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Impetigo

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I started getting a small, localized patch of itchy skin in the center of my chin. it became swollen and blisters erupted.

Submental nodes are swollen, and I can see in my profile that my chin is larger.

Both have happened before on separate occasions.

Whenever the submental nodes swell, I get the feeling that it is not normal at all. What should I do besides ‘see a doctor’? What type of tests do you think I should request?

I also feel like my menstrual cycle for the past year has had extreme symptoms, depression, tender swollen/breasts. I have medicaid and go to a community health center. The OBGYN PA chalked it up to getting older and having changes, saying my tests look fine. But I feel like something is not right.

I am an ex smoker, but alternated between smoking and being very athletic and healthy. I went to the emergency room 3 months ago for severe back back that turned out to be Acute Pyelonephritis. My mother has had lung cancer 2 years ago and had shingles two months ago.

What types of tests, scans, or panels should I be requesting?


Category: Endocrinologist

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Category: Diabetologist
Dr. J Muthukrishnan is online now

Expert:  Dr. J Muthukrishnan replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

The lesion appears to be a infective lesion. (bacterial infection like impetigo in view of the lymph node enlargement )

You need to take a course of antibiotics, as it seems to be an infective lesion on your chin. A course of 10-14days of Cefixime or Azithromycin may help.

Regarding your menstural symptoms could you explain it more ? When you say severe is it like more days / increased bleeding ? / or just increased pain and symptoms ?

I will recommend you some suggested tests based on this information.

You can reply as a followup
Thank you


Patient replied :


I have breast soreness about 20 days out of my 30 day cycle. About 14 days before I start bleeding I have weight gain, from having an unsatisfiable appetite. Right before my period, I get warm. I'm not in my 50s but I can only describe it as a hot flash. I get severe depression at this time too, crying spells ,and I lose weight right before my period comes. I have brown spotting/mid cycle bleeding as well. When it does come, I have extreme fatigue and painful cramps. Once every 3 months, I'll be very nauseous with it and buckle over in pain although I will not vomit. Throughout the month, I get a dull pain in my lower left quadrant. Sometimes if I bend in the wrong direction, the pain will shoot from the front to back. It is located about 1 cm above my hip and 4 cm toward the midline.... This pain though, I have told several doctors about and I have had for probably 10 years of my life now, on and off, and they all say there are no major organs there... and follow up with a standard blood test panel, which is such an incredibly ignorant way to go about diagnosing. I felt for a long time I should probably be referred to a specialist of some sorts.... It wasn't until I finished school to be an EMT this year, that I realized I probably need an endocrinologist. Thank you for your help. I am going to find a clinic today to try to get a prescription for an antibiotic. I have my cousin's wedding to go to next weekend. Do you know how terrible it feels to have a swollen double chin and an infection on your face when you try to look for a dress to wear for a wedding? And I going to be a featured reader/speaker! Good thing I don't like to drink anyway....


Expert:  Dr. J Muthukrishnan replied 3 Days.

Hello,

Thank you for the additional information.

I would prefer a step by step approach than a blind shot of tests. A possibility of endometriosis has to be ruled out. You will require a physical examination, Ultrsound of abdomen and pelvis, CA 125 levels, Thyroid levels (if not done already).

Regarding the lesion on the face, I understand it could be really troubling. Although Dermatology is not my area of specialisation, I am sure the last thing you want is any kind of scarring. So do not scratch or rub the lesion.

Take care
Hope this helps
Feel free to ask followups
Thank you


Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
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