OpenHealth Q&A

Unexplained Skin Issues for 5 Months

At 28 years old, I've been experiencing peculiar skin spots that appear unexpectedly throughout the day, each episode lasting roughly three hours. The situation is becoming increasingly frustrating and is taking a toll on my mental well-being. **Personal Background:** - I follow a pescatarian diet. - Currently, I'm not taking any medications or vitamins, but I do consume Huel shakes up to twice daily. - I have ADHD. - My genetic background indicates that I am BRCA2 positive, as my family has a history of breast cancer, typically developing it by their mid-40s. - I might be sensitive to cow's milk and shrimp according to a blood test conducted by my PCP. - Blood results show a rheumatoid factor (IgM) level of 42 and a slightly elevated albumin level of 5.2 g/dL over the years. - I received a rabies vaccine in August 2025. - I am in a committed relationship for twelve years. I trust my partner and we consistently use condoms. - My last menstrual cycle was from February 24 to February 28, and I am not aware of any pregnancies. - I do not consume alcohol or drugs and strive to eat a balanced diet with whole foods, although I indulge in snacks and chocolates when I want. **Symptom Overview: Skin Spots/Rash** - The issue began in early September 2025. - I have documented three types of skin presentations: * Red spots surrounded by a white halo. * Red skin with white spots. * Swelling of eyelids and lips. - The spots are predominantly located on: * Forearms and hands (most frequent area) * Inside of the knees and along the legs (second frequent area) * Palms and soles of feet * Entire arms and legs * Torso * Face and neck - Each occurrence lasts about three hours, generally non-itchy, though occasionally they become intensely itchy (5-10% of the time). - These spots seem to show up at random times and can manifest multiple times a day in various locations, regardless of clothing or company. - Initially, the spots were limited to my forearms for about half an hour in September but continued through October. By mid-November, while at work around 11 AM, I experienced severe eyelid swelling and developed spots on my face, around my mouth, and down my arms. I might have also had spots on my legs, hidden by long pants. I went to urgent care due to concerns about a potential anaphylactic reaction where they administered Zyrtec and a tapering dose of prednisone, providing temporary relief. However, upon returning home, I experienced a resurgence of the spots and swelling, which then spread to my trunk and legs over the following days. **Other Observed Symptoms:** - I've been feeling notable discomfort in the abdomen, around two inches to the right and two inches above the belly button. This can sometimes escalate to severe pain with a sensation akin to an aching stomach, occasionally radiating to my right shoulder. The pain is intense, but my appetite remains intact, and it typically subsides after about eight hours. I've had a gallbladder ultrasound and a HIDA scan in January and December 2025, both yielding clear results. - I underwent a colonoscopy and upper endoscopy in November, which also revealed no concerns. - Experiencing significant menstrual cramps on the right side; my last period was especially painful, leading to nausea and discomfort in my right leg. I also have ongoing issues with my Achilles tendon, though I believe that to be unrelated to the skin issues. - Noticed unusual particles in my urine, resembling the floaters people sometimes see in their eyes. - Have had bowel irregularities, including large stools that carry a distinct odor. - Occasionally experience a sensation in my chest that triggers a cough, feeling like something is wiggling in there, which can happen in rapid succession. - I’ve been feeling unusually fatigued; previously, I’d wake up at 5 or 6 AM for work or a workout, but now I struggle to get out of bed until 9 or 10 AM. **Stress Factors:** - I recently left a job that I found unfulfilling, which was impacting my mental health negatively, and started a new job at the end of November 2025 that I enjoy, despite taking a lower salary. I realized the previous job might have contributed to feelings of depression. - My mother was diagnosed with breast cancer last month, which didn't come as a surprise given a family history of breast cancer; both my grandmothers faced the disease in their 40s. - After receiving the rabies vaccine in August 2025, I experienced heightened anxiety about my health, obsessively researching symptoms, which even disrupted my sleep for around ten days. I had to take mild anti-anxiety medications to manage sleep disruption. Thankfully, I've made progress in calming health-related worries and avoiding excessive Googling of symptoms. **Inquiries & Next Steps:** - I've consulted with four different medical professionals: * Dermatologist diagnosed chronic idiopathic urticaria, possibly stress-related, which fits since I experienced notable stress, but the spots are mostly non-itchy and transient. * My primary care doctor suggested a pruritic rash, a diagnosis I find less likely. * An allergist dismissed potential allergies to cow's milk or shrimp and did not conduct a scratch test since the rashes did not localize around my mouth or appear after meals. * A rheumatologist noted that while I have mild joint discomfort in my knees and stiffness in my fingers, it wasn't particularly alarming. - There seems to be scarce information regarding conditions that cause spots to appear on the palms. Possible concerns include syphilis, autoimmune diseases, pregnancy, and liver issues. Given my IgM levels, autoimmune disease would be a consideration, yet the rheumatologist did not seem worried. - Hormonal factors may be in play, raising questions about endometriosis or other female-related health matters. - The lack of pain from the spots is welcome, but their continued presence is bothersome, especially without an identifiable cause. I would like clarity on whether this is merely stress-related or if it signifies a more significant issue requiring intervention. If it turns out to be stress-related, I might explore meditation or return to therapy. - What further testing or specialists should I seek?

