3 summers ago i severely gashed my left underarm,about 2" deep by
about 8" long.very nasty trauma.it required internal stitches,many
outer stitches and a drain tube for about a month or so.i still feel
"pain" when i lift something a certain way using the muscle behind the
armpit area(deltoid?).took many months to heal enough to use upper
arm.was kept in a sling for about 2-3 months.blah,blah,blah.to get to
the point,after extensive reading and research,have recently learned
that this injury may relate to my actual concerns.knowing lymph nodes
in the underarm where most likely damaged and the lymphatic system
plays alot of key roles in general health matters,and after recently
learning a little about the systom,node locations and possible
corillation between skin,sinuses,infections afterwards,etc.etc.etc.
now beleive the injury may relate to my problem.(please ask for more
info. if need be).problem is basically this:early january following
injury,i rapidly developed a large infected "boil or cyst" under my
right eye,1" from nose and 1" from lower eyelid.always had moderate
acne problems,but never anything of this sort.the boil swelled my eye
closed for a while.got antibiotics,manually drained boil for weeks and
it started to heal,leaving only a flat reddish spot about 1 cm. in
size.at that point an identical spot appeared under the other eye in
the exact same location,same size,same colour,etc. as the one that was
just finishing to heal.but nothing else ever came of the second
spot,yet it remained as did the original one.after putting up with the
spots for months and figuring they were related to my
moderate,sporatic acne condition,i went to dermatologist.told him
about boil onset,symptoms,duration,the second spot that never
abcessed,their perfect symmetry,etc.seemed not to listen or consider
much of anything i said and simply prescribed accutane.accutane
basically cured acne (which was probably never severe enough for such
a powerful drug)with all the usual side effects.the spots remained
throughout course of accutane which ended that august.right after
finishing accutane the spots disappeared completely and i finally
enjoyed basically clear skin for the first time ever.for a whole year
i had no problems.the following august,last year,the flat reddish
brown spots reappeared rapidly.same size,same location,but the one
that never abcessed was more prominent and still is.they also came
with,over a little time,slight "broken capillaries" surrounding the
spots,some fluid-like puffiness under the spots about 1" in
diameter,then a slight rash type redness extending from spots to edges
of nose,under the spots to where facial whiskers would grow,and
outwards to my hairline edge of sideburns.about 1 cm. under each
eye,outer edge to inner edge of eye has no "slight rash or
redness".for months after spots came back,i could feel the 1" puffines
throb occasionally and feel warm,this has seem to stop,but puffiness
remains.several months after return of spots,i also developed 1"
round,very ,very,lightly reddish rash-like spots on each highest peak
of "forehead bones",about 1.5" each side of center forehead,about 1.5"
above eyebrows.they are not very noticeable,but defineately there and
probably related somehow.remember,dark undereye spots,slight rash
around them,forehead spots,etc. are all perfectly symmetrical in size
and position.(cant be coincidence)maybe sinus related also,as the
sinuses are located basically under eyes,where spots are and in
forehead where the other "spots" are as i have
described.blah,blah,blah.last 5-6 months i have become overly oily on
face(was never before)most noticeably on forehead,eyelids,nose,inner
ear area,basically everywhere but facial hair region.why,why,why?
months back,saw family dr.,basically about undereye spots,and he
thought maybe rosacea,even after telling him history of boil,second
spot,their disappearance and return,etc.i knew he was off base,as most
dr.s dont think complexion related problems are of much
concern(because they dont have to look in the mirror  at it).tried
metrogel for rosacea,didnt help of course.antibiotics didnt
help.frustrated with his seemingly lack of concern or dedication to
helping the patient,i went back to same dermatologist and once again
retold of original boil symptoms,second spot,their timeline,their
disappearance and subsequent return with slight added broken
capillarie addition,etc.once again he seemed not to listen or consider
much.that was months back,when excessive oil was not as previlent,nor
was the slight rash around undereye spots,etc.went basically about
undereye spots with puffiness.quickly he suggested some sort of broken
blood vessel condition but nothing about their relation to the old
boil and other spot well over a year before.also referred to them as
portwine stains,which if you look up,they defineately could not
be.suggested laser treatment but i didnt go through with it as i am
convinced that these symptoms,their recurrence,added symptoms.etc. are
more than your basic dermatology type condition,but more of a "system
disorder",a disease,a result of something else like the arm trauma in
which the lymphatic system would be involved,or what.im not the
dr.,but i know what i know and just need a little help to nail it
down.blah,blah,blah.also in the last 5 months or so have had larger
than normal lacrimal sacs(those are the little thingys in the inside
corner of your eyes)with whiteish pus-like,small globs that discharge
several times a day(you know,eye boogers)which was always a rare
occurence before.could this also be related? we may need a team of
specialists to figure this out,huh.or maybe just one person to
listen,diagnose properly or sympathize enough for me to help.well,i
could go on and on,but lets try to sum it up.will answer any questions
that may help,of course.if this is too much for you,could you maybe
steer me to someone that could help.please,please,please.by the
way,money is of no object when it comes to getting your self-esteem
back,the confidence to look people in the eye and to just feel good
about yourself.we are vain in some way,its human nature.most physical
conditions cause stress and stress can cause alot of physical
conditions,but which comes first? awaiting your response,grateful for
any help,willing to pay anything, what ever you ask,sincerely,      
BRENT

