OpenHealth Q&A

Seeking Insights on Persistent Rash and Associated Symptoms

I wanted to share some updates and crucial information regarding my ongoing health concerns. While I understand Reddit isn’t a substitute for professional medical advice, I’m eager to gather insights from those who may have faced similar challenges. Currently, I’m awaiting a visit with my PCP, which won't happen until August. In the meantime, I've already visited urgent care, where the physician recommended that I see a rheumatologist as soon as possible. To alleviate the incessant itching, I was prescribed Triamcinolone, but unfortunately, it hasn’t provided any relief. I find myself in search of shared experiences from individuals who have been through diagnostic processes for conditions like lupus, rheumatoid arthritis, or lymphoma. At urgent care, I was informed that my symptoms might relate to one of these illnesses, specifically concerning my skin. Here's a bit about me: I am a 27-year-old woman, 5'3" tall, weighing 144 pounds, and I don’t currently take any medications. I have been a regular smoker of both cigarettes and marijuana for approximately 12 years. About two months ago, I noticed a severe, itchy rash on the back of my neck. This rash occasionally burns and radiates warmth. I haven’t changed any personal care items, and despite trying various lotions and allergy medications, none have helped. My only previous skin issue has been Polymorphic Light Eruption (PMLE), which developed in the last few years. Additionally, I've observed swelling in the lymph nodes in the back of my neck, as well as those on the sides of my neck and behind my ears. About five years ago, I experienced notably swollen lymph nodes for the first time, which were substantially hard. The neck swelling seemed to arise concurrently with the rash. The irritation from the rash has led to painful, non-healing sores. Interestingly, I also feel itchiness around the lymph nodes themselves, where there isn’t any rash present. Before I let the internet lead me to believe that this could all be a serious condition, I thought it best to share my situation here for any helpful advice or similar accounts. Update 1: I realized that I've been experiencing additional symptoms. A couple of months prior to the neck rash appearing, I developed circular, itchy patches on my legs and stomach. These spots haven’t disappeared or improved; they tend to barely itch compared to the rash on my neck, becoming noticeable only during warm showers or bathing. Update 2: I've captured photos of these patches on my legs, in addition to the ones on my stomach and foot. Update 3: I recently received some blood test results indicating abnormalities in my CBC, and I’ve attached those for reference. Update 4: The Basic Metabolic Panel also showed some unusual results, including an elevated D-dimer. Over the past couple of years, I have struggled with swollen lymph nodes, overwhelming fatigue, and numerous other ailments resulting in a significant weight loss of around 100 pounds without any intentional change to my diet or lifestyle. I suspect a potential slow-growing lymphoma may be at play here. Moreover, my tonsils appear asymmetrical and have an odd appearance. My appetite has decreased drastically; on a good day, I can only manage to eat once, and when I feel hungry, I have a brief window to consume food before the sensation vanishes again. I often feel utterly drained after minimal exertion, like walking a short distance with my dog. I experience fatigue that doesn’t improve with rest; it lingers after even the lightest activities. I have also dealt with recurrent cases of Polymorphic Light Eruption during the summers over the last several years, affecting only my arms. For context, I’ve tested negative for HIV, Lyme Disease, and have normal ANA levels. My rheumatoid factor measures <10, with thyroid testing at 1.20 mcIU/mL. My sedimentation rate is 13, and I've noted trace protein in my urine occasionally. I had a bout of mononucleosis as a teenager, during which my Epstein-Barr Virus levels were notably high according to my medical records. Should I be requesting specific tests at this juncture? Would a lymph node biopsy or a skin biopsy be advisable? Should I consider heading to the emergency room, or can I wait for my August appointment with my primary care physician?

Answers (1)

6/22/2025, 5:30:47 PM

OpenHealth AI

It sounds like you're navigating a complex and distressing situation with your ongoing health issues. Your symptoms, including the persistent rash, lymph node swelling, fatigue, and other abnormalities, certainly warrant attention. Here’s a structured overview of what you should consider moving forward:

Main Points:

1. Ongoing Symptoms and Possible Conditions: Your symptoms may relate to autoimmune conditions like lupus or rheumatoid arthritis, but more investigation is needed given your history and the severity of your symptoms.
2. Urgent Care Recommendations: You're already on the right path by seeking advice from urgent care and being referred to a rheumatologist.
3. Prioritize Monitoring and Tests: Consider what tests might provide the next step in understanding your condition while managing symptoms in the meantime.

Explanation:

Given the complexity of your symptoms, it's understandable to feel anxious. The burning, itchy rash on your neck, the circular patches elsewhere, swollen lymph nodes, and profound fatigue suggest an underlying condition that requires thorough investigation. Your history of significant weight loss, a past episode of mononucleosis, and recent abnormal lab results also raise concerns needing prompt attention.

While the wait for your appointment in August may feel long, it’s crucial to avoid unnecessary panic. Instead, focus on managing your symptoms and gathering more information.

Next Steps:

1. Document Symptoms: Keep a detailed symptom diary. Note when symptoms worsen or improve, any possible triggers, and how you feel overall each day. This information can be invaluable to your healthcare providers.

2. Request Specific Tests:

   • Blood Tests: Discuss with your PCP the possibility of more specific tests that could rule out or confirm conditions like autoimmune disorders or lymphatic issues (e.g., additional autoimmune panels, immunoglobulins, or even specific viral markers related to Epstein-Barr).
   • Imaging or Biopsies: Consider asking about the necessity of a lymph node biopsy or a skin biopsy, especially if your symptoms evolve or worsen before your appointment.

3. Symptom Management:

   • For itching and inflammation, if Triamcinolone is ineffective, you might inquire about alternative treatments such as antihistamines or other topical treatments that may provide relief.
   • Practice gentle care for your skin, using mild soap and fragrance-free moisturizers.

4. Monitor for Urgent Symptoms: If you experience severe symptoms like:

   • Rapid, severe swelling of lymph nodes
   • Uncontrolled pain
   • Shortness of breath or rapid changes in your health
   • Significant difficulty eating or severe fatigue

Consider seeking urgent care or going to the emergency room, as these could indicate a need for immediate medical intervention.

5. Lifestyle Adjustments: While you wait, ensure you maintain good hydration and nutrition as much as possible. Try to eat smaller meals throughout the day if large meals feel overwhelming.

Your health journey can feel overwhelming, but seeking community and sharing your experiences is a positive step. You deserve comprehensive care and the right answers. Keep communicating openly with your healthcare providers, and advocate for yourself as needed. Consider these actions as priorities until you receive direct professional care.