OpenHealth Q&A

Seeking Insight on Unexplained Rash and Symptoms: A Personal Account

I’ve come to share an update and highlight some crucial details regarding my current health condition. I understand that Reddit isn't a platform for medical diagnoses. Recently, I visited urgent care and have scheduled a consultation with my primary care physician, hoping to secure a referral to a rheumatologist. Unfortunately, my appointment isn’t until August, which leaves me anxious and concerned while I wait. The urgent care physician prescribed me Triamcinolone, which I was informed was an urgent step towards evaluating potential issues. Unfortunately, this treatment hasn't alleviated the itching at all. At this point, I'm reaching out to the community for similar experiences related to lupus, rheumatoid arthritis, lymphoma, and other conditions as I navigate my symptoms. While urgent care suggested that it might be one of these concerns, they recommended starting with a rheumatologist to specifically assess my skin issues. As a 27-year-old woman, standing at 5'3" and weighing 144 pounds, I do not take any medications and have been a daily smoker of cigarettes and marijuana for about 12 years. About two months ago, I developed an intensely itchy rash localized only on the back of my neck, occasionally accompanied by a burning sensation. I haven't changed any personal care products or detergents, and treatments such as lotions or cortisone creams haven't made a difference. Historically, I have not experienced eczema or significant skin issues, with the only exception being PMLE that manifested in the last few years. I've also noticed swelling in the lymph nodes at the back of my neck, as well as those on the sides and behind my ears. This isn't new for me; I've had hard, swollen lymph nodes for the past five years, originally identified on the left side of my neck. The recent swelling appeared after the rash developed. The rash is not just itchy; it also radiates warmth and has led to open sores that remain unhealed. The skin on top of my swollen lymph nodes also itches at times, even where the rash isn’t present. Before I allow internet searches to convince me that a simple rash could be indicative of serious conditions like lymphoma, I wanted to turn to this platform for insights. In a follow-up note, I should mention that a couple of months prior to the neck rash, I began to notice circular, itchy patches appearing on my legs and stomach, as well as one on my foot. These spots have persisted without significant change and tend to become irritating under hot water or during showers. Additionally, I've discovered more of these patches on my legs and stomach, including one on my foot, which seems to remain constant and only mildly irritating compared to the neck rash. Moreover, I have identified a lump in my lower left leg, situated on the internal side of my shin. While I have bumps from previous bruises, this lump feels distinctly hard and rounded, similar to a swollen lymph node, measuring around 1 cm across, with slightly pink skin covering it. Is it typical for lymph nodes to be found in the lower leg area? I have also included my most recent Complete Blood Count (CBC) from October 2024, marked as "abnormal." In addition, my Basic Metabolic Panel conducted on October 24 was abnormal, and I had an elevated D-dimer level. Over the last couple of years, I’ve faced a range of health issues including swollen lymph nodes, general malaise, fatigue, and significant weight loss of around 100 pounds without any intentional effort. I suspect I may have some form of slow-growing lymphoma. Interestingly, my tonsils appear uneven and abnormal as well. My appetite has dwindled significantly. When I feel hunger, it lasts only a brief moment, barely giving me enough time to eat before it dissipates again. Most days, I manage to eat just once, if I can muster the appetite. I find myself feeling utterly exhausted. Simple tasks like a short walk with my dog leave me breathless, compelling me to take breaks to sit down. The fatigue is different from typical tiredness and lingers even after resting. I also experience a polymorphic light eruption every summer on my arms. I want to clarify that I have tested negative for HIV and Lyme disease. My Autoimmune Disease Profile (ANA) was normal, and I had relatively low levels of the rheumatoid factor and a normal thyroid function. My sedimentation rate was recorded at 13, and my comprehensive metabolic panel showed occasional traces of protein in my urine. Years ago, I had mono, with high levels of the Epstein-Barr virus at that time. I'm looking for advice on potential tests to discuss with my doctor or should I consider requesting a biopsy of the lymph nodes, the rash, or proceed to the ER? Is it wise to endure until my PCP appointment in August?

Answers (1)

6/23/2025, 4:20:48 AM

OpenHealth AI

Navigating complex symptoms like yours can be understandably overwhelming, especially with ongoing concerns about your health. Your detailed description highlights several issues that warrant close monitoring, and it’s good that you’re seeking timely medical advice. Here’s a clear outline of key points, potential actions, and the best next steps for you.

Main Points

1. Multiple Symptoms: You are experiencing various symptoms, including a rash, lymph node swelling, and significant fatigue.
2. Skin Issues: The treatments prescribed have not alleviated your itchiness, and there are concerns about the persistent nature of your rash and other skin patches.
3. Lymph Node Swelling and Other Signs: The new swelling and the lump in your leg, along with your fatigue and weight loss, raise important health questions.

Explanation

Your symptoms can be linked to several possibilities, including autoimmune diseases, infections, or even skin conditions. The complexity, particularly with the itching rash, persistent lymph node swelling, and abnormal lab results, suggests a need for comprehensive evaluation. The fact that these symptoms have triggered your anxiety is understandable; it's important to monitor them closely.

Next Steps

1. Document All Symptoms: Maintain a detailed journal of all symptoms, changes, triggers (like foods, temperature), and the progression of your rash and lymph nodes. Note any new symptoms, such as changes in appetite or fatigue levels, which can be valuable for your doctors.

2. Consider Urgent Care for New or Worsening Symptoms: If you experience severe symptoms such as increasing fatigue, difficulty breathing, or significant changes in your lymph nodes (size or tenderness), seek immediate medical attention.

3. Request Specific Follow-Up Tests: During your upcoming appointment with your primary care physician (PCP):

   • Discuss the possibility of testing for specific autoimmune markers beyond the ANA, like specific autoantibodies (e.g., anti-dsDNA for lupus).
   • Consider a biopsy of the lymph nodes if they continue to swell or change, particularly the lump in your leg—this can help rule out serious conditions.
   • Ask about additional imaging or tests that could assess lymphatic function or vascular health.

4. Lifestyle Considerations: While you wait, focus on hydration, maintain a balanced diet as best as you can based on your appetite, and consider reducing smoking—both tobacco and marijuana—as it might influence your immune system and overall health.

5. Mental Health is Important: The anxiety and fatigue you are experiencing can take a toll on your mental health. Reach out for support from friends, family, or mental health professionals if the emotional burden becomes too heavy.

6. Stay Informed but Cautious: While it’s tempting to research your symptoms online, try to limit this to reduce anxiety. Stick to reputable medical sites for information and continue to focus on your documented symptoms to discuss with your healthcare providers.

Conclusion

Your health concerns deserve attention, and it's great that you're in the process of securing proper care. By taking these steps, you can gain clarity as you wait for your upcoming appointment. Remember, you’re not alone in this—keep reaching out for support, and ensure your voice is heard in medical settings. Please feel free to keep us updated on your journey or share any further questions.