OpenHealth Q&A

Recent Lab Findings: Understanding My Rash

Update 2: I have received some blood test results, although I'm still waiting for a few more. My tests included a Complete Blood Count (CBC) and differential analysis, a Basic Metabolic Panel, Vitamin D levels, and Vitamin B12 levels. Update: I had a meeting with my primary care physician (PCP) today, June 25th. He expressed understanding regarding concerns about potential conditions such as lymphoma, lupus, and other disorders like rheumatoid arthritis and fibromyalgia. Following our discussion, I undertook additional blood tests, which included the CBC, basic metabolic analysis, rheumatoid factor, ANA, C-Reactive Protein, PSC liver assessment, Vitamin B12, and Vitamin D levels. He also mentioned that he would consult with some surgeons about the possibility of conducting a lymph node biopsy. I expect to receive the blood work results within a couple of days and should hear about the biopsy within a week. He advised postponing referrals to dermatology and rheumatology until after we get the blood work results. I want to clarify something important: I know that Reddit cannot provide a diagnosis. I've visited urgent care and scheduled an appointment with my PCP to hopefully obtain a referral to a rheumatologist. Unfortunately, my PCP isn't available until August, which leaves me anxious and uncertain. After my visit to urgent care, I was prescribed Triamcinolone and advised to see a rheumatologist as soon as possible. I am reaching out here to see if anyone has had similar experiences leading up to a diagnosis of lupus, rheumatoid arthritis, or lymphoma. I'm also interested in anyone's thoughts on my current health situation. At urgent care, I was told it might be one of those three conditions, but that starting with a rheumatologist would be wise for addressing the skin issues. I'm 27 years old, 5'3", weighing 144 lbs, a female with no medications currently, and I've been a daily smoker of cigarettes and cannabis for approximately 12 years. About two months ago, I developed a severely itchy rash localized to the back of my neck, which can occasionally feel burning. I haven't altered any soaps, products, or detergents recently, and despite trying lotions, cortisone creams, and allergy medications, nothing seems effective. I have no previous instances of eczema or other skin issues, aside from developing PMLE in the last few years. Additionally, my lymph nodes at the back and sides of my neck, as well as behind my ears, have become swollen. Historically, I've experienced hard, swollen lymph nodes on the sides of my neck and the area behind my ears, first noting one on the left side around five years ago. The swelling in the back nodes appeared after the rash developed. The rash is extremely itchy and sometimes burns. There are also areas where the skin has broken down into open sores that aren't healing well. Interestingly, the skin over my lymph nodes also itches, particularly in areas where there’s no visible rash. Before I let my imagination run wild with worries that my mild rash might signify something severe like lymphoma, I thought I'd turn to the community for insights. Edit 1: I should mention that a couple of months prior to the emergence of the neck rash, I began noticing round, occasionally itchy patches on my legs and abdomen, as well as one on my foot. These patches seem to be persistent, do not heal, and only become bothersome when exposed to heat or water, such as during showers. Edit 2: I have several such spots spread across my legs and abdomen along with one on my foot as mentioned in my previous edit. Moreover, I have a lump located in my lower left leg, on the internal side of my shin. Although I have a few old bruises from years past, this lump is distinctly different; it feels akin to a hard, swollen lymph node and is about one centimeter in size, with slightly pink skin over it. Are there lymph nodes located in this area of the shin? Edit 3: I've added the latest CBC results from October 2024, which were flagged as "abnormal." Edit 4: The Basic Metabolic Panel conducted on October 24th showed abnormalities, and there was an elevated D-dimer from the same date. I've also noticed a visibly swollen lymph node in my neck currently. For the past few years, I have been experiencing swollen lymph nodes, persistent fatigue, and numerous other ailments, along with a weight loss of around 100 pounds without any effort. I suspect I may be dealing with some form of slow-growing lymphoma. Additionally, my tonsils appear uneven and have an odd appearance. I have no appetite at all. If I do experience hunger, it lasts for only a short time, and I feel as though I must eat quickly when it does occur. My meals have become infrequent, with me eating only about once a day when I can muster the appetite. I constantly feel utterly drained. Even simple tasks leave me feeling depleted; movements that once felt normal, like a brief walk with my dog, now require me to pause frequently to rest. The relief I experience when I lie down in bed is immense. I recognize the fatigue that comes after an exhaustive day, but this exhaustion persists even after minimal exertion, be it light cleaning or just moving around. My body feels heavy, and I find it challenging to function normally. I also experience polymorphic light eruption every summer for the past three or four years, but only on my arms. Tests have shown I am HIV negative. I tested negative for Lyme disease, my ANA is normal (less than 1.8), rheumatoid factor is below 10, thyroid stimulator is at 1.20 mcIU/mL, and my sedimentation rate is 13. My comprehensive metabolic panel indicated occasionally foamy urine with trace amounts of protein present. Years ago, I had mono, and prior medical records indicate very high levels of Epstein-Barr Virus during that time. I've also included a recent photo showing the neck rash, with visibly swollen lymph nodes highlighted. Is there a specific test that I should request at this stage? Should I proceed directly to asking for a lymph node biopsy or other suitable examinations? Would it be more prudent to visit the emergency room, or am I better off waiting until August for my PCP appointment? The corticosteroid cream I received from urgent care (Triamcinolone) does relieve the itching temporarily, but the effects wear off quickly, returning to discomfort shortly after. The persistent itch is becoming unbearable. I've also experienced itchiness in various areas of my body where there is no visible rash. As I write this, I am in the bath, experiencing a sudden onset of chills followed by sweating, amplifying the itchiness on my legs due to the water. I marked the area where I'm itching, which is close to one of the spots—though the spot itself is not irritated. This is increasingly frustrating and distressing for me.

