Skin Issues: Which Specialist Should You Consult?

What tests should I undergo?

Hello Doctor: I am 173 cm tall and weigh 100 kg, which makes me somewhat overweight.
Regarding my health, my father has diabetes, and I have Asperger's syndrome with jaundice (I do not have any hepatitis, and I undergo annual check-ups, although my GOT and GPT levels can be slightly elevated at 40 or 50).
I am unsure which department I should visit.
Every time I go to the dermatology clinic near my home, they prescribe medication and ointments, but I want to understand the underlying cause.
The topical treatments only provide temporary relief, and the issue tends to recur about once a month.

The symptoms involve my skin on the lower legs and upper limbs, where initially there are small red bumps that are not very noticeable but feel slightly swollen to the touch, measuring about 8 mm in diameter, and are extremely itchy.
By the evening, the redness becomes more pronounced and spreads, and I can feel 3-4 small blisters raised under the skin when I touch them.

Could you please advise what this might be, and which department I should consult for further examination? Thank you for taking the time to read my lengthy description.
Below is a link to a picture of my skin: http://ppt.cc/T8pH

Māomī, 30~39 year old female. Ask Date: 2013/04/13

Dr. Wu Yuxin reply Dermatology

Of course, you should see a dermatologist.
I can't see your image, but I recommend bringing it along to your appointment with the dermatologist.

Reply Date: 2013/04/13

More Info

When it comes to skin issues, especially those that are persistent and troublesome, it is essential to consult the right specialist to get an accurate diagnosis and effective treatment. Based on your description, it sounds like you are experiencing recurrent skin lesions characterized by small red bumps that are itchy and may develop into blisters. This could potentially be a form of dermatitis, such as contact dermatitis, or even a condition like urticaria (hives), but a definitive diagnosis would require a thorough examination by a qualified healthcare professional.

Given your medical history, including a family history of diabetes and your own health concerns related to liver function, it is advisable to consult a dermatologist. Dermatologists specialize in skin conditions and can provide a more in-depth evaluation of your symptoms. They can also consider any underlying systemic issues that may be contributing to your skin problems, especially since you mentioned having elevated liver enzymes.
In addition to a dermatologist, you might also consider consulting an allergist or immunologist if your symptoms are suspected to be related to allergies. They can perform tests to identify any allergens that may be triggering your skin reactions. This is particularly relevant if you notice that your symptoms worsen after exposure to certain substances, such as specific foods, fabrics, or environmental factors.

When you visit a dermatologist, it is crucial to provide them with a comprehensive history of your symptoms, including when they started, any potential triggers you have identified, and the treatments you have already tried. This information will help the dermatologist make a more informed diagnosis. They may recommend patch testing to check for allergies, a biopsy to rule out other skin conditions, or blood tests to assess for systemic issues.

In terms of treatment, while topical medications can provide temporary relief, they may not address the underlying cause of your skin issues. A dermatologist may prescribe stronger topical steroids, antihistamines for itching, or even systemic medications if your condition is severe or persistent. It is also important to follow up regularly with your healthcare provider to monitor your condition and adjust treatment as necessary.

To prevent future flare-ups, consider maintaining a skincare routine that includes gentle cleansing and moisturizing. Avoiding known irritants and allergens, wearing breathable fabrics, and managing stress can also help reduce the frequency and severity of your skin issues. Additionally, if you have any dietary habits that may be contributing to your symptoms, such as consuming high-sugar or processed foods, it may be beneficial to evaluate those as well.

In summary, for your skin concerns, it is best to consult a dermatologist who can provide a thorough evaluation and appropriate treatment plan. If necessary, they may refer you to an allergist or other specialists to address any underlying issues. By taking a proactive approach and seeking specialized care, you can work towards finding a solution to your skin problems and improving your overall skin health.

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