Biopsy Done On Face. Have Butterfly Rash, Swallowing Difficulty And Muscle Weakness. What Is Wrong?
Also have difficulty with swallowing from time to time - especially after sun exposure. Recently, my left thumb became very flaccid in the MCP joint. And most alarming I an developing devits in my nose and forehead. I live in a small town and the doctor is puzzled after all the tests. With my permission, he invoked a sun triggered attack while my husband was present and I vasodilated and had tachycardia after 7 minutes and headed into shock. The doctor had to keep me on his examining table for over an hour while I stabilized. . After sun exposure I have very painful stomach problems. The rash has a butterfly appearance on my face but the other breakout is more like a "bite" appearance on my arms, back and face. I do have purple discoloration on my forehead, hands and feet. I have had a CPK that was normal. Does this constellation of symptoms indicate anything to you. Any help would be appreciated as he says whatever this is is life threatening to me and now I have epipens at all times. I am going to go to the city and he is trying to find the right specialist but is sure to whom I should be referred.
Thanks for writing in.
The symptoms like butterfly rash, photosensitivity,difficulty in swallowing,skin rashes ,muscle weakness all point towards autoimmune dermatomyositis, systemic sclerosis or mixed connective tissue disease.
These are common in females.The condition usually have overlapping features and diagnosis can be determined only after extensive testing.
The best specialist to deal with all your symptoms would be immunologist or rheumatologist.
You will need basic investigations like complete blood counts,renal function test,ESR etc.
Also few other investigations like muscle biopsy, XXXXXXX test, dsDNA ,anti Ro,anti XXXXXXX anti centromere etc.Also a lung function test would be useful.
If you can post the images of affected skin ,it would be of great help in predicting the condition.
Hope this helps.
I would be available for follow up.
Regards
DrSudarshan
MD
Dermatologist