Should I Consider Imaging or a Biopsy for My Forehead Dent?
A 50-year-old female, standing 5'4" and weighing 155 pounds, with a Caucasian background, does not take any medication and has never smoked or consumed alcohol. I recently noticed a dent on my forehead that emerged a few weeks ago. Previously, I had visited a rheumatologist who conducted thorough blood tests, determining that I do not have an autoimmune disorder apart from alopecia areata. Coincidentally, I also have a round bald patch, approximately 2 inches in diameter, situated on the same side of my head as the dent. Additionally, there’s a small lump on my skull that corresponds with the dent, which I observed around two years ago, initially attributing it to a probable head injury. I've recently discovered that I might align with the characteristics of Ehlers-Danlos syndrome, having recalled that I would have received a score of 7 out of 9 on the Beighton Test during my childhood. When I consulted a dermatologist regarding my alopecia, I pointed out the forehead dent. The dermatologist speculated it could possibly be linear morphea, scleroderma, lupus, or a mixed connective tissue disorder. She recommended that I reconvene with my rheumatologist for further exploration. Upon doing so, my rheumatologist dismissed my concerns, attributing the dent to a dermatological rather than a systemic issue. Now, I find myself questioning whether I should further investigate this condition. While the dent is not particularly prominent, I am curious if it may indicate an underlying issue. Would it be wise to seek a second opinion from another rheumatologist?
Answers (1)
7/30/2025, 1:01:54 AM
OpenHealth AI
It’s understandable to have concerns about changes in your body, especially when they involve potential underlying health issues. The dent on your forehead, along with other symptoms, can certainly raise questions. Here’s a summary of your key concerns and the steps you might consider taking.
Main Points:
- The forehead dent, although dismissed by your current rheumatologist, warrants careful consideration given your history and associated symptoms.
- Seeking a second opinion can provide clarity, especially when there are differing views on the potential implications of your symptoms.
Explanation: You’ve already consulted a rheumatologist and a dermatologist regarding your symptoms, which is a good first step. The dent on your forehead, the lump on your skull, and your alopecia areata bring about questions of connective tissue disorders, especially with your recalled scoring on the Beighton Test. While systemic issues like Ehlers-Danlos syndrome or other connective tissue disorders could be rare, they might warrant further exploration, particularly if they could inform how you manage your overall health.
Since your current rheumatologist dismissed the brachial symptoms as purely dermatological, getting a second opinion from another specialist could provide you with a more comprehensive view on whether further imaging or biopsy might be necessary.
Next Steps:
- Seek a Second Opinion: Look for another rheumatologist or a specialist in connective tissue disorders. Bring along your previous test results, notes, and any images of the symptoms if you have them.
- Document Your Symptoms: Keep a detailed record of any changes in the dent, the lump, your alopecia, and any other symptoms. This can help specialists better understand your situation.
- Consider Imaging: If the new specialist thinks it’s warranted, imaging (such as an MRI or ultrasound) can provide more detail about what's happening beneath the skin.
- Stay Informed: Research Ehlers-Danlos syndrome and related conditions to better understand symptoms, management, and any referrals you might need.
Remember, you’re doing the right thing by seeking clarity for your health concerns. Trust your instincts about your body, and don’t hesitate to ask for further evaluations. Let me know if you have more questions!
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