A summer spent identifying my unpronounceable skin conditions

It started with what I had assumed was an ordinary breakout. I’d been stressed from moving for the first time in my life, and had punted on my typically zealous hygiene because, well, moving. You can’t really blame your skin for getting bad when you stop doing the things that make it good.

Breakouts are already stressful enough, but this one was particularly bad. I had a brand photoshoot coming up in August (more on that in my next column), which meant I had a little under two months to whip my skin into shape.

Fortunately, I have a standing doxycycline prescription for this exact scenario. Unfortunately, my oft-requested miracle drug didn’t seem to be doing much of anything. I wasn’t seeing the kind of improvement I’d experienced in the past. The acne was itchy, too, to the point where I had to wonder if it was an ordinary breakout after all.

A cursory Google search told me that itchy zits are a sign of fungal acne, as opposed to hormonal or bacterial. A light bulb went off above my head; it would certainly explain the sudden and uncharacteristic resistance to my beloved doxycycline. I submitted a request for an antifungal I’ve had success with in the past, Diflucan (fluconazole), and hoped for the best. Within two weeks, my skin was almost completely clear.

Then the rash started.

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A quick eVisit had me starting a round of desonide, a topical steroid typically used to treat contact dermatitis. In my naïveté, I thought the diagnosis made sense; I was using only one BiPAP mask at the time, as opposed to the two I normally bounce between, and the rash was squarely beneath the left strap. Thankfully, it responded well, and by Aug. 11, aka D-Day, aka Photoshoot Day, my skin was glowing.

But less than 24 hours after the shoot, a large, painful bump started to grow behind my left ear. I initially assumed it was a recurrence of my old friend, cystic acne, but it was increasingly warm to the touch. Moreover, it had a small black dot in the center, suggesting it was an epidermoid cyst of some sort. Of course, the rash was coming back, too. When it rains, it pours.

Virtual urgent care told me to run, not walk, to the nearest clinic. Suspecting the cyst was infected, they prescribed me a round of Augmentin (amoxicillin and clavulanate potassium) and said to come back if things didn’t improve. Less than a week later, I was back in with a worsened rash — apparently hydrocortisone doesn’t work for everything — and a painfully persistent cyst.

I was able to get into dermatology within the week. A steroid shot to the cyst took care of problem No. 2. The rash, on the other hand, simply did not want to cooperate. The doctor, who I decided seconds after leaving the clinic was going to be my dermatologist going forward, prescribed me — surprise! — yet another topical. He also told me to wash the area daily with my ketoconazole shampoo in case the rash was due to my likely inflamed seborrheic dermatitis.

Are you tired of all the medical terms? Me, too. But we’re not done yet.

The following weeks were fraught with waiting. The initial cyst was replaced by two new ones, in front of my left ear and below my left eye. The rash became redder, itchier, and was even scaling over. My neck was getting worse as well; the fungus I’d suspected forever ago had clearly spread under my chin. I looked straight out of Looney Tunes — Wile E. Coyote after getting beat up by the Road Runner.

When another round of Diflucan kicked the cysts, my hopes were buoyed. Nevertheless, the rash persisted. One semi-frantic, hypochondria-fueled message to my dermatologist later and I had a new diagnosis (get ready, this one’s a doozy): gram-negative folliculitis. Supposedly, it’s a rare bacterial infection that doesn’t respond to antibiotics typically used to treat acne, i.e., doxycycline and Augmentin.

My insurance denied his first choice of antibiotic, ciprofloxacin, so we settled on a two-week course of Bactrim (sulfamethoxazole-trimethoprim). Of course, Bactrim has an admittedly rare and highly unlikely side effect of severe, full-body rashes. I was told to go to the ER if anything cropped up, which, as I’m sure you can imagine, did not give me warm fuzzies.

My mom watched me like a hawk the first few hours. Fortunately, I showed no signs of a reaction. Improvement has been slow, but my skin looks better than it has since August. I still look like Wile E. Coyote, but at least I’ve got bandages covering the worst parts.

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Note: SMA News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of SMA News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to spinal muscular atrophy.