Hiya :)
I have had many problems with the same fish, a male blue gourami. just recently he developed a big swollen lump on his side, and all his scales fell off in that area. That has now been treated, and is almost healed, but I have now just noticed that he has a lot of tiny little holes all over his head.
One has just gone red, and now a while lump is sticking out of it (it looks like a white spot from ich) but i have never seen ich before with tiny little holes to start with - and only on their head? any idea what this could be?

http://animal-world.com/encyclo/fresh/i ... seases.htm

I would get this fish asap into a hospital tank before it infects other fish unless this is the only fish in your tank (which I doubt)

the above link is an excellent place to diagnosis the problem

hope this info helps