serious sleeping problem comes lately (not throughout the past 10 yrs when I have had the hypertension issue?
As to the scar issue, some other doctor said it's does not occur all the time but some times.
Hi,
Apologies for the delayed response.
Mild sleeplessness can be improved by these measures
Sleeping same time of the day and getting up at the same hour in morning even if couldn't sleep much in night
Avoiding afternoon naps
Avoid tea coffee and alcohol
Having dinner at least two to three hours prior to sleeping time
Creating an environment conducive to sleep- putting the lights off, avoiding reading books, net surfing, watching TV etc
Taking warm milk prior to sleep as it contains a compound that induces sleep
Exercise, meditation Yoga are advised to be incorporated in daily routine as these relieve stress and induce sleep.
Any cause of stress, chronic illness or irregular sleeping pattern can lead to sleeplessness for few days.
If above measures do not help like I said take a sedating medicine for few days. Also I hope that you are on anti hypertensives on regular basis.
Any invasive procedure will definitely heal with scar however it can be mild or severe and so in some might not be visible.
Hope that helped.
Take care
Apologies for the delayed response.
Mild sleeplessness can be improved by these measures
Sleeping same time of the day and getting up at the same hour in morning even if couldn't sleep much in night
Avoiding afternoon naps
Avoid tea coffee and alcohol
Having dinner at least two to three hours prior to sleeping time
Creating an environment conducive to sleep- putting the lights off, avoiding reading books, net surfing, watching TV etc
Taking warm milk prior to sleep as it contains a compound that induces sleep
Exercise, meditation Yoga are advised to be incorporated in daily routine as these relieve stress and induce sleep.
Any cause of stress, chronic illness or irregular sleeping pattern can lead to sleeplessness for few days.
If above measures do not help like I said take a sedating medicine for few days. Also I hope that you are on anti hypertensives on regular basis.
Any invasive procedure will definitely heal with scar however it can be mild or severe and so in some might not be visible.
Hope that helped.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your detailed direction, which I'mm sure helpful.
Hi,
Wish you good health always!.
PS should there be no other query, you may close the discussion.
Regards
Wish you good health always!.
PS should there be no other query, you may close the discussion.
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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