Brief Answer:
Possibility of infestation; Do you itch?; Keratosis pilaris on knee

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have also reviewed the Image. I can see red, inflammed, excoriated skin lesion on leg.

I would like to know whether these are itchy? do you scratch them?

I will like to treat you empirically for infestation (either scabies or pediculosis). Scabies is caused a mite, sarcoptes scabiei and pediculosis by body lice.
I suggest a single application, whole body application of 5% permethrin cream Or 1% gamma benzene hexachloride lotion, whole body, from neck downwards, left overnight for 8-12 hours and followed by a bath next day.
I have answered one of your previous queries a few days ago in which I had suggested you to treat for infestation. Did you follow that?

In another Image I can see that you have pin-head sized, pointed, seemingly rough lesions on knee.
They seem as lesions of 'keratosis pilaris' and is due to underlying dry skin of legs. I suggest you to use a good moisturizing cream/ lotion, preferably a urea Or ammonium lactate based moisturizer, twice daily, for a few days.

I also suggest you to take a tablet of cetrizine 10 mg once daily in evening.

Regards

---

Brief Answer:
Not related to herpes

Detailed Answer:
Hi.

No. These are not related to herpes i.e hsv-1
Hsv 1 typically causes cold sores which presents as small, fluid filled, grouped lesions on Or around the lip mucosa and has a weird tingling or burning sensation associated.
I suspect this to be most likely an infestation and If I was the treating doctor I would suggest treating you empirically for the same.
You may also take a tablet of cetrizine 10 mg once daily for a few days for symptomatic relief from itching.

Regards

---

Brief Answer:
Lesions not typical Of EM; upload pic of face again.

Detailed Answer:
Hello.

Herpes associated erythema multiforme (EM) is a well known entity.
Erythema Multiforme typically present as target shaped lesions i.e three zone.. 1. central necrosis or ulceration ,2. a ring of edema and 3. peripheral zone of erythema.
Acral body parts like hands, feet, face (lips) etc are involved with EM lesions.
Lesions which you have don't seem very typical of EM.

Herpes simplex is usually a localized eruption of fluid filled vesicles. Apart from secondary bacterial infection there isn't any other complication really.

I could not find any picture of face. Kindly try and upload again. You may upload either at Reports Section Or else you may mail me at YYYY@YYYY with the subject line as Attn:Dr. Kakkar.

Thank you

---

Brief Answer:
Keratosis Pilaris; Urea or ammonium lactate based moisturizer & Oral Vit A

Detailed Answer:
Hi. I have reviewed the Image.

I can see follicular papules which are acuminate and devoid of hair. The hair that emerges from the follicle is trapped/ coiled inside the keratin plug at the orifice of hair follicles. These are Keratosis Pilaris. Keratosis pilaris can be itchy.
You had the same condition on skin of sides of knee as well, which you posted in earlier images.

I suggest that you use a moisturizer preferably one which contains urea 10-20% Or ammonium lactate 12% in it. Use it twice daily. Urea and ammonium lactate are keratolytic and help dissolve the follicular keratin plugs of keratosis pilaris.

An Oral Vitamin A supplement e.g 50000 IU of retinyl palmitate once daily for 1-3 months, would also help dissolve these follicular keratin plugs.

You may take a tablet of cetrizine 10 mg once daily for symptomatic relief from itching.

Regards

---