onsdag den 28. maj 2014

Observing rashes / At observere udslæt

The rash has special qualities. It's apparent to observers of a condition, and it's often specific to one single condition. Therefore the Erythma Migrans holds a special property and potential in not only diagnosis but also in research on Lyme disease. It's trivial that a rash means infection, but how about the case where there's a rash but the serological testing says that there is no infection? Should one trust the clinical presentation, or the serology? A rash could be shrugged off as a recent infection that has been defeated by the body. But what if the rash persists for months after a negative serological response? That's what happened to me.

At Bispebjerg Hospital in Copenhagen, I was told by a neurologist and an additional doctor that the combination of twitchy face and toes was highly indicative of infection (especially held against 6-months-earlier symptoms of summer fever with migraine and stiff neck after one identified tick bite, long developing erythma migrans and no medication because I ignorantly shrugged the risk of persistent illness off, even as I had a receipt for Doxycycline). A meeting was held on whether they should proceed to do a spinal tap. I waited in an acute emergency room, and they returned to say 'go' on the test. Hours later, when the results came back, a third neurologist entered the ward where I laid in wait for results, briefing me that the results said 'no infection', and then proceeded to give the following explanation for my symptoms: The twitches were just 'common stuff'. The rash was declared ringworm, with no closer inspection of its characteristics. Personally, I would call this step malpractice, but it follows logically from adhering to serological testing. Although you would have to accept an unreasonable string of coincidences for it to be true:

=> Tick bite
=> Random summer fever with random neck stiffness and migraine and nausea
=> Random distinctively flat ringworm rash developing slowly in size over five months without spreading to other body parts and absence of itching and absence of lightly protruding edges as is to be expected from ringworm rashes according to medical handbooks
=> Random neurological 'common twitches' to suddenly introduce themselves after lifetime of zero experience with such symptoms
=> ....

... And this is where it gets even weirder. For, as I was sent home, I continued to experience twitches more and more frequently over months, until some nights involved lightly shaking through my entire legs as I attempted to fall asleep. And what happened to the rash? It started to disappear spontaneously one day, clearing over a week or so. I had asked for a receipt for ringworm medicine but had not taken any from the tube that to this day remains full in my refrigerator. So the 'ringworm' just cleared with no medication. I have yet to consult a dermatologist on whether this miracle is common among 'ringworm'-patients ...

... So to the list of randomly coinciding occurrences, we should add ...

=> twitches intensifying over several months
=> spontaneous clearing of ringworm-infection

And the cherry on top, here are some pictures of weird skin rashes on my buttocks and around my hips. They have been there at least one year, and I thought of them as stretch marks. But all this weird stuff that's happening with me, it makes me think they should be investigated by a professional, just to know precisely what caused it.












My plan is to visit a dermatologist and ask what they are, and also whether 'ringworm' can clear spontaneously by itself, and be flat.

Ingen kommentarer:

Send en kommentar