Complex History of Skin Rash
**Age:** 27 years **Gender:** Female **Height:** 5 feet 6 inches **Weight:** 180 pounds **Ethnicity:** Caucasian **Duration of Symptoms:** Approximately 4-5 days **Affected Areas:** Initially, the rash appeared on one upper arm and my face. It quickly extended to both arms, forearms, the chest, as well as the abdomen, back, and upper thighs. The rash is mildly itchy at times, though it's usually not bothersome, leading me to question whether the itchiness could be psychological. I have developed unexplained bruises that are visible in some photographs. **Pre-existing Medical Conditions:** - Coronary artery disease - Primary myocardial ischemia - History of N-STEMI - SCAD (Spontaneous Coronary Artery Dissection) - Undiagnosed connective tissue disorder - Sweet's syndrome - Migraines - Bipolar depression - Anxiety disorder - OCD (Obsessive-Compulsive Disorder) - ADD (Attention Deficit Disorder) - Chronic Lyme disease - POTS (Postural Orthostatic Tachycardia Syndrome) - Moderate to severe GERD (Gastroesophageal Reflux Disease) - Raynaud's phenomenon **Medications Currently Administered:** - Ranolazine 1000 mg every 12 hours - Zoloft 150 mg daily - Latuda (dosage unknown) daily - Diltiazem 240 mg daily - Vyvanse 40 mg daily - PRN medications: Ondansetron ODT 8 mg, Nitroglycerin tablets **Treatments Attempted:** I have tried Benadryl, Zyrtec, and hydrocortisone cream but have not experienced any improvement. **Additional Notes:** If anyone has advice or suggestions that I could discuss with my physician, I would be very grateful. My cardiologist is not convinced that my current medications are the cause of these symptoms. The only recent adjustment in my treatment was an increase in the Diltiazem dosage from 120 mg to 240 mg daily, with the symptoms beginning shortly after, although the doctors believe this change is unrelated. I also have a 9-month-old baby at home who hasn’t completed her vaccinations yet, so I’m feeling a bit anxious. Thank you for your help!
Answers (1)
3/25/2025, 1:40:46 PM
OpenHealth AI
It sounds like you're experiencing a concerning and wide-ranging skin rash that has developed rapidly, along with some unexplained bruising. Given your complex medical history and current medications, it's important to approach this situation carefully. Here are some key points to consider:
Explanation
Rashes can arise from a variety of factors, including allergic reactions, infections, systemic conditions, or medication side effects. Since you noticed the rash appear shortly after a dosage adjustment in your medication, it’s possible that it could be related, though correlation doesn’t always imply causation. The presence of unexplained bruises also warrants close attention, as they can be associated with different medical issues, including blood clotting disorders or side effects of medications.
Prioritized Next Steps
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Track Your Symptoms: Begin a detailed symptom diary. Note the appearance of the rash, any changes in itchiness, locations, anything that worsens or alleviates it, and the occurrence of bruises. This detailed information will be very useful for your healthcare provider.
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Monitor for Other Symptoms: Keep an eye on any additional symptoms such as fever, increased pain, or swelling around the rash, and any signs of an allergic reaction, such as difficulty breathing or swelling of the face.
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Skin Care: Continue to keep the affected areas moisturized with a gentle, fragrance-free moisturizer. Avoid perfumed products or harsh soaps that could irritate your skin further.
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Temperature Management: Since you have Raynaud’s phenomenon, monitor your body temperature to prevent symptom exacerbation. Stress management techniques and warm environments could help reduce discomfort.
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Discuss Medication Re-evaluation: Considering the recent change in Diltiazem dosage, you should consult your healthcare provider regarding all medications to evaluate potential side effects, interactions, or the necessity for adjustment, especially given your complex history.
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Prepare for Doctor’s Visit: When you speak to your physician, bring up the possibility of a referral to a dermatologist, especially if the rash continues to spread or becomes more bothersome, and express your concerns about the bruising.
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Stay Informed About Vaccinations: While this relates more to your anxiety about your baby’s vaccinations, keeping a schedule and staying updated with healthcare advice for your child is essential for peace of mind.
Empathy & Support
I understand that managing a new rash while dealing with various health conditions and caring for a young child can be overwhelming. It’s clear you are taking proactive steps by seeking advice, and that’s commendable. Please know that seeking clarity from your healthcare team about these symptoms is important, and they can help tailor a specific plan for you.
Feel free to reach out for more support or specific questions—your health and peace of mind are paramount.
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