Very odd facial rash. doctos are stumped

[Anna17]

Anyone reading this description of my current skin problem is going to think I'm completely nuts,. but here's truly what's been happening to me for the last three months.
-I wake up to a red, slightly bumpy rash on my face with some raw, open sores
-At some point during the day, my face begins to tingle, and then the texture of my skin turns very smooth, like Saran wrap.
-Then I begin to feel sharp, fibrous stuff, like little burrs, beneath the "Saran wrap."
-Saran wrap feeling goes away, little blisters begin to form around my nose and on my temples. I think blisters are actually forming everywhere on my face and neck, some are just deeper. If I stretch an area of my skin out, I can see cyst/blister-like things underneath. I also see some very small pustules/whiteheads and a few hard cysts.
-Many of the blisters break open on their own, leaving raw places
-My whole face burns and stings

My doc tried me on an antibiotic, but it got worse! She said she really didn't know what it was and sent me to a dermatologist. What an idiot. He said it's acne, quit picking it and I'll be fine, and gave me a different antibiotic. It's NOT acne (my teen years were 30 years ago, and I hardle ever had acne even then), and I'm NOT picking it; the lesions break open on their own.

I tried some over-the-counter fungal creams, because I've heard of fungal infections masquerading as all kinds of things. It seemed to help some, but soon things got just as bad again. When my face is at the "sharp burr" stage or is burning and stinging, it's hard to concentrate at work or sleep at night. And while makeup can cover some of the lesions, my face still looks really bad. (No, it's not the makeup causing it - same thing happens over the weekend when I let my face go completely bare.) People love to tell me it's an allergy, something I'm eating, or something I should be eating. It's none of those things, and I frankly don't want to hear about anymore. When I've looked for info over the internet, the only things that possibly fit are pustular psoriasis or one of those weird autoimmune blistering diseases like pemphigoid or something. I do have some autoimmune problems (rheumatoid arthritis) that I control with a low daily dose of prednisone.

Can anyone shed ANY light on this? The symptoms are so strange I'm sure I sound like some kind of nutcase, but I swear this is all really happening!

[Anna17]

Thanks for your reply. It is absolutely not acne. Topical acne treatments did nothing, and both Batrim and minocycline made it worse. In recent weeks, I have been careful to not touch it or pick at it, ever. The redness is slightly better but still pretty bad, and the lumps have not improved at all. Even in the "clear" parts of my face, if you press on it, there are small masses beneath the surface. They aren't quite like cysts; they're sharp and/or fibrous. Also, on the clear parts are some largish pits under the skin where a previous lesion occurred. It's creepy - I press on it and my fingertip just sinks into what feels like empty space.

My GP (who is very good) is completely stumped. It was a derm who gave me minocycline to treat the "blackheads." Hello, I have no blackheads at all on my face, and the derm barely even looked at me. I think some dermatologists are just so used to treating acne and "easy" things that they don't bother to do a through exam. He's the only derm in town, so I guess I'll have to travel to see a different one, but the brushoff from the one on town makes me feel like I shouldn't even bother.

This all sounds very odd, I'm sure, but I assure you something very strange is going on. Six months ago, I had clear, perfect skin and now the word "disfigured" definitely applies. I normally am very healthy except for some autoimmune problems (swollen joints). My hunch is that I've developed some kind of cutaneous autoimmune issue as well.

[Bhupinder Kaur, MD]

Hello,
From the symptoms the possibility of adult acne needs to be ruled out. Keep your face clean by washing with a mild soap atleast twice a day. Pat it dry and do not rub it. Avoid picking or pressing the acne.  You can also use Benzoyl peroxide 5% lotion or gel once at bedtime. An amount of lotion the size of a pea should be enough to cover most of the face. If the skin becomes red or peels, you are using too much of the medicine or applying it too often. If the symptoms persist then please get it evaluated from a dermatologist and get rosacea and cysts ruled out.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.