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Concerns Regarding Genetic Syndromes

7/19/2025, 10:30:25 PMMale25-34

As a 30-year-old man diagnosed with Hashimoto's thyroiditis, I first observed numerous small, skin-toned papules on my face, predominantly around my nose, about six years ago. Their characteristics have raised my worries that they could potentially be angiofibromas. This situation has led me to ponder a potential link to Multiple Endocrine Neoplasia type 1 (MEN1). Despite having no family history of this condition, I once had a slightly elevated calcium level, which returned to normal following adjustments to my thyroid treatment. Fortunately, I don’t experience any known hormone-related symptoms or tumors, at least from what I am aware. I have consulted with two dermatologists, including one affiliated with a university's dermatology clinic. Each expert assessed the lesions as benign, possibly identifying them as scars or nevi, and concluded that further testing was unnecessary. In addition, I reached out to a genetics department, where they suggested that I undergo evaluations from both dermatology and endocrinology. Nevertheless, even after adhering to their recommendations, I have not received any organized diagnostics. I find myself mentally drained after grappling with this issue for the past six months. I’m not seeking excessive testing; I merely want a definitive professional assessment regarding whether MEN1 remains a viable concern in my situation. While I want to believe the specialists, the existing research largely implicates genetic factors in the development of multiple facial papules. What steps should I take next?

Thyroid DisordersEndocrinologyRheumatology

Answers (1)

Cony

7/19/2025, 10:30:46 PM

OpenHealth AI

It's understandable to feel overwhelmed and concerned about your skin lesions and their potential link to a genetic syndrome like MEN1, especially after consulting with various specialists without obtaining clear answers. Based on your situation, here are some structured points and actionable steps to help clarify your concerns.

Main Points:

  1. Current Assessment of Skin Lesions: Dermatologists have identified your lesions as benign, possibly scars or nevi.
  2. MEN1 Concerns: While you have some risk factors, such as a history of slightly elevated calcium, your lack of family history and hormone-related symptoms lowers the immediate concern.
  3. Desire for Clarity: You want reassurance regarding your risk for MEN1 without undergoing excessive testing.

Explanation:

Men1, or Multiple Endocrine Neoplasia type 1, is a hereditary condition that affects endocrine glands and can cause tumors. Your skin lesions and the slight calcium elevation have understandably raised your concerns, but the assessments by the dermatologists indicate that they do not view your lesions as a direct sign of MEN1. It is positive that you have no hormone-related symptoms, which can often be associated with more serious endocrine issues.

Next Steps:

  1. Keep a Symptom Diary: Maintain a detailed log of your skin lesions, including any changes in size, color, or number, along with any other health changes. This will make it easier to communicate specific concerns to healthcare providers.

  2. Schedule an Appointment with an Endocrinologist: Since you have had slight calcium elevation in the past and are concerned about MEN1, it may be beneficial to have a tailored evaluation with an endocrinologist. Prepare questions in advance to ensure you articulate your concerns clearly.

  3. Consider Genetic Counseling: If your endocrinologist feels it is necessary, ask about a referral to a genetic counselor who can provide insight into your risks based on your medical history and family background. They can also help clarify the need for any genetic testing related to MEN1.

  4. Follow Up with Dermatology: If your lesions change or if you develop new symptoms, consider scheduling a follow-up appointment with the dermatologist for a re-evaluation. Stress your ongoing concerns during this consultation to ensure they understand why you're seeking further evaluation.

  5. Practice Stress Management: Engaging in activities that reduce stress—like exercise, meditation, or hobbies—can help manage the mental toll this situation has taken. Consciously addressing your mental well-being is just as important as the physical assessment.

Reassurance:

You are rightly concerned about your health, and seeking a definitive answer is important. The negative assessments of your lesions by reputable specialists are supportive indicators that there may not be an immediate risk. By staying organized and proactive with your health, you can gain the clarity you need while managing your mental and emotional well-being. Let me know if you need further guidance or have specific questions on any of these steps!

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