---

Request for Question Clarification by richard-ga on 15 Aug 2002 15:05 PDT

brent123:

By any chance are you a young man of Asian descent?
There's a rare disease that could possibly account for your symptoms.

---

Request for Question Clarification by lot-ga on 17 Aug 2002 10:50 PDT

Hello brent123-ga,
to help researchers,
after various comments and a withdrawn answer,
can you clarify what further information can help you?
(and perhaps why the answer was retracted if it is known to you)
As your feedback will stimulate further comments and prompt a better answer.
kind regards
lot-ga

---

Clarification of Question by brent123-ga on 02 Sep 2002 14:41 PDT

am not of asian decent

Hello Brent123-ga,

This is a tall order! And I don't want to lock this question.  I would
rather add any thoughts/research as Comments as I go forward on this
question and hope that some of it might help you.  With 500 Google
researchers, there must be a few that are medical experts and can
direct you better than the rest of us.
However, we can contribute and I hope any comments made by us do lead
you to resolution of this health issue.

I will add additional comments soon as I hope other researchers
contribute what they can.  I have noticed that we do have some
brilliant ones out there.

Somehow you have to transmit your feelings and ideas to your doctors;
they must know how miserable you feel.  The silver lining might be
that they understand your disorder and they are not overly
concerned...this might be good news, but they should find a way to
reassure you.
I'll also be looking for your comments as well as the findings of
other researchers.

The problem that comes with immersion studies into all sorts of skin
disorders is that you might become overwhelmed, confused and even more
miserable, or worse, you might start to believe that you have one
thing or another just because it vaguely resembles your medical
situation.
I do hope that you keep close contact with your health professionals
as we kick around these issues.  It seems a healthy pursuit to
research so that you can intelligently discuss possibilities with
these physicians, and I hope that we can help direct you to some great
websites that enlighten you.
And remember to protect your privacy...it is not necessary for you to
discuss anything that makes you uncomfortable.  If you have more
dental problems since the accident, it is your personal business and
you have to decide whether that is a possible result of the injury and
something that you want someone to consider during their research.
Stay positive and enjoy the friendly discoverys or ideas of our fellow
researchers.
********************************

