Hi guys, I am new to this forum and need some help....

Please see these pictures



http://img393.imageshack.us/my.php?i...012croptl2.jpg

http://img293.imageshack.us/my.php?i...016cropgv4.jpg

http://img463.imageshack.us/my.php?i...014cropwh5.jpg



The spots (they all have a hair coming out of the middle and)pretty much stay there permanently. They have been around months but got real bad a month ago. Putting retin-A on made it much worse giving massive whiteheads and cysts. After stopping it reverted to how it is now.

It started in the left corner of my mouth (where I once had a spot that gre with no pain and had to be ruptured by a cosmetic surgeon leaving a bit of a scar) and little spots started popping up and were especially visible if you pulled the skin. There are now plenty all over my chin, particularly in the crevice in the middle. Strangely there are many near the left corner (see pic) but none on the right (at least yet!)..


Sometimes there are whiteheads but these are more like scabs. I get quite a lot of big spots (that lead to whiteheads but then go away) on the corners of my mouth (esp. the left).

I saw a derm a month ago. He said it was acne and put me on accutane (my 4th dose). Its done nothing so far.



I've read about perioral dermatitis and have started using a non SLS toothpaste but no effect so far. I also have no spots above the lip. The photographed regions are the only affected.



My derm prescribed daktacort but that has a steroid in it, I read these can make things worse.



I was on Azathioprine (autoimmune hepatitis) for 2 years till a month ago. I haven't had oral steroids for AIH in 9 months.

I recently got a diagnosis from an online dermatologist that this was follicular keratosis. Is this similar to KP, a google search seems to bring that name up a lot. The thing is I dont have this problem on my arms.

The only skin cream I used was Duac (a benzyl peroxide cream). I am not using any at the moment.

Is there any reason it is only on my chin or can I expect it to progress? Should I stop shaving for a while to see if that stops it. How is it best to shave?

If it is genetic should I see other symptioms?

Could it be due to my use of azathioprine for so long?

I am going away on holiday to Asia and Australia in 5 weeks where I have a couple of girlfriends . I really would like this to subside before then. is there anything I can do?

Thanks for reading

Dan

OK the dermatologist has put my pics on his online blog
http://www.gulfdoctor.net/blog/
it has lots of stuff on different conditions

He says what I have here is follicular keratosis and not acne nor an infection.

I am unsure why it has come up like this though and in this area. It may be I have developed an allergy to duac (bp) (I use it elsewhere but not in other places where there is facial hair). That may explain why a lot is in that crevice (where the cream may accumulate). I havent used the duac in a month though.
I have been using bactoban and it has reduced the size a little but the follicule problem is still there. It is over most of the hairs of my chin now.
The things arent so much red spots but little white/yellow dots (but not whiteheads) at the base of the hair. These new pics show it better. I am trying not to shave for a while to see if that helps. I guess I will need some means of removing those dead cells because my skin doesnt seem to be doing it naturally here. I may try differin or some alpha hydroxy acids




Thing is it looks a little different to KP (esp the white bits at the base of the follicle rather than the red lumps). Any advice???