Persistent Back Pain and Acne: Seeking Dermatological Insights - Dermatology

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It sounds like you are experiencing a complex interplay of dermatological and neurological symptoms that have persisted for three years. Your description of the burning sensation, pain, and the recurring acne-like bumps on your left shoulder blade is concerning and warrants a thorough evaluation.
Firstly, the persistent back pain and the unusual skin sensations you describe could be indicative of a few underlying issues. One possibility is that you may be experiencing a form of neuropathic pain, which can occur when the nerves are damaged or irritated. This could explain the burning and tingling sensations, as well as the pain that feels like it is deep within the tissue. Neuropathic pain can sometimes be triggered by stress or anxiety, which you mentioned exacerbates your symptoms.
The fact that you have seen multiple specialists, including dermatologists and neurologists, and have not received a definitive diagnosis suggests that your condition may be multifactorial. The acne-like bumps on your shoulder blade could be a form of folliculitis or another skin condition that is exacerbated by friction or pressure. This could also contribute to the discomfort you feel in that area.
Additionally, the relationship between your emotional state and the physical symptoms is significant. Stress and anxiety can lead to muscle tension, which might exacerbate any underlying nerve irritation or pain. The sensation of your skin feeling "burned" or "tingling" could be a result of this tension, especially if you are prone to stress responses.
Here are some recommendations that may help you manage your symptoms until you can return to Taiwan for further evaluation:
1. Stress Management: Since your symptoms worsen with stress, consider incorporating stress-reducing techniques into your daily routine. Practices such as mindfulness meditation, deep breathing exercises, or yoga can help alleviate tension and may reduce the intensity of your symptoms.

2. Skin Care: For the acne-like bumps, ensure that you are using non-comedogenic skin care products. Avoid picking at the bumps, as this can lead to further irritation and potential scarring. Over-the-counter treatments containing salicylic acid or benzoyl peroxide may help reduce the occurrence of these bumps.

3. Physical Therapy: If possible, seek out a physical therapist who can help you with exercises to strengthen the muscles around your shoulder and back. This may help alleviate some of the discomfort and improve your posture, which can also contribute to nerve irritation.

4. Neurological Evaluation: When you return to Taiwan, consider seeing a neurologist who specializes in pain management. They may recommend nerve conduction studies or other diagnostic tests to better understand the nature of your pain.

5. Dermatological Follow-Up: A dermatologist may also provide insights into the skin issues you are experiencing. They might suggest treatments that target both the acne-like bumps and the underlying skin sensitivity.

6. Medication: If your symptoms are significantly impacting your quality of life, discuss with your healthcare provider the possibility of medications that can help manage neuropathic pain, such as gabapentin or pregabalin, which are often used for nerve-related pain.

In conclusion, your symptoms are complex and may require a multidisciplinary approach for effective management. It is essential to communicate openly with your healthcare providers about the full scope of your symptoms and how they affect your daily life. This will help them to tailor a treatment plan that addresses both the physical and emotional aspects of your condition. I hope you find relief soon and that your return to Taiwan allows you to seek the care you need.