instruction: hello doctor I have acne inflammation on the hair follicles on my butt for a long time which goes on and off but the marks and blackness of skin have been there forever the marks are dry and persistent when a particular one dries the skin can be easily pulled off and it often has a tiny whitish needle in the middle it does not pain but the marks are really bad I have just used home remedies like aloe vera and conut oil please suggest a lasting solution
output: hi I went through your case though photo are bit blurred upload a clear one if possible characteristics you mentioned are spines dry and their persistence but again you said they go on and off I can see some are having small pus that is important make it clear if they are always or have any seasonal variation you did not mention itching I want to be clear do they itch or not do you have a history of allergy in the form of itchy rash are these bumps only on buttock area or elsewhere also like elbow neck etc did they ever make large pus filled abscess do you have any other medical conditions it is a chronic and rare disease but to be sure I need above history then I may advise you a biopsy to confirm the diagnosis constitutional biopsy for he histopathological examination keratosis pilaris lichen spinulose and follicular eczema ureative20 cream in the morning tretinoin 05 cream at night moisturizer review with history and photo then plan further