OpenHealth Q&A

Urgent Appointment Rescheduled: Seeking Insights on Rash

I've made some edits to include crucial details. While I understand that Reddit isn’t a substitute for medical advice, I wanted to share my current situation. I sought help at urgent care and have scheduled a visit with my primary care physician (PCP) for a possible referral to a rheumatologist. However, my PCP isn't available until August, leaving me anxious and in anticipation. The urgent care doctor prescribed Triamcinolone but it hasn’t alleviated the itching. I’m hoping to connect with others who have had similar experiences prior to being diagnosed with conditions like lupus, rheumatoid arthritis, or lymphoma. I’ve been told by medical staff that my symptoms could potentially indicate one of these conditions, but they recommended starting with a rheumatologist to assess the skin issues first. About me: I’m 27 years old, 5'3", weigh 144lbs, and I’m female. I currently take no medications but have been a daily smoker for approximately 12 years. Approximately two months ago, I noticed a severely itchy rash exclusively on the back of my neck, which occasionally burns. I haven’t changed any soaps, creams, or laundry detergents, and none of the over-the-counter remedies seem to provide any relief. My skin history is relatively clear aside from a few instances of polymorphic light eruption (PMLE) that emerged over the last few years. To complicate matters, I’ve experienced swollen lymph nodes on both sides and at the back of my neck and behind my ears. I've had hard, swollen lymph nodes intermittently, with the first one identified around five years ago. The swelling of the neck lymph nodes began after the rash appeared. The rash is not only extremely itchy, but it also radiates warmth and has caused open sores that won’t heal. Interestingly, the skin over the lymph nodes themselves seems irritated, even where there is no visible rash. Before diving headlong into Google’s troubling rabbit hole of medical conditions, I reached out to Reddit for guidance. Additionally, a couple of months prior to the neck rash, I started seeing some circular, mostly itchy patches on my legs and abdomen, with one on my foot. These patches have not healed, and although they sometimes itch, they are less noticeable compared to the neck rash. They do seem to be aggravated by heat or water, especially during showering. I’ve counted several spots on my legs, three on my stomach, and another on my foot, as well as a suspicious lump located on the inner side of my shin, which feels like a swollen lymph node. This lump is about 1cm in diameter and the surrounding skin is slightly pink while the lump itself is deeper within. I recently underwent a complete blood count (CBC) test, and the results were marked "abnormal". My metabolic panel and D-dimer from the same date also indicated abnormalities. Currently, I have a visibly swollen lymph node on my neck as well. Over the last couple of years, I've been contending with swollen lymph nodes, persistent fatigue, and other unsettling symptoms, alongside a significant weight loss of about 100 pounds without any effort. Regarding my tonsils, they appear uneven and alter their appearance. My appetite is practically nonexistent; when hunger strikes, it lasts only briefly, limiting me to one meal a day if I’m fortunate to eat. Even light physical activity leaves me feeling utterly drained, starkly contrasted with the fatigue associated with a long day’s work. This is an all-consuming weariness that lingers long after rest, making simple tasks monumental challenges. Additionally, I have experienced recurring polymorphic light eruption symptoms every summer for the past few years, limited to my arms. I’ve ruled out HIV and Lyme disease, my ANA levels are normal, and other tests have yielded non-conclusive results. Years back, I had mononucleosis, showing extremely elevated Epstein-Barr Virus metrics, as per the medical records I managed to obtain. With swollen lymph nodes readily visible in a photograph accompanying my neck rash, I ask for guidance on which specific tests I should pursue moving forward: should I request a biopsy of a lymph node, the rash, or proceed directly to emergency care, or tough it out until my PCP is available in August?

Answers (1)

6/23/2025, 9:10:53 PM

OpenHealth AI

It seems you're experiencing a complex combination of symptoms that are understandably causing you considerable anxiety. Your ongoing issues with a severe rash, swollen lymph nodes, and systemic symptoms like fatigue warrant attention, particularly given the potential implications. Here’s how to approach your situation.

Key Points

1. Symptom Monitoring: Your symptoms require careful observation due to their complexity and potential seriousness.
2. Short-term Relief: Since Triamcinolone isn't providing relief, consider adjunct strategies.
3. Testing and Evaluation: Certain tests could determine the underlying causes of your symptoms and aid in appropriate management.

Explanation

The rash you're experiencing, paired with the swollen lymph nodes and fatigue, can be indicative of various underlying conditions, including possible autoimmune disorders or infections. The fact that your lymph nodes are swollen and tender, combined with the persistent rash and weight loss, suggests that your body's immune system is reacting to something.

Given your history of polymorphic light eruption and significant weight loss without effort, it's crucial to obtain a comprehensive evaluation. As you have noticed abnormal blood test results, further investigation is needed to clarify these findings.

Next Steps

1. Symptom Diary: Keep track of your symptoms, noting when they worsen, any triggers (like heat or water), and the status of your rash and lymph nodes. This will help provide your healthcare provider with detailed information.

2. Contact Your PCP’s Office: Even though your appointment is in August, consider reaching out to see if there's a possibility of an earlier visit or if they can provide interim guidance based on your current situation. Express the extent of your symptoms, particularly the fatigue and lymph node issues.

3. Urgent Care Evaluation: If your symptoms worsen significantly before your scheduled visit—such as increased pain, severe difficulty breathing, or newfound symptoms like fever—it is advisable to seek immediate medical attention.

4. Request Specific Tests: When you do see your PCP or rheumatologist, consider asking for:

   • A biopsy of the lymph node or the rash to rule out conditions such as lymphoma or other skin disorders.
   • Further blood tests to assess markers of inflammation (like CRP or ESR) and possibly evaluate for specific autoimmune conditions.
   • Imaging studies if indicated, especially considering the swollen lymph nodes.

5. Adjunct Relief for Rash: In the meantime, you may try:

   • Cold compresses to soothe the rash.
   • Over-the-counter antihistamines to help with itching (if no contraindications).
   • Avoiding known irritants or triggers, including harsh soaps and hot water.

Reassurance

It’s normal to feel anxious given the situation, but being proactive by tracking your symptoms and communicating clearly with your healthcare providers will enable you to get the help you need. Your health and comfort matter, and the goal is to identify the underlying cause of your symptoms as effectively as possible. Please keep monitoring your symptoms, and don't hesitate to seek help if they worsen.