Seemingly untreatable cracked skin + infection on chin for 2.5yrs. anyone seen similar?

Skin, nail and hair health
1

I don't even know where to begin. This is going to be really long. I am losing hope and will try any platform to try and get answers. I am seeing doctors and dermatologists regularly to little avail and the psychological effects of this thing on my face for so long are ruining my life.

My skin issue can be split into two areas: severely dry, cracked skin on my chin and the reoccuring, untreatable infection of the wound.

I have been suffering with incredibly dry, cracked, scaly, on-and-off infected skin on my chin for 2.5+ years. I have seen so many doctors I've lost count, seen two dermatologists. Not a single thing we have tried in 2.5 years has worked. Saying that, the dermatologists have been disappointingly uninterested and the doctors have admitted to having little to no skin knowledge.

Pics of my chin: https://imgur.com/a/a2Yga .

I have a million and one pictures of my skin in varying states but those are all from the last month. Worth noting the spots around my mouth have only appeared in the last 6 months and are none stop.

Brief history:

- never had problems with my skin growing up

- Jan 2015 (age 21). Woke up new year's Day 2015 with dry, red, sandpaper-like skin on my chin and underneath my bottom lip. Visited doctor a number of times who have me varying moisturisers and emolients. Over 5 months it spread to my top lip, eyelids and under eye area. In may 2015 it (almost) disappeared for a whole year.

- may 2016. My skin started to 'flare' in the same places, such particular patches on my skin and eyelid that it was definitely the same thing. Kept trying different moisturisers and treatments.

- august 2016. I got impetigo around my mouth for the first time. Easy to treat with fusidic acid.

- for the rest of 2016 my skin got increasingly worse, turning from red, flakey, itchy patches to cracked, weeping, often bleeding patches localised only to my chin underneath my bottom lip.

- from November 2016-September 2017 I have had impetigo so many times I cannot count (over 25) but in reality it could be ongoing impetigo that hasn't been properly treated.

- by July 2017 I was resistant to fusidic acid and flucloxacollin and my impetigo was untreatable. Nose swabs taken in May 2017 came back negative for any MRSA/staph colonization.

- September 2017. My doctor has given up. I have given up. I requested two more swabs of my nose and mouth for MRSA this morning at the doctors. My skin has become less about treating the underlying dry skin issue and more now about the recurrent infections I get due to my open wound.

now: the pictures above show my skin up until yesterday (they are in no order). Sometimes I wake up with impetigo, sometimes I wake up with slight yellow skin, sometimes I wake up with no visible infection but just cracks. Sometimes it weeps, sometimes it is accompanied by lots of puss-filled spots. Sometimes it looks like I have got the most severe chin-dandruff you can imagine. Some days it looks like it may be going away. No matter what, infection or not, by the middle of the afternoon, my skin is torn open, cracked, itchy and severely dry.

Over the last two years I have had the following treatments/tests/antibiotics for the dry, scaly skin:

- ketoconozole cream and shampoo (2015 - first doctor said it may be sebhorric dermatitis. No improvement)

- metronidazole tablets. No improvement.

- lymecyline (for the possibility of perorial dermatitis. Taken in 2016 and I am currently on this now for no real reason other than the doctor doesn't know what else to prescribe currently 1 month into a 2 month course. No improvement)

- steroid cream. No response.

- several blood tests for things such as thyroid, diabetes. All came back fine.

- b12 levels tested. All good.

- taken multivitamins

- take evening primrose oil

- did an elimination diet where I basically ate potatoes for 6 weeks. No change.

-patch test revealed minor allergy to nickel and nothing else. I have never had a rash anywhere else on my body from contact with jewellery, zips, holding keys/coins. Am very skeptical of this but continue to avoid as much nickel as I can for the purpose of testing any relation to my chin.

- I have had the Mirena coil in for 4.5 years and have had a mess of issues caused by the hormones. I am getting it removed before the end of the year in case the hormones have anything to do with it.

In relation to the infection:

- used fusidic acid cream for about 9 months successfully. By the end it was back-to-back infection and I was resistant to the cream.

- uses flucloxacollin twice, impetigo came back straight after the course finished.we concluded that I am also resistant to this antibiotic

- nose swabs taken for MRSA in May 2017. Negative.

I have probably missed so much out of this because after 2.5 years of none stop trying things and making sporadic notes and taking literally hundreds of pictures, it has all blurred together.

My current skincare routine: I don't really have one. I splash my face with water and use Simple rich moisturiser all over my face. Then on my chin I put whatever emolient/heavy cream I have to hand. Diprobase, dermol, cetraben. You name it, I have a giant bottle of it. On a night I do the same thing.

The only makeup I have worn in the last year is something to fill my eyebrows in, either eyeshadow or a pencil.

Has anyone ever seen anything like this before? Even prior to the obvious mysterious infection my chin/mouth was severely dry. We have always treated both as two separate issues but I do think it's possible they may be the same issue form the beginning, building up?

