Topic

Unknown Syndrome?

This is the 3rd time in 3 years I am having this 'syndrome' which so far has not been labelled or properly treated. It starts with a a subtle feeling of difficulty in swallowing. This is usually followed by a tingling sensation in my throat. It becomes sore throat and low grade fever for which I take paracetamol to relieve. Few days later I start feeling tenderness in my tongue and after a couple of days I wake up to find my tongue has this white surface typically like thrush. When I had this the first time I was prescribed oral anti-fungal azole. However now I know it is not a fungal infection. This continues for few days before it starts to clear leaving a red and tender tongue with very tender and itchy tip. Then the main attraction starts. My finger tips in my palms start to become hard (near the tips close to the nails) and gradually each tip becomes hard and dies off. each finger tip then pops open and the skin dies off and I start removing the dead skin leaving the skin underneath red and sensitive. The whole process goes to my sole of feet as the whole sole of each foot also dies off and the skin becomes insensitive to touch and I start removing large pieces like when you take off your socks. The whole process is painless but distressing visually horrible and the affected areas are tender and it hurts to walk. In the past my dermatologist started me on steroids (a week or 10 day's course gradually reducing). However I am not sure if this has been helpful. The syndrome continues for a month before it clears off. What is happening?

2014-12-10 03:47:44

Ben

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You have described your symptoms very well. Since the symptoms occur again and again and follow a course and end by themselves possibility of a viral illness of the hand foot and mouth (HFM) disease type should be seriously considered. This viral illness is common in children under five years of age but it can also affect adults. It begins with a feeling of malaise fever sore throat mouth ulcers and a blistering rash on palms and soles which may extend to involve elbows and knees. You may not have the typical rash seen in HFM disease but the course of symptoms is identical to this disease. Throat samples can be sent to look for virus (usually the enterovirus group). There is no treatment specific to the illness except managing the symptoms maintaining good personal hygiene eating healthy and leading a healthy lifestyle. The second possibility is H pylori infection of the stomach. Usually there is acid reflux and this causes sore throat and the infection itself causes malaise. The tongue becomes red and sensitive due to the acid reflux. H pylori infection has been linked to several types of dermatitis. Diagnosis is through blood tests endoscopy and carbon urea breath test. Treatment is through antibiotics and medications to reduce acid production and treat reflux. The symptoms wax and wane according to climate diet stress and lifestyle. The third possibility is an inflammatory bowel disease such as Crohn’s celiac or IBS. This can present with reflux and vitamin B12 deficiency which can cause the tongue like symptoms. The symptoms wax and wane with days of inflammation interspersed with days of remission. Sometimes IBS and Crohn’s is linked with dermatitis and skin rashes and this could be happening in your case as well. Another possibility is a skin disorder called pemphigus. This can cause blisters in mouth and skin and the skin blisters can peel off. This is diagnosed by identifying desmoglein antibodies in blood tests and doing a skin biopsy. It can also be a condition called Staphylococcal scalded skin syndrome (SSSS). Diagnosis is through culturing the peelings and raw skin surfaces and identifying the staphylococcal bacteria. If SSSS is diagnosed then a sensitivity test is run and the antibiotic most suited is given to control the infection. Other than this it can be a fungal infection which can be diagnosed through blood tests biopsy and culture. It is difficult to confirm the diagnosis on net but please thrash out these ideas with your treating doctor. Hope you get well soon! Good Luck and take care!

2014-12-10 03:48:57

Amy