What causes fluid filled vesicles on legs and arms?

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Posted on Fri, 24 Jun 2016 in Skin Hair and Nails
Question: Hi,

I have these sores on my legs and arms that will not go away. They look like a pimple but are not pimple sometimes the fluid is clear or bloody. They are round and when the scab comes off they are deep. I also have some on my scalp. I get really hard nodules on my scalp then in a few days to a week they turn to blisters then scabs and will not go a way. Sometimes the get bigger in diameter and have raised edges with ridges around them. The itching is unbearable the worst I have ever felt. I am also loosing my hair in these spots. Some of the hair loss is up to 1/2 inch x 3/4 inch. At times scabs have come off that are s shape and zig zagged.
doctor
Answered by Dr. Asmeet Kaur Sawhney 19 minutes later
Brief Answer:
Upload pictures

Detailed Answer:
Hi
Thanks for being at healthcaremagic
I would recommend you to upload the photographs of the affected areas so that I can have a clearer picture of the condition and can guide you accordingly.
Regards
Dr Asmeet
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Asmeet Kaur Sawhney 1 hour later
Did you receive my pictures?
doctor
Answered by Dr. Asmeet Kaur Sawhney 5 hours later
Brief Answer:
Seems to be folliculitis declavans, scalp biopsy for confirmation

Detailed Answer:
I have reviewed the attached photographs.
According to your complaints and after analysing the pictures it seems you are having folliculitis decalvans.
It is a chronic folliculitis which can lead to progressive scarring and hair loss.
I would recommend you to go for swabs to check for the presence of organisms as well as scalp biopsy to confirm the diagnosis.
It is usually treated with tablet rifampicin 600 mg once daily along with either tablet clindamycin 300 mg twice daily or doxycycline 100 mg twice daily.
Along with this topical antibiotic like mupirocin cream or fusidic acid cream is applied on the affected areas as well as carriage sites like nostrils. external ears, finger and toe web spaces, umblicus, arm pits , groins and perianal area for a long time.
These are prescription drugs and you need to see the doctor in person to get them.
Besides this for itching you need to take antihistaminics like tablet Chlorpheniramine 4 mg twice daily.
I hope to have answered your query and would be happy to clarify any further doubts.

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Asmeet Kaur Sawhney 4 hours later
I just finished a round of doxycycline 100 mg twice daily and have used the mupricoin I have also been on other antibiotics for approx 6 months off and on. Could this possibly be scabbies. The itching is much more sever at night, almost to the point I cannot sleep.

doctor
Answered by Dr. Asmeet Kaur Sawhney 3 minutes later
Brief Answer:
Doesn't seem to be scabies

Detailed Answer:
Looking at your scalp lesions it doesn't fit into the diagnosis of scabies as scabies doesn't involve head region in adults.
Your night itching goes in favour of scabies but again I couldn't see any burrows or inflammed papules on the finger web spaces, wrist, sides of wrist, axilla, breasts, abdomen and thighs.
Is there any family history of night itching present?
For confirmation go for skin biopsy.

Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Asmeet Kaur Sawhney 31 minutes later
No there are not a history of night itching and the spot on the head were inflamed papules. They next went to blisters, and now this. I have really thick white scabies that come out of the lesions. And I have read from several doctors that you can have scabies in your scalp. You cannot see the burrows, but I can feel some elongated raised areas that feel like the have ridges. I have had some scabes that came off that looked like a snake skin, and some were zig zag shape. All of the spots at one time were inflamed papule. And they just keep moving around my body. A lot of the papules are in a row on my scalp. I have had three or four rows that start from the crown of my hair and move forward over a week or so at a time. There is a pattern where they start at the back move forward to the front of my head. The papules once they break or the scalb comes they have a circle that is hard with ridges around it.
doctor
Answered by Dr. Asmeet Kaur Sawhney 46 minutes later
Brief Answer:
Go for empirical treatment of scabies

Detailed Answer:
I have seen many cases of scabies and I still believe it is not looking like scabies.
Head involvement is rare in case of adult scabies.
If you are still feeling it is scabies you can go for empirical treatment of scabies .
You can use permethrin lotion but it is a prescription drug and you need to see the doctor in person to get it.
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Asmeet Kaur Sawhney 18 minutes later
How does a doctor diagnose scabies. Can you see them with a microscope? What kind of test is done.
Also I have had inflammed papuals. I just don't have any pictures at this time. And I have scabies that have come off that look like burrows. Only have 1 picture but have had quite a few scabies that have come off looking S shaped or like a snake and some were zig staged. I will attach a picture of only one I have.
doctor
Answered by Dr. Asmeet Kaur Sawhney 10 hours later
Brief Answer:
Scabies is a clinical diagnosis, microscopy shows the mite

Detailed Answer:
Scabies is basically a clinical diagnosis. It can be diagnosed under microscopy.
A burrow is scraped and the mite can be seen under the microscope.
The picture you have attached is not looking like scabies as the mite can only be seen under microscope and not with naked eye.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Asmeet Kaur Sawhney 12 hours later
I understand you have to see them under the microscope. But that is a scale from my scalp that is squiggly and s shape. Looks like it could be a scab from a burrow. I have had several that look like that. Is there any other scalp disease that has s shaped scabs that look like burrows.
doctor
Answered by Dr. Asmeet Kaur Sawhney 29 minutes later
Brief Answer:
Scabs from burrow are not S shaped, they are linear

Detailed Answer:
Scabs from burrows are very small and not S shaped, they are linear. Scabs are seen in multiple scalp disorders like folliculitis, discoid lupus erythematosus, lichen planus, dissecting cellulitis of the scalp and many other inflammatory diseases.

For confirmation of your diagnosis you should go for scalp biopsy.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Asmeet Kaur Sawhney

Dermatologist

Practicing since :2007

Answered : 4338 Questions

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