Confused About My Skin Symptoms: Seeking Clarity on Eczema or Scabies - Dermatology

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It sounds like you are experiencing a complex and frustrating array of skin symptoms that have not been adequately addressed by previous medical consultations. Based on your description, it seems you have been diagnosed with both eczema (湿疹) and scabies (疥瘡) at different times, which can understandably lead to confusion about the underlying cause of your symptoms.

Eczema is a chronic inflammatory skin condition characterized by dry, itchy, and inflamed skin. It often appears in patches and can be triggered by various factors, including allergens, irritants, stress, and changes in temperature or humidity. The fact that your symptoms began around the breast area and then spread to other parts of your body, along with the rough texture and discoloration, aligns with typical eczema presentations. The blackened areas you mentioned could be a result of chronic scratching, leading to a condition known as lichenification, where the skin thickens and darkens due to repeated trauma.

On the other hand, scabies is caused by a mite infestation that burrows into the skin, leading to intense itching, especially at night. The rash associated with scabies often appears as small red bumps or blisters and is typically found in specific areas, such as between the fingers, on the wrists, and around the waist. If you were treated for scabies but still experience itching and new rashes, it is possible that the treatment was not fully effective, or you may have been re-exposed to the mites.

The presence of red bumps on your arms and the recent development of severe acne-like lesions on your face, particularly around the chin and cheek, could indicate a few different conditions. These could be related to an exacerbation of eczema, a secondary bacterial infection due to scratching, or even a separate condition such as acne or folliculitis. The fact that you are experiencing itching at work could suggest that environmental factors, such as stress or allergens in your workplace, are contributing to your symptoms.

Given the complexity of your case and the lack of improvement despite multiple consultations, I recommend the following steps:
1. Seek a Dermatologist Specializing in Complex Cases: It may be beneficial to find a dermatologist who specializes in difficult or chronic skin conditions. They can provide a more thorough evaluation and possibly perform skin tests or biopsies to determine the exact nature of your skin issues.

2. Keep a Symptom Diary: Document your symptoms, including when they occur, any potential triggers (such as foods, stress, or environmental factors), and the treatments you have tried. This information can be invaluable for your healthcare provider in diagnosing and managing your condition.

3. Consider Allergy Testing: Since eczema can be exacerbated by allergens, consider asking your doctor about allergy testing to identify any potential triggers that may be contributing to your symptoms.

4. Avoid Scratching: While it is easier said than done, try to minimize scratching, as it can lead to further irritation and potential infections. Keeping your skin moisturized and using anti-itch creams may help alleviate some of the discomfort.

5. Explore Treatment Options: Depending on the diagnosis, treatment options may include topical corticosteroids for eczema, antihistamines for itching, or prescription medications for scabies if that is confirmed. If you have developed secondary infections, antibiotics may be necessary.

6. Follow Up Regularly: Regular follow-ups with your dermatologist can help monitor your condition and adjust treatments as necessary.

In conclusion, your symptoms may stem from a combination of eczema, possible scabies, and other skin conditions. A comprehensive approach involving a specialist, thorough evaluation, and careful management of triggers will be essential in finding relief from your symptoms. Remember, skin conditions can be complex and may require time and patience to manage effectively.