Answers (1)

6/26/2025, 3:31:19 PM

OpenHealth AI

It sounds like you're going through a very challenging and concerning time with your health. The symptoms you described, including the persistent rash, swollen lymph nodes, fatigue, and changes in appetite, are understandably distressing. While you're rightly seeking insights, please remember that the diagnosis and management of any medical condition should always be guided by a healthcare professional.

Key Points:

1. Current Symptoms: Rash, swollen lymph nodes, fatigue, and decreased appetite.
2. Pending Tests: Blood work results and potential lymph node biopsy.
3. Current Treatment: Use of topical corticosteroids for itching.

Explanation:

Your symptoms are complex and could indicate a range of conditions, some of which you mentioned, such as lupus or rheumatoid arthritis. The itching and rash, combined with swollen lymph nodes and significant fatigue, warrant thorough investigation. The fact that you have been losing weight unintentionally and experiencing noticeable fatigue are additional red flags that need to be addressed.

The corticosteroid cream (Triamcinolone) may help manage the itching temporarily, but if the relief is short-lived and the rash persists without improvement, further steps should be taken.

Actionable Next Steps:

1. Continue Monitoring Symptoms: Keep a detailed diary of your symptoms, noting any changes in the rash, itchiness, fatigue levels, and any new symptoms that arise. This will be valuable information for your healthcare provider.

2. Follow Up on Pending Results: Once your blood tests and any potential biopsy results come back, discuss them with your PCP promptly. Given the complexity of your symptoms, these results are critical for defining your next steps.

3. Consider Emergency Care if Necessary: If you experience severe symptoms like significant swelling, difficulty breathing, fever, or intense pain, seek immediate care at an emergency room. While it may not be necessary to rush there now, trust your instincts about your body.

4. Discuss with Your PCP About Referrals: Given that your symptoms are persisting and worsening, it might be worthwhile to directly express the urgency of your case when you next contact your PCP's office. Ask if they can expedite your referral to a rheumatologist or dermatologist based on the current distress and condition.

5. Skin Care Adjustments: While waiting for professional guidance, consider using gentle, fragrance-free moisturizers and limit exposure to potential irritants, including hot water. Cool baths may soothe itchiness more effectively than hot ones.

6. Manage Symptoms at Home:

   • Avoid known irritants: Keep a lookout for any environmental factors that could worsen your symptoms.
   • Chill out: Use cool compresses on itchy areas to help reduce irritation temporarily.
   • Stay Hydrated: Ensure you're drinking enough fluids, as dehydration can exacerbate fatigue and skin issues.

7. Wellness Strategies: As much as your fatigue allows, engage in light activities such as gentle stretching or mindfulness practices to help manage stress.

Conclusion:

This is understandably a stressful time for you, and proactive steps will aid in addressing your symptoms and concerns. Keep advocating for your health, and make sure to follow up on your test results as they come in. You deserve the support needed to find relief and clarity in your health situation. Remember to reach out if you have urgent concerns, as your wellbeing is paramount.