Blue tang sick?

Here's my current frozen selection
 

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I don't think that's HLLE disease, although I can see how it could be thought that by the appearance on the cheeks.

I'm way more concerned with velvet or a bacterial infection by that presentation. It looks like a dense dusting on the fish.

Is the fish breathing rapidly? Is it trying to swim directly into the flow from a powerhead? Is it acting more skittish than normal and trying to hide?
 
Not HLLE and what is visible is head and face erosion (unconfirmed due to fuzziness of pics). The black spots which I believe I can faintly see lower rear of fish are turbellarian flatworms which are known to parasitize marine fish. Black spot/black ich appear as grains of black spots rather than lumps. Piscinquilinus are relatively large and lie deep within the dermis. As a result, a pigmented dermis may show once killed, resulting in a black spot, regardless of a living parasite within the skin. The primary symptom is small black dots on the fish. There may be some bacterial activity with fish also. Best recourse will be treatment in QT using ethromyacin /Maracyn 2.
Best chemical treatments for black spot disease are praziquantel/prazi Pro and formalin (quick cure). Freshwater dips or hyposalinity are an alternative treatment option but can induce stress on the fish.

Dosages:
-Praziquantel – 2 mg/L single dose for 7 days in a QT. Both Prazipro (2.5 mg/L) and API General Cure (2.0 mg/L) contain sufficient concentrations of praziquantel
- Formalin– 45 to 60 minute bath treatment, followed by transfer into a sterile QT afterwards.
 
To you does it look like this?
 

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I don't think that's HLLE disease, although I can see how it could be thought that by the appearance on the cheeks.

I'm way more concerned with velvet or a bacterial infection by that presentation. It looks like a dense dusting on the fish.

Is the fish breathing rapidly? Is it trying to swim directly into the flow from a powerhead? Is it acting more skittish than normal and trying to hide?
fish is breathing fine, like usual. He was acting a little skittish but I am not finding that unusual since he had always been a little skittish.
 
Not HLLE and what is visible is head and face erosion (unconfirmed due to fuzziness of pics). The black spots which I believe I can faintly see lower rear of fish are turbellarian flatworms which are known to parasitize marine fish. Black spot/black ich appear as grains of black spots rather than lumps. Piscinquilinus are relatively large and lie deep within the dermis. As a result, a pigmented dermis may show once killed, resulting in a black spot, regardless of a living parasite within the skin. The primary symptom is small black dots on the fish. There may be some bacterial activity with fish also. Best recourse will be treatment in QT using ethromyacin /Maracyn 2.
Best chemical treatments for black spot disease are praziquantel/prazi Pro and formalin (quick cure). Freshwater dips or hyposalinity are an alternative treatment option but can induce stress on the fish.

Dosages:
-Praziquantel – 2 mg/L single dose for 7 days in a QT. Both Prazipro (2.5 mg/L) and API General Cure (2.0 mg/L) contain sufficient concentrations of praziquantel
- Formalin– 45 to 60 minute bath treatment, followed by transfer into a sterile QT afterwards.
but the fish doesn't have tiny spots on it? the patches are white or black and they are rather large so its not ich correct?
 

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