1. Initial Google Search for facial skin disorder after axillary lymph
node injury requested by  brent123-ga is  as follows:
"diseases of the skin" +lymph.
2. First result: Case Western Reserve University
"Our special expertise in tumors, especially melanoma and lymphoma,
and inflammatory disease are considered a valuable regional resource.
Services: comprehensive analysis of skin lesions, including routine
histology, specialized immunohistochemistry, and cytochemistry."
http://mediswww.meds.cwru.edu/dept/dermatology/diag.html
My thoughts:  Could Case accept a sample delivered from brent123's
doctor/dermatologist for analysis since Case mentions the following:
 "Specimens: Skin and mucosal biopsies (shave, punch, or excision)
Storage: Formalin"
"There are complete immunofluorescence facilities available for the
diagnostic evaluation of serum, skin and mucosal specimens from
patients with autoimmune blistering diseases of the skin, including
pemphigus, pemphigoid and related disorders."
My thoughts:   Do a little research on pemphigus, pemphigoid, etc
"molecular specificity diagnosis of particularly rare autoimmune
disorders"
My thoughts:  Brent thinks it is related to lymph injury...why
not?....could be an autoimmune disorder encouraged by the accident. 
Also, ask Brent if he has good dental health.  If his immune system is
fighting gingivitis and otherwise manageable infections like the
common cold or flu, etc, he might have an exhausted immune system such
as happens to people with AID's.  AutoImmuneDeficiency(AID) is not
always related to the well-known HIV virus.  Many factors can lead to
AID other than the HIV virus.  Also, ask Brent if he's ever taken an
HIV test.  It's a smart choice in current society.
"Diagnostic Clinical Applications: Congenital blistering diseases
(epidermolysis bullosa), vasculitis, lupus erythematous, porphyria"
My thoughts:  Research  epidermolysis bullosa, vasculitis, lupus
erythematous, porphyria

"Diagnostic Clinical Applications: Mycosis fungoides, other cutaneuos
lymphomas, lymphoproliferative disorders"
My thoughts:  Must research these terms as any of them might be
relevant.  Define Mycosis fungoides, lymphoproliferative
"The reference laboratory receives specimens in convenient mailers for
rapid fluorescence-aided microscopic diagnosis of fresh material, as
well as for culture identifications"
My thoughts:   Brent must be knowledgeable of the method of transport
of his samples if he chooses Case Western, so that he can inform his
doctor's of the proper methods for storage/delivery, or at least be
able to have contact information with those at Case Western, so that
his local doctor can discuss exactly what they need in terms of
samples whether shavings or biopsies and their safe, proper and timely
delivery to CASE Western.
"reference center for the identification of fungal pathogens"
My thoughts:   Do not overlook anything especially the obvious.  It
may be as simple as fungal pathogens.  Research this area as well.
These pathogens can be in the bloodstream and cause havoc forever or
until the proper fungicide is administered.  Forget surface treatment
like creams....they don't tackle the problem in the bloodstream.
Dermatophyte infections of skin, nails and hair; candidal yeast
infections, deep fungal and opportunistic infections
My thoughts:  Ask Brent about any changes in his hair and
nails.....itchy scalp....nail malformations, hardness, etc as it might
be related to fungal pathogens.

"CONTACT US! Phone (216) 844-1507 Fax (216) 844-4707
Our Staff is available to assist you from 8:30 A.M. to 5:00 P.M."
My thoughts:  Brent should fax the details in the Google query to CAse
Western at the above fax number to see their response.  Brent should
include his health insurance information in the fax as well. 
Hopefully, the initial contact will result in fruitful communications
with Brent, his local doctors and his health insurance company.
This approach should be followed with any health organization that
Brent decides is right for him.  Also, ask Brent to think about his
family history of skin disorders.  Brothers, sisters, parents(when
they were younger), etc.
Saved the initial webpage of sites for further site reviews.  Now,
it's time to research some of those terms mentioned above.
*******************************************************
pemphigus, pemphigoid
"auto-immune skin disorders known as pemphigus and pemphigoid"
http://www.pemphigus.org/
"Pemphigus is a group of rare autimmune blistering diseases of the
skin and/or mucous membranes...immune system mistakenly perceives the
cells in skin and/or mucous membrane as foreign, and attacks
them...burn-like lesions or blisters that do not heal" "Because it is
rare, pemphigus is often the last disease considered during
diagnosis".
My thoughts:  Only Brent can know for sure, but based on his
description, pemphigus does not seem to be his problem.  Brent does
not mention such blistering and this pemphigus is rare.
*****************************************************************
http://www.monicaslupus.co.uk/vasculitis.htm
"vasculitis is a "hurting disease", because it is so commonly
associated with pain of one type or another: pain from a nerve
infarction, pain from insufficient blood to the gastrointestinal
tract, pain from skin ulcers"

