Dr. Mark Seraly

Good morning. It would be unusual, but not impossible, to experience a delayed infection after an animal bite. In addition, your symptoms of not feeling well are a concern of worsening (SPREAD to the blood or lymphatic system) infection. You clearly need to go to your local Emergency department for an evaluation, possible x-ray and additional blood work. You should not delay.



Dr. Seraly

Hi. I suspect you are referring to enlarged blood vessels called telangiectasia’s which can be seen with certain liver conditions including patients with hemochromatosis. They can be treated with a laser that targets red (such as the pulsed dye laser) or with an electric epilating needle. You should make an appointment with a dermatologist for an evaluation and to discuss pricing. Most insurers deem removal of telangiectasia cosmetic. Best regards and good luck.



Dr. Seraly

There are a number of skin conditions that can present in a manner such as yours including progressive pigmentary purpura, lichen amyloidosis, contact dermatitis and psoriasis. Based on your clinical presentation and severity of itch, a confirmatory biopsy is indicated to establish a diagnosis and guide treatment selection. Dermatologists are specifically trained to diagnosis and treat your condition once established through a biopsy. Best regards,

Dr. Seraly

Hi! I reviewed your image and question. Although a bit blurry, the grouped nature of this eruption is suggestive of a herpetic outbreak. Inflammation from an inflamed follicle, trauma due to shaving, and other mechanical irritation can induce a flare. My suggestion is to see a dermatologist and request a culture for herpes simplex and ask for it to be typed HSVI and HSVII. If this is an older image and the eruption is now clear, ask for a blood test called a Herpes Select HSVI and HSVII antibody profile. Don't worry, if this is herpes related, it is highly treatable and highly suppressible. Some bacterial infections can mimic a herpetic outbreak as well so an in-office evaluation for additional testing would be necessary in your case. I hope that you find this information helpful. Best regards!

Good afternoon. You are describing a probable allergic lip dermatitis or “allergic lip cheilitis” due to fragrance mix or preservative mix. I would discontinue the use of Neosporin as this can also aggravate allergic lip dermatitis and even cause an allergic reaction with frequent application. I will suggest that you see a board-certified dermatologist who also has an expertise in “patch testing.” Patch testing is a process to determine if your condition is an allergic reaction to a chemical product, agents for example commonly found in dental products. The North American Contact Dermatitis society has designated 90 allergens as the most problematic. Patch testing is a 3 day process and is generally covered by insurance. This testing is critical in your work-up. In addition, you should consider switching your toothpaste to Toms of Maine or plain Colgate. Crest toothpaste has a number of allergens that can be problematic as well. Good luck!

Dr. Seraly

To whom it may concern,

Acne is highly treatable with prescription therapy ranging from topical benzoyl peroxides, Retin A, and oral antibiotics. An evaluation either in-office or online would suffice to begin therapy. Depending upon where you live, go to DermatologistOnCall.com and pick a network provider who is licensed in the state to which you reside or go to the AAD.org website and find an in-office dermatologist in your locale.

Dr. Seraly