Could This Be a Malar Rash?
Greetings everyone! I’m a 35-year-old woman with a history of several diagnoses, including ADHD, bipolar disorder, fibromyalgia, and IBS. Over the last five years, I’ve faced an array of unusual symptoms and persistent illness. My experiences include intermittent mobility issues, daily hives, significant ankle swelling, and occasional bouts of nausea accompanied by vomiting. I've also been highly sensitive to heat and sun exposure; I burn within minutes without any chance of developing a tan. Additionally, I seem to have a low tolerance for various discomforts, including heat, hunger, my menstrual cycle, and fatigue. I often find myself exhausted, to the point of nearly dozing off unless I take my prescribed Adderall. In the past, I underwent tests to investigate potential autoimmune disorders, and my healthcare provider indicated there might be something unusual, though nothing definitive was established. I recall that one of my smooth muscle tests yielded elevated results. Currently, my medication regimen consists of 20mg of Adderall, 150mg of Wellbutrin taken twice a day, 40mg of citalopram, and 10mg of Zyrtec. At night, I also consume magnesium capsules, a daily women's vitamin, and probiotics to support my overall health.
Answers (1)
7/25/2025, 3:40:41 AM
OpenHealth AI
It sounds like you're experiencing a range of complex symptoms that could be concerning and frustrating. Given your symptoms — particularly the intermittent mobility issues, daily hives, significant ankle swelling, and sensitivity to heat — there is a possibility that you could be dealing with an autoimmune condition, which may include the potential for a malar rash (a characteristic rash associated with conditions like lupus).
Understanding Your Symptoms
A malar rash typically occurs as a butterfly-shaped rash across the cheeks and nose, often associated with systemic lupus erythematosus (SLE). Your ongoing symptoms — including hives, swelling, fatigue, and sensitivity to sun exposure — may relate to autoimmune activity, especially since you've had previous tests that indicated something unusual.
Prioritized Next Steps
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Symptom Tracking: Start keeping a detailed diary of your symptoms, noting when they occur, their duration, and any potential triggers (like food, stress, or environmental changes). This can help identify patterns and provide valuable information for discussions with your healthcare provider.
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Skin Examination: Pay attention to any skin changes, especially to see if a rash develops during sun exposure or if you experience other changes in your skin texture or color. Take photos if possible, as this will be helpful later.
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Hydration and Sun Protection: Ensure you're staying well-hydrated and use a high-SPF sunscreen (at least SPF 30) whenever you're outdoors to protect your skin, especially since you experience burning easily in sunlight.
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Review Medications with Your Provider: Given the multiple medications you're taking, including Zyrtec (an antihistamine), check if any side effects may be contributing to your symptoms. You might also discuss the potential of switching medications if they are not effectively addressing your concerns.
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Follow-Up Testing: Given your past evaluations with inconclusive results and elevated smooth muscle tests, consider asking your healthcare provider about further testing for specific autoimmune diseases or related conditions. Finding a specialist, such as a rheumatologist, may be beneficial.
Reassurance and Support
It's important to recognize that while your symptoms can be troubling, there's a range of possibilities, and many can be managed effectively. Communicating openly with your healthcare team will be key in getting the support you need. Be patient with yourself as you navigate this process, and ensure you prioritize self-care during times of symptom flare-ups.
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