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Suggest Treatment For Rash That Spreads On Elbow And Forearm

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Posted on Fri, 10 Oct 2014
Question: I have a rash that started on my elbows and forearm then spread to the other. Doctor gave me steroid ointment but it got worse. He gave me prednisone for six days. It cleared then after the last dose it has come back and spread to my hips, collar bone, and sternum with shortness of breathe and weakness in my arms. I have left a message for him but haven't heard back yet. Have an appt on Friday.. Don't want to go to the ER before then bc I have twin toddlers to take care of. At ideas??? Before the girls were born I had an EEG that showed weakness in my leg and they had me scheduled for an mri but I was pregnant so they couldn't do it. I also had a period where my hair fell out in clumps and dark bruises on the joints of my hand. Everything cleared up when I got pregnant. So now that this is going on do you think it could be related. Tried to ask the new doctor who replaced my old doctor.. It's a university hospital and interns.. He just said we are gonna just look at dealing with the rash for now? Before this all started two years ago I have been perfectly healthy and hadn't been to the doctor in ten years which was for a checkup. In my gut I know this is not normal or just a bunch of coincidences. Trying to take care of my kids and dealing with this and feeling like no one is listening is wearing me down. Help. Please.
doctor
Answered by Dr. Shoaib Khan (1 hour later)
Brief Answer:
?? Suspecting autoimmune condition

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing to us.

I have gone through your query with diligence and would like you to know that I am here to help. Your symptoms could very well be related, and in my opinion could possibly depict an autoimmune condition.

The only issue with possible autoimmune conditions is the time they take for an accurate diagnosis. But it is very important to get diagnosed accurately, because autoimmune conditions can affect multiple systems causing many complications and symptoms.

For now, a short list of possible conditions:

-Dermatomyositis
-Systemic lupus erythematosus (SLE)
-Discoid lupus erythematosus
-Sarcoidosis
-Hypersensitivity reaction
-Polymyositis
-Polymorphous light eruption
and a few others.

For now I would strongly recommend a visit to the doctors visit and a few investigations like:
-MRI
-EMG (electromyography)
-Chest x-ray
-Muscle biopsy
-Skin biopsy
-Complete blood count
-Ultrasonography

I hope you find my response helpful. I also hope you can schedule an appointment with your doctor at the earliest and undergo the investigations with conclusive reports. Please do not hesitate to write back to me for any further clarifications, I would be more than happy to help you.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (14 minutes later)
Thanks so much Dr. XXXXXXX I will talk to the doctor on Friday and I hope he listens.I've always been tough and healthy this a little humbling and frustrating for me. Hard for me to ask for help used to being the one helping others. I really appreciate the quick response and caring. I hope you have a great day.
doctor
Answered by Dr. Shoaib Khan (12 minutes later)
Brief Answer:
I am sure you will be fine

Detailed Answer:
Hello once again ma'am.

We are all humans, and God not only provides us with all that we can handle (and not a gram more). So I am sure you can get through this without breaking into a sweat.

Sometimes being doctors, we start believing we are invincible. But we too have been made like every other human walking this planet, and when we fall sick, it helps us to realize this.

Let us (doctors) take care of you for a change, as a gift for all the help you have provided to our race. Think of it as a thank you from all the people you have helped.

Do not stress, and if there is anything you need to clarify, you know where to find me.

Best of luck, do keep me posted.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shoaib Khan (2 days later)
Hey Dr XXXXXXX just got back from the doctor.. He gave me more prednisone and referred to a dermatologist three weeks from now. Asked him about an autoimmune possibility and let know again know about my past medical issues. He stated that he had checked my thyroid and ran a protein test to see if I had any inflammation when they drew my blood the last time I saw him. He said they came back normal so that meant that there was a 95 percent chance I did not have an autoimmune. I asked about the shortness of breathe he said that could just be a side effect from the steroids. Said it could all just be stress and the best he could do was refer me to a dermatologist bc he doesn't know what is causing the rash. I think I might call and try to find a different doctor on Monday. A little frustrated and itching like hell and worn out but don't worry I'm not going to break a sweat over it. At least the steroids will help for a week and it's Friday.. Going to have a few glasses of wine and listen to some music.:) just wanted to update you and I hope you have a great weekend!!! Thnx again for the caring.:)
doctor
Answered by Dr. Shoaib Khan (1 hour later)
Brief Answer:
We need another doctor or dermatologist

Detailed Answer:
Hello once again.

As I mentioned earlier, you need not thank me ever. I am always here for you, and after you called me your brother, how could I not? :)

Yes, breathlessness can be caused by steroid use as steroids cause the retention of fluids in the body. These can easily accumulate in the lungs and restrict them from taking in the usual amount of air resulting in breathlessness.

I am happy to know that a thyroid profile and protein investigation returned normal which does rule out autoimmune disorders to quite an extent, although not completely. For this reason, to avoid your doctor who is gloating with overconfidence at the moment (although, as correctly stated by him there is a 95 % chance that you are free from an autoimmune disorder, there still exists a 5% chance of him being wrong); a second opinion would be wise, just to make sure.

I do not support the idea of just prescribing steroids to a patient without making a conclusive diagnosis. It is like prescribing a pain management medication for a patient who has a knife penetrating them; the problem is not the pain, it is the knife. As long as the knife is present, the pain will be; so remove the knife, not the pain.

If your doctor had not made a diagnosis, why did he prescribe the steroids? I do not understand this, but I am no one to question another doctors technique. Enjoy your wine, your music and I hope they are as therapeutic as they can get. I really appreciate the information, and your strong will and mind.

Take care,
Dr. Shoaib Khan.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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Suggest Treatment For Rash That Spreads On Elbow And Forearm

Brief Answer: ?? Suspecting autoimmune condition Detailed Answer: Hello ma'am and welcome. Thank you for writing to us. I have gone through your query with diligence and would like you to know that I am here to help. Your symptoms could very well be related, and in my opinion could possibly depict an autoimmune condition. The only issue with possible autoimmune conditions is the time they take for an accurate diagnosis. But it is very important to get diagnosed accurately, because autoimmune conditions can affect multiple systems causing many complications and symptoms. For now, a short list of possible conditions: -Dermatomyositis -Systemic lupus erythematosus (SLE) -Discoid lupus erythematosus -Sarcoidosis -Hypersensitivity reaction -Polymyositis -Polymorphous light eruption and a few others. For now I would strongly recommend a visit to the doctors visit and a few investigations like: -MRI -EMG (electromyography) -Chest x-ray -Muscle biopsy -Skin biopsy -Complete blood count -Ultrasonography I hope you find my response helpful. I also hope you can schedule an appointment with your doctor at the earliest and undergo the investigations with conclusive reports. Please do not hesitate to write back to me for any further clarifications, I would be more than happy to help you. Best wishes.