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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do red bumps in the pelvic and lower extremities indicate?

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Dr. Prasanna Heijebu

General & Family Physician

Practicing since :2010

Answered : 1423 Questions

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Posted on Mon, 2 Nov 2015 in Skin Hair and Nails
Question: Signs: patches of red bumps from the pelvic area, buttocks, and lower extremities, primarily on the left side.

Symptoms: acute to moderate itchiness

Allergies: no known food or drug allergies

Medications: Truvada 1qd, cetirizine 1qd, multivitamin 1qd

Pertinent medical history: sexually active MSM with multiple sexual partners, roommate works at health care facility that had patient with dead bedbugs found, but no known direct contact with any bedbugs.

Duration: 4 days, rash seems to increase and decrease in area during the time frame, most noticeable at night.

Have not changed soap or shampoo, laundry detergent may have been different for some of the clothes worn during time frame. No dietary changes in the past week.No visual , apparent signs of bed bug infection at home on or in bedding . Started Truvada about 2 months ago, cetirizine regularly for more than 1 year, multivitamin for more than 1 year. Brand has not changed for either cetirizine or multivitamin.
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Answered by Dr. Prasanna Heijebu 11 hours later
Brief Answer:
Possible Vasculitis associated rash.

Detailed Answer:
Hello, Sir.

I can understand your concerns.

I have gone though your attached images.

These rashes could possibly relate to Hepatitis B induced cutaneous vasculitis.

Since it did not respond to standard antihistamines and antiviral agents, It seems to be autoimmune in origin.

I advise you to get a skin biopsy before starting therapy with immunomodulatory agents.

A complete 10- panel STD screen testing is also advisable before considering it to be vasculitis, considering your high risk sexual behavior.

Further management is based on test results.

Post your further queries if any.
Thank you.




Above answer was peer-reviewed by : Dr. Raju A.T
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