This is a totally new subject to my last post so I am keeping them separate.
I commented that mentally I have improved but physically I'm still having a lot of problems. It's odd how much difference it makes to ones outlook even feeling 'half' better (didn't know how to word it).
I had a biopsy done via the dermatology department of the hospital this past week. On the request the registrar wrote, ?Behcet's, ?PG (Pyoderma Gangenosum), ?neoplastic, ?vascular/neuropathic, ?traumatic
The pathologist has gone on to answer the queries above, in part ...
The features are of ulceration, dermal necrosis and acute inflammation. The morphology is not specific but due to the abrupt edge of the ulcer an ischaemic/neuropathic cause or trauma is favoured. Pyoderma Gangenosum and Behcet's typically show more extensive dermal neutrophillic inflammation than seen in this biopsy.
I have been getting these 'punched out' lesions for years. The first one was on my left calf with a coffee coloured ring around it. Over the years I have had similar lesions (thank goodness smaller) on my nose, chin, cheeks and arms. Now I have them around the nail beds on my thumbs and big toes (later on I will post a photo of my thumb to show how misshapen it has become through losing the nail and a significant amount of flesh).
They all seem quite similar, starting off with either a small sore, blister or split in the skin, but rapidly break down to what is a larger lesion below the surface. Then, for example say the larger lesion is 1 cm (1/2 inch) round, then it goes from there all the way through the thicknesses of the skin. This 'dead' tissue then slowly starts to break down, often it is in sacs or balls of debris with fairly obviously a dead vein or vessel inside the sac. Another thing that happens is it will build up quickly and then a pussy abscess will be expelled (quite often in the middle of the night, so it is not something I am doing). Sorry to be so gross, but the abscess will have a lot of granuloma, dead veins and again what looks like an attached nerve. I've thought it was the body's way of getting rid of things. Apart from that I have a lot of granuloma imbedded into the skin, particularly around the walls of the ulcer.
I'd like to hear from people with these types of wounds with abrupt deep edges, especially related to BD, but I'm wondering if I have two diseases together.
Now for the big one - has anyone else been accused of causing these wounds themselves (trauma). This is what is being hinted at all the time, because what the doctor usually sees is the ulcer already there, although come to think of it, a couple of times I have tried to show a them the start of these ulcers, but they are fairly small and I look like I am overreacting.
I've been looking at other people's posts and part of my problem is I have a very helpful neurologist, but the immunologist and dermatologist I think have had enough. I takes me three to four hours to get the hospital and I don't think i would have been in there for more that ten minutes, which included chatting to the nurses and getting a dressing done! I was out so quick I realised I hadn't shown them a large new one starting, but I honestly wasn't given the time. It is the difference between public and private health and I might see if I can do something about moving on.
Sorry if I have waffled on there, but basically has anyone else been accused of doing these deep lesions to themselves when you know very well you haven't. Also can anyone point out some information on punched out lesions and necrosis of veins and tissues.