[44F] With chronic skin issues and fatigue post-Lyme disease

Patient Description

A 44-year-old female presents with severe itching and skin lesions primarily on the face and neck, persisting for approximately 4.5 years. The symptoms occur 15 to 20 days a month, with episodes lasting 2 to 3 days. The itching is described as a sensation of something crawling on the skin or an electric shock feeling. These symptoms began after being untreated for Lyme disease for a year and a half. Additionally, the patient reports increased vaginal discharge with odor and a history of frequent bacterial infections over the last 5 years. Medical history includes anemia, degenerative disk disease, arthritis, heart infection disease, and Lyme disease. No known allergies.

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Arora's Assessment

What might be happening

Based on the symptoms you've described and your medical history, here are some possibilities:

  1. Chronic Lyme Disease: Since your symptoms began after being untreated for Lyme disease, it's possible that some of your ongoing symptoms, like skin lesions, itching, and fatigue, could be related to chronic Lyme disease. This condition can sometimes cause persistent symptoms even after treatment.

  2. Chronic Dermatitis or Eczema: The severe itching and skin lesions on your face and neck could be related to a chronic skin condition like dermatitis or eczema. These conditions can cause intense itching, skin changes, and lesions.

  3. Autoimmune Disorders: Conditions like lupus or psoriasis can cause skin changes, itching, and lesions. These disorders occur when the immune system mistakenly attacks healthy tissue.

  4. Fungal or Bacterial Skin Infections: Chronic skin infections can lead to persistent itching and lesions. Given your history of bacterial infections, this might be worth exploring.

  5. Nutritional Deficiencies: Anemia and other nutritional deficiencies can sometimes lead to skin changes, hair thinning, and nail changes. Ensuring a balanced diet and checking for deficiencies might be helpful.

It's important to discuss these possibilities with a healthcare professional who can perform a detailed evaluation and recommend appropriate tests or treatments.

What you can do

Severe Itching and Skin Lesions:

  • Consider using a gentle, fragrance-free moisturizer to soothe your skin and reduce itching.
  • Over-the-counter antihistamines like loratadine (Claritin) may help alleviate itching. Be sure to follow the manufacturer's instructions for dosage.
  • Keep your skin clean and dry, and avoid scratching to prevent further irritation or infection.

Vaginal Discharge:

  • Maintain good hygiene and wear breathable, cotton underwear to reduce moisture and irritation.
  • Avoid using scented products or douches that can disrupt the natural balance of bacteria.

General Health:

  • Ensure a balanced diet rich in vitamins and minerals to support overall health and potentially address any nutritional deficiencies.
  • Use the MDandMe journal to track your symptoms, identify potential triggers, and share this information with your healthcare provider.

What you should look out for

Given the chronic nature of your symptoms, it's important to seek medical care to determine the underlying cause. Reasons to seek care more urgently include:

  • New or worsening skin lesions or changes in their appearance
  • Severe fatigue that impacts your daily activities
  • Any signs of infection, such as fever or increased redness and swelling around skin lesions

Remember, while I can provide guidance, it's essential to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have any more questions or need further assistance, feel free to ask!

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17 d ago

People Also Ask


Can chronic Lyme disease cause persistent skin issues like itching and lesions?

Yes, chronic Lyme disease can cause persistent symptoms, including skin issues like itching and lesions, even after treatment. It's important to consult with a healthcare provider for proper management.


What are the common symptoms of chronic dermatitis or eczema?

Chronic dermatitis or eczema can cause symptoms such as intense itching, red or brownish-gray patches on the skin, small raised bumps, and thickened, cracked, or scaly skin. Managing these conditions often involves moisturizing, avoiding irritants, and sometimes using medicated creams.


How can autoimmune disorders affect the skin?

Autoimmune disorders like lupus or psoriasis can lead to skin changes, including rashes, lesions, and itching. These occur because the immune system mistakenly attacks healthy skin cells, leading to inflammation and other symptoms.


What steps can be taken to manage increased vaginal discharge with odor?

To manage increased vaginal discharge with odor, maintain good hygiene, wear breathable cotton underwear, and avoid scented products that can disrupt the natural bacterial balance. If symptoms persist, it's important to consult a healthcare provider to rule out infections or other underlying conditions.


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