Answers (1)

3/2/2026, 2:21:00 AM

OpenHealth AI

It sounds like you’re dealing with a complex situation regarding your skin spots and overall health, which understandably can be quite distressing. Your experience seems multifaceted, involving dermatological, possibly autoimmune, and psychosocial factors. Let's focus on prioritizing your next steps and addressing your concerns while considering your overall health context.

Key Points:

1. Your skin spots are unusual and persistent, and there may be several interrelated causes, including stress, potential autoimmune responses, and dietary sensitivities.
2. The discomfort and abdominal pains, alongside fatigue, suggest that further exploration is warranted to rule out any underlying conditions.
3. Managing stress and considering mental health support could also be beneficial in addressing your symptoms.

Explanation:

Chronic urticaria (hives) has been suggested, which can often be triggered by stress and sometimes autoimmune mechanisms. While the spots are mostly non-itchy, the transient nature and locations you've described can overlap with other conditions, including dermatological issues or even allergic reactions. Given your BRCA2 gene status and family history of breast cancer, you may have heightened health anxiety, which could also contribute to your symptoms or perception of health.

Prioritized Next Steps:

1. Consider Stress Management Techniques: Since stress has been noted as a potential trigger, explore relaxation techniques (like mindfulness meditation, deep breathing exercises, or yoga) to reduce overall anxiety. These practices can greatly improve both mental and physical health.

2. Keep a Detailed Symptom Diary: Document the frequency, appearance, and duration of your skin spots, alongside any other symptoms (abdominal pain, fatigue, etc.). Note any potential triggers, including foods, stress levels, or environmental changes, as this may help identify patterns.

3. Nutrition Review: Since you suspect sensitivities to certain foods, consider a temporary elimination diet (under the guidance of a dietitian) to help pinpoint any dietary causes for your symptoms. This can be especially useful since some symptoms may be related to intolerances rather than allergies.

4. Consult with a Dermatologist with Expertise in Autoimmune Conditions: Given the persistent nature of your symptoms and family history, seek out a specialist who can perform more specific tests (like a skin biopsy or additional blood tests) to rule out autoimmune diseases or other conditions that may not be apparent in routine evaluations.

5. Follow-Up on Abdominal and Urinary Symptoms: Continue to monitor your abdominal pain and any unusual particles in your urine. If the abdominal pain intensifies or new symptoms develop, keep a healthcare provider informed to ensure comprehensive evaluation.

6. Mental Health Support: Given the stress surrounding job changes and family health history, consider talking to a counselor or therapist to help process these feelings. Cognitive-behavioral therapy (CBT) has proven effective for managing health anxiety.

7. Regular Checkups: Keeping a routine check on your health with regular follow-ups every few months could help monitor any developments in your symptoms, especially with the existing autoimmune indicators.

Although these steps may seem extensive, approaching your situation systematically can provide clarity and help you regain confidence in managing your health. Remember, you're not alone in this, and seeking support—whether medical or emotional—can be vital for your well-being.