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Thanks all; I should mention that the white spots on the fish are gone; I didn't do a fresh water dip, so will are not able to fully confirm ich vs flukes vs lympho. The odd discoloration around the face continues though, hard to take a picture as the fish is very spooky. It appears that the scales around the face are abraded or pitting. I am guess a bacterial infection or some intolerance to cuperamine? It's been near 18 days at therapeutic dose of copper, so I decided to do a couple of large water changes to clear the cuperamine out of the system, then did a dose of API genera cure to help with the possible bacterial infection - it has the same antibiotic as metroplex. This fish has been frustrating to qt; seems like whenever we are done with one ailment, another symptom presents itself
It's a vicious cycle. Parasites/worms feed upon a fish, which leaves behind tiny holes which are ripe for infection. Compounding the problem is copper (and other medications) are immunosuppressants, and that makes it much more difficult for the immune system to overcome infection. Dosing an antibiotic helps, but since that merely controls the population growth of bacteria in a fish long enough for its immune system to eliminate them... the immune system itself still has to be capable of delivering the knock out punch.