[29F] With persistent scalp sore and associated symptoms

Patient Description

A 29-year-old female presents with a persistent open sore on the scalp, approximately half an inch in width, with jagged edges, red or pink coloration, and an indented middle. The sore has been present for 3 months, is itchy, flaky, and painful, and has grown in size. The patient experiences numbness and tingling around the sore, swollen lymph nodes near the ears, fatigue, slight anemia, and a feeling of being cold with cold extremities. The patient's medical history includes major depression, ADHD, and PTSD, for which she is in therapy and takes 50 mg of Vyvanse on weekdays. She also takes folic acid every other week due to a slight deficiency. The patient occasionally uses marijuana for PTSD symptoms and has a past history of hypothyroidism during pregnancy and was previously considered pre-diabetic. Menstrual cycles and bowel movements are irregular. No known drug allergies or family history of skin cancer. The patient does not smoke tobacco or consume alcohol regularly.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible conditions that could explain your symptoms:

  • Skin Infection: The presence of pus, pain, and swelling could indicate a bacterial infection, such as impetigo or cellulitis. These conditions often require antibiotic treatment.

    • Treatment typically involves oral or topical antibiotics.
  • Basal Cell Carcinoma: This is a type of skin cancer that can appear as a raised, pink or red patch that may itch or hurt. The center often appears sunken and may have visible blood vessels. It can ooze or crust over, and can bleed easily. This type of cancer is usually caused by long-term exposure to the sun or tanning beds.

    • Treatment can include surgery, radiation therapy, or topical treatments.
  • Squamous Cell Carcinoma: This is another type of skin cancer that often appears as a firm, red nodule or a flat lesion with a scaly, crusted surface. It's also usually caused by cumulative UV exposure over time.

    • Treatment can include surgery, radiation therapy, or topical treatments.
  • Dermatitis: This is a general term that describes inflammation of the skin. It can take many forms and cause a variety of symptoms such as redness, swelling, itching, and skin lesions. It can be caused by a variety of factors, including irritants, allergens, and stress.

    • Treatment typically involves avoiding irritants, using moisturizers, and applying topical steroids or other medications.

Please note that these are only possibilities, and you should see a healthcare provider for a formal diagnosis.

What you can do

  1. Make an appointment with a healthcare provider as soon as possible. They can examine the sore and may take a sample for testing to determine the cause.
  2. In the meantime, try not to scratch or pick at the sore, as this can lead to further infection or scarring.
  3. Keep the area clean and dry. You can gently wash the area with mild soap and water, but avoid scrubbing or using harsh cleansers.
  4. Avoid sun exposure to the area, as this can worsen certain skin conditions and impede healing.

What you should look out for

Seek immediate medical attention if:

  • The sore continues to grow or change in appearance
  • You develop a fever or other signs of infection, such as increased redness, swelling, or pus
  • You experience severe pain or discomfort
  • The lymph nodes in your neck become more swollen or painful

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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10 mo ago

People Also Ask


What are the common symptoms of basal cell carcinoma?

Basal cell carcinoma often appears as a raised, pink or red patch that may itch or hurt. The center can appear sunken, and it may have visible blood vessels. It can ooze, crust over, and bleed easily, usually due to long-term sun exposure.


How can skin infections like impetigo or cellulitis be treated?

Skin infections like impetigo or cellulitis are typically treated with antibiotics, either oral or topical, depending on the severity. It's important to keep the affected area clean and avoid scratching to prevent further infection.


What are the potential causes of numbness and tingling around a skin sore?

Numbness and tingling around a skin sore can be caused by nerve irritation or damage, which may occur due to inflammation, infection, or pressure from swelling. It's important to have these symptoms evaluated by a healthcare provider.


How does hypothyroidism affect skin health and overall well-being?

Hypothyroidism can lead to dry, flaky skin and may contribute to feelings of fatigue and cold extremities. It can also affect hair and nail health. Proper management of thyroid hormone levels is crucial for maintaining overall well-being.


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