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Dr. Bob please help
Jan 22, 2009

Dr Bob,

This is my second question as you answered one a few weeks ago from me and this is a follow up. I really need the facts here. I am concerned with Seb Derm. I am now 37 and for the past couple of years I have been having an off and on problem with Seb Derm. It is usually worse in cold weather and when I am feeling very anxious (as I am now). The thing is that it all seemed to start about 3 weeks after a potential encounter. Every time I go to the dermatologist and show it to them they say it is very mild and that it is not unusual at all. They also say that the Seb Derm that they see in patients that are indeed infected with HIV present itself much different than what I have.

Anyhow, I seem fine otherwise and my wife is HIV negative for sure because she just had a test for work. I know the big answer is to just go get tested. I know that, but I need some information because it is driving me crazy.

I have read that Seb Derm starts very early in HIV and long before other symptoms. When does it usually occur in the progression of HIV? Does it normally occur right after initial infection and then linger around or does it normally occur years after initial infection when the CD4 count wanes? I was very upset and having panic attacks right after the encounter so that may have contributed, and the dermatologist say once it starts Seb Derm usually comes and goes thereafter.

What do you think about this? When does it usually occur? My encounter was with a female of unknown status. Please help me put my mind to rest so I can stop being so anxious and I have already sent $40.00 and will do again.

Thanks Dr. Bob. You are a great guy and an inspiration to all.

Response from Dr. Frascino

Hello,

You ask: "What do you think about this?" First of all, I think your dermatologist is right on target. The vast majority of Seborrheic dermatitis cases have absolutely nothing to do with HIV. Second, you state: "I know the big answer is to just go get tested." BINGO! I absolutely agree.

Trying to second guess your symptoms and the timing of those symptoms is nothing more than mental masturbation. The only reason to worry and the only reason to get an HIV test is risk exposure. If you've had "a potential encounter," you need an HIV test at the three-month mark whether you are symptom-free or have "every symptom in the book."

It's time to man-up, stop all this senseless procrastination and just get tested! I can assure you you'll be glad you did. (I purposely did not answer all your questions about HIV-related Seborrheic dermatitis, because that is not where your focus or attention should bet at this time.)

Dr. Bob



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