I'm so sorry this has been so long. If you need any more information from me, I will happily provide.

Thank you.

2

Hi. Interested to know if you have other health issues...you make reference to 'hormone' issues. Wonder what else is going in that could be significant?

3

Hi, thanks for responding.

Since i got the Mirena Coil 4.5 years ago I have had the following issues which I put down to the coil/hormone imbalance (but not confirmed):

- spotting for 1.5yrs straight

- 6 months of hair loss

- 6 weeks of 3-day long migraines back to back

- more frequent spots/acne on my chin (around the affected chin area)

My general health:

- aches and pains. My right knee gets sore often, especially after exercise. I saw a physiotherapist and we tried balance exercises etc. which temporarily helped but after any exercise or prolonged movement my knee aches too much to continue. I've also recently had an issue in my coccyx region with a similar joint pain when sitting/sneezing etc.

- i get headaches quite often, general dull headaches but also random spikes in all sorts of areas of my head. I put it down to stress because i drink 3 pints of water or more a day and seem to be relatively healthy in terms of the nutrients/vitamins i eat.

- i lack energy. I get tired very quickly even when I haven't done anything. It comes over me in waves and if i'm at home, I'll go and nap during the day. Could just be boredom!

I'm 24 if it is relevant. 

Thanks

4

Sorry Margaret, forgot to mention I have had tinnitus in my right ear for the last 5 months and recently had an MRI scan to rule out anything growing on/near my ear.

5

Hello Natalie, what an awful time you are having.  Have you had the coil removed yet?  I have just done a little research on it & some women do have an allergic reaction to it & not necessarily immediately.

I can only say what I would do & I am not telling you that this is what you should do.  I would have it removed & then see whether my skin improved.  

A potent steroid cream might help clear the skin condition.

I do urge you to have the coil removed

And regarding the nickel allergy.  I too am allergic to nickel & things were much better, when I discovered that Marks & Spencers bras are nickel free, unlike some of the much more expensive ones.

Good luck.

6

Have all of these other problems you mention started since you had the coil fitted?

7

Hi Natalie. Cimplicated picture there. My personal feeling is have the coil removed and see if it affects anything in a positive way.

But the symptoms you describe were all symptoms I had with an auto immune disease, a form of vasculitis.

If I were you I would certainly ask for a referral to a rheumatologist. There is no standard blood test fir these conditions which is why gp's struggle to diagnose. Scans likewise often clear. There can be clues in bloodwork looking at esr crp ana and dsDNA. Not the all tests your gp will do but a rheumatologist should.

Getting a diagnosis if it is something like that can be tricky. You need a goid rheumy and they aren't always very understanding if these conditions. If you are in the uk please look at the website for vasculitis uk. Very knowledgeable and helpful.

If in the end it isn't vasculitis you would be closer to understanding what it is. The joint pain has to be addressed if nothing else as does your skin problem.

8

Hi,

Unfortunately no, I have to wait a little while to get it removed as the strings wrapped around the coil before the 6 week check so I need an ultrascan to identify where the coil is and then be referred for 'minor surgery' to have them take it out by prodding around me until they find it!

In terms of the nickel allergy, I can only imagine mine is super mild because i have never had a reaction on my wrists/ears/hands etc. where I have worn jewelry or held keys/coins etc. I will reconsider all my clothing for nickel though!

I had the coil fitted in May 2013.

​All of the 'temporary' problems in my response to Margaret came on between May 2013-2015.

All of the problems in my original post have been since January 2015.

9

Thank you very much for the advice.

I am in the UK and will take a look at the website you mentioned. 

I have posted my story on other forums/websites and all suggestions point to an auto-immune disorder. I will suggest to my doctor the tests be taken and if necessary, a referral to a Rheumatologist.

Thanks again.

10

I am no expert obviously and can't diagnose your problem. But my personal feeling is that the coil is a coincidence or contributing to an already underlying problem. I had hair loss, tinnitus, migraine, vestibular problems and sore joints. I have never had a coil fitted. I feel your symptoms were underlying and progressing (as mine did....month upon month year upon year) and the coil is leading you up another path which may be unrelated. It may be exacerbating issues at most but I feel not causing them. I would try to get that diagnosis properly. Speak with Vasculitis uk and see if they can recommend someone close to you who might be good. If you live around the Cambridge area there is a great clinic at Addenbrooke's but if not ask the helpline where might be good. xx

11

What an interesting story,and I'm sorry I dont have any answers but have you tried using Manuka honey on your chin? It seems to be used for all sorts of skin eruptions with great success. Try to get a medical grade,but if you just buy a pot look for the grade. The higher grade the more % pure Manuka honey. The cheaper brands are a blend. Hope you find an answer soon

12

More thoughts........have you had this lesion biopsied? If so what were the results?   Has anyone suggested UVB light therapy?  Have you tried a retinol cream?      .