My thoughts:   Brent should visit this site just to become acquainted
with vasculitus and see the pictures at the Hopkins site.  If nothing
else, it will eliminate this area as a source of concern for him.
******************************************************************
http://www.mffoundation.org/
"Mycosis fungoides patches are often mistaken for eczema, psoriasis or
non-spcific dermatitis ..Plaques are thicker, raised lesions. Tumors
are raised "bumps" which may or may not ulcerate"
My thoughts:   Brent is the only one who can visit and study these
websites to determine if they might apply to him.  He has his work cut
out for him.  All we researchers can do is offer him possibilities for
his personal searches.  We are not medically qualified to diagnose a
pimple or a wart much less tackle Brent's disorders which require his
efforts as well as discussions with his doctors.  At the least we can
point out areas that he can review and ponder.

Brad-ga

I'm not sure about the link between your current problems and the
previous injury, if you think it is something to do with decreased
immunity as a result of damage to the lymph node.  The rest of the
lymphatic system would compensate for damage in one part.  However,
overall decreased immunity could be part of your problem if you are
generally run down.  You could try supplementing your diet with
vitamin C and zinc and see if this helps.  The herb echinacea is also
good for boosting the immune system, but it should not be used for
more than three weeks or so without a break.

I'm wondering if some of your problems could be due to changes in your
hormonal balance, specifically the sex hormones.  This certainly could
be one thing to get checked by an endocrinologist.

If you feel that your dermatologist has not been particularly
sympathetic, it would also be worth looking for another one who would
be more prepared to listen to you and offer a second opinion.

It is quite common to remove nodes to the lympathic system for
diagnosis and prevention of certain cancers from spreading as
cancerous cells tend to accumulate there as one port of call. I know
somebody who had their nodes removed from under one arm and their
health is quite normal. Though the use of the arm was restricted it
has improved considerably since the operation. However if too much
physical activity occurs some pain and swelling occurs in the arm as
it 'drains' inefficiently due to the absence of part of the lympathic
system there. (so they are told)
lot-ga

Although you are right in stating that lymph nodes may have been
damaged when you injured your underarm (after all, they are
everywhere), I feel pretty confident in saying that even if this
happened, it did not harm your immune system in general. Think of
lymph nodes as "filtering stations" that drain parts of your blood
that has exited from small capillaries. Even if you were to remove
some of that filtering capacity (which we can't even take for granted
that it happened), the rest of your immune system which is distributed
throughout your whole body would not be affected very much. Every
heartbeat sends out an armada of cells that have nothing better to do
then to attack anything that is unknown to them. To learn more about
how the immune system works, check out this tutorial by the National
Cancer Institute:

http://newscenter.cancer.gov/sciencebehind/immune/immune01.htm

So I would like to second tehuti's view and speculate that the two
incidents are not directly related.
If you feel your dermatologist is not listening to your concerns
properly, you should maybe get a second opinion. Sometimes it may be
advisable to discuss the fact that you feel your doctor is not
listeing well enough with him directly before turning your back on
him, though.

searchbot

Just a thought, have you been checked for diabetes?  Diabetes is
linked with an increased incidence of skin conditions, and these are
sometimes the first sign of diabetes.
http://www.diabetes.org/main/application/commercewf?origin=*.jsp&event=link(C3_1)

I'm not trying to scare you.  It's just that with these sort of things
you need to work through all possibilities and eliminate those which
do not apply.