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6-month-itch

Misdiagnosed As Arthropod Reaction?

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I have been dealing with a horrendous rash/bug bites for the past six months. First biopsy (on lesion) that was taken of the lesion suggested arthropod. Put on prednisone for 4 weeks and gave me permethrin just in case, though doc did not think scabies). Did not respond to prednisone (only that new bumps did not show up and still itchy after permethrin). Other three family members at home have no signs. Went to another derm who also did NOT think scabies and did another biopsy which suggested possible pemphigoid but not strongly. Went to another derm who said I had scabies and nummular eczema and gave me oral ivermectin. When my bumps were still there with only mild improvement he gave me a shot of triamcinolone right before my 2nd and last dose of ivermectin. Finally bumps were going away though large nummular-looking ones were stubborn. However, once the triamcinolone started wearing off, the bumps/bites started coming back, many of them in the exact same spots (I could tell because of the scars that I had). Went to fourth derm who suggested DH but my blood tests came back neg. So she took another biopsy (on the lesions, not next to them) and said the results suggested arthropod reaction.

My question is if one has dermatitis herpetiformis and a skin biopsy is done ON the lesion, can pathology come back to suggest an athropod hypersensitive reaction?

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A DH biopsy must be taken adjacent to an active lesion.  DH sufferers can have normal blood test results.  

 

What bug do the doctors think is biting you.  Do you have pets?  Because you are possibly having an allergic reaction, the status of other family members becomes a non-issue because they may not have the same allergy.  What is the most likely scenario for your situation taking out the other family members?

 

Colleen


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I do have two dogs who in the summer had fleas, so I thought these were flea bites.  But we got those under control in September and have not seen a flea since.  The dogs were also given doses of ivermectin when I was given ivermectin.  The bumps are all over my body except for soles of feet and there are just a few on my hands (not in webs).  When the triamcinolone had worn off, the bumps also were on my scalp under my long hair, though now I believe those have healed since my scalp is not too itchy anymore.

 

The bumps often start out looking like, maybe a pimple.  They are still small when the tips become fluid filled (clear) and burst easily if clothing rubs against them.  So since they break easily the bump starts to scab over, the bumps get wider, and then as the center is scabbed little secondary reddish bumps form around the perimeter, which make them look a lot like the "herpes" description.  This evolution takes about a week and a half to two weeks.  Though itchy all day, get extremely itchy starting around 2 p.m. and on.  Very scarred, with my skin darker where the bumps were.

 

Another thing is we did move into a new house last summer.  Bumps started about a month and a half later when we had the flea problem.  We had two companies come out to look for bedbugs and each said absolutely no signs and with the amount of bumps I have they said they would have likely found some evidence.  They also checked the dogs for fleas and did not see any either.  We also have had those bedbug covers on all mattresses.  We have had a total of 13 family member and friends come visit us and stay overnight on four different occassions (5 people we let sleep on our bed at least three nights in a row) and no one has said they had experienced any bites.  We have not had any suspicions of mice or rats.  We do live in a pretty woody area but it is winter now.

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I can't say if a biopsy ON the lesion can come back to suggest an athropod hypersensitive reaction although dh biopsies done INCORRECTLY on a lesion have come back with all sorts of various "suggestions". The derms have all done a dh biopsy WRONG. They must be taken on clear skin ADJACENT to an active lesion AND if you've been on oral or injected steroids in the last 2 months you will get a false negative. Don't use topical steroids either for about 3 weeks before a dh biopsy. You MUST be eating a full gluten diet for the dh biopsy or you will have to do a gluten challenge.

It sounds to me like you have dh -- the way you describe it, how it acts as well as what you've been through with treatments to no avail.


Gluten free Dec. 2011
Dermatitis Herpetiformis

Reynaud's October 2018

Rheumatoid Arthritis October 2018

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6-month-itch, did you ever get this resolved? I have been going through exactly what you described with my 11 year old son. We've been dealing with this for 1 year now, have tried all kinds of creams including topical and oral steroids, scabies cream, there are no bed bugs, no fleas on the dogs...the dermatologist did a biopsy of the lesion (incorrectly I've been reading) and it comes back as a "bug bite". I even suggested DH after hours of research, but he didn't think it was that.

 

I would love to know if you've successfully diagnosed this. I am so frustrated with all the doctors we've seen (pediatric, dermatologist, and allergist). He also has intentional issues (explosive diarrhea), which I know can be related to the celiac and DH. We're set to see a pediatric dermatologist, but can't get in until December. Meanwhile, poor thing is self-conscious of his arms/legs, and itches like crazy. Has a hard time sleeping because he wakes up itching all night.

 

Thanks!!!

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My biopsy showed arthropod bites/hypersensitivity to an external allergen/drug erruptions. Turned out, the rash was caused by a prescription drug I had been taking for years to sleep. Out of the blue.  It recently started again when I started taking generic  Ambien, which never caused problems in the past, but the lesions took two weeks to start popping up in many of the same places as before: abdomen, top and back of thighs, fingers, arms, hips.

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