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What causes tender lesions on back spreading towards breast?

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Posted on Tue, 17 Mar 2015
Question: I had a massage a 1 1/2 weeks ago, the next day I had pain in my back and went to the chiro (he said I had a rib out of place. I started taking over the counter naproxen to help with pain. I have now developed lesions with a center they are tender to touch but are not painful, it started with one on my back and has spread I have 2 on my side and now on my breast., yesterday there was one on my breast red lesion looking and this morning I woke up to more on my breast. It happens to be the same side of the muscle/nerve pain I have been having issues with the lesions are no where else on my body, the been showing up over the last 3 days. My husband said the one on my back appears to be healing around the edges, but is still there in the center.
doctor
Answered by Dr. Klarida Papaqako (3 hours later)
Brief Answer:
Need more information to rule out all the possible diagnoses of lesions

Detailed Answer:
Hello XXXXXXX

Thank you for posting to HCM.
I read carefully your query. I may need some other information though, and its also possible to attach photos of the lesions to our system, so I can see them. Its difficult to understand skin lesions without having a look at them.

Some other things I need to know are:
-- Does the skin feel like numb to the place the lesions are appearing?
-- Vesicles? fluid coming our of them?
-- Fever? Does it affect general condition? Other associated symptoms?
-- Have you traveled lately, been in contact with children, or ever heard about contagious problems in your area? Does anyone else has those lesions in your family?
-- Do you suffer from any other diseases or take any medicine daily (including herbal supplements or over the counter medicines)?
-- Can you tell me the name of itchy cream you are applying?
-- When was the last time you have done blood check ups? What have you done and how did they come out in general?
-- Are you sexually active, and in a regular relationship? How is your mendtrual cycle?

I'm sorry to make all these question, but in order to give a proper advise, I need to do a thorough differential diagnoses.
From what you are describing, the massage may not be related to the lesions, and maybe they were just a coincidence to have appeared right after the massage. But please, give me the information required and I will be happy to give you my thoughts about your problem.

Looking forward to your reply.
Regards,
Dr. Papaqako.

Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Klarida Papaqako (2 hours later)
Answers to your questions.
No numbness some tingling
no fever or other issues except the nerve/muscle pain in back.
have not traveled
no contagious issues iny area
live with my husband he has no lesions
I take generic Xanax 1mil
I take 1 impramine not sure of dosage but low helps with my bladder (urgency)
recently started taking Advocate
the cream I used this morning was hydrocortisone 1%
November my blood was drawn for work health assessment normal ranges
married monogamous sexual active
still having regular menstrual cycle last period 1/23/15
I have uploaded a picture of my breast with the lesions
doctor
Answered by Dr. Klarida Papaqako (1 hour later)
Brief Answer:
Doesn't look worrisome to me, but will need follow-up anyway.

Detailed Answer:
Hello again dear XXXXXXX
Thank you for the information provided.

In summarizing all that, it looks like a low risk for problems who would be complicated. Its not a typical common problem either.
My thoughts about your lesions are to be most probably a fungal infection.
It is not a bacterial infection, so bacitracin wont help much- no skin damage, not painful or pus on it.
Doesn't look like an allergy either- would have been very itchy and and the lesion elevated from a skin, so hydrocortisone may not be helpful as well.
If I was your caring doctor I would use an antifungal cream like ketoconazole 2% twice/day and an antifungal shampoo for 2 weeks, and see it it helps. It will keep the skin moisturizing, even if dry skin is causing them.

Again, I dont think it is related to rib pain, not with what Im hearing from history of how your rib pain started. Unless you are taking other meds, not mentioned above for the pain, and you are somehow allergic of them (?)

Some red flags you should look though, are if they get painful, if spreads in all your body, if you start having fever, if its getting worse or not better in 2 weeks time. In that case consider doing visit to a dermatologist and some labs like a complete blood count + a liver function test.

I hope I answered your question. Let me know if you have further questions.
Take care
Dr. Klarida.
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Klarida Papaqako

General & Family Physician

Practicing since :2010

Answered : 1614 Questions

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What causes tender lesions on back spreading towards breast?

Brief Answer: Need more information to rule out all the possible diagnoses of lesions Detailed Answer: Hello XXXXXXX Thank you for posting to HCM. I read carefully your query. I may need some other information though, and its also possible to attach photos of the lesions to our system, so I can see them. Its difficult to understand skin lesions without having a look at them. Some other things I need to know are: -- Does the skin feel like numb to the place the lesions are appearing? -- Vesicles? fluid coming our of them? -- Fever? Does it affect general condition? Other associated symptoms? -- Have you traveled lately, been in contact with children, or ever heard about contagious problems in your area? Does anyone else has those lesions in your family? -- Do you suffer from any other diseases or take any medicine daily (including herbal supplements or over the counter medicines)? -- Can you tell me the name of itchy cream you are applying? -- When was the last time you have done blood check ups? What have you done and how did they come out in general? -- Are you sexually active, and in a regular relationship? How is your mendtrual cycle? I'm sorry to make all these question, but in order to give a proper advise, I need to do a thorough differential diagnoses. From what you are describing, the massage may not be related to the lesions, and maybe they were just a coincidence to have appeared right after the massage. But please, give me the information required and I will be happy to give you my thoughts about your problem. Looking forward to your reply. Regards, Dr. Papaqako.