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What Causes Shortness Of Breath, Red Itchy Skin Rashes On Legs And Arms?

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Posted on Wed, 10 Aug 2016
Question: Yes. I have developed shortness of breath, red, itchy skin rashes mostly legs and arms and very dry index and thumb fingers. Doctors think it may be a form of myositis/connective/collagen tissue disease . The myositis blood panel is negative but my CK and Aldolaise are high. We've been investigating for months with no definitive diagnosis and I am afraid of the Prednisone treatment recommendation. Should we be testing for anything else?
doctor
Answered by Dr. Naval Mendiratta (1 hour later)
Brief Answer:
Myositis

Detailed Answer:
Good evening

thank you for writing on health care magic

Well, the history of shortness of breath, rashes, dry scaly skin over the hands along with High CPK and aldolase does go in favor of a muscle disease.I am not sure where the delay is. I would like to ask you a few queries to give me a clearer picture..

1. How bad is your muscle weakness...Are you able to comb your hair or get up from squatting position??/

2. Do the rashes worsen on sun exposure??

3. ANy rash over the face or forehead??

4. How high are the CPK and ALdolase..What about SGot, SGPT and LDH levels?/

5. has EMG been performed on you to give us the myositis pattern?

6. DId they plan on doing muscle biopsy???

DO let me know these queries..

A Lot of times all autoantibodies are negative in Muscle disease..But a constellation of symptoms do point towards the myositis diagnosis...If you could attach the picture of the rashes, that would be helpful as well

Await your reply

REgards
Dr naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta (11 hours later)
1. I really don't have any muscle weakness--I can comb my hair easily and can get up from a squatting position with my arms crossed with ease.

2. They don't seem to worsen with sun exposure and they go away after a day or so.

3. No rash on the forehead. Rashes on knees and shin and ankles as well as forearms and side of the back. They itch (the first indication) and sometimes I put a steroid cream on them and it brings relief. I also have dry, scaly skin on my two elbows.

4. Last test the CPK was 1402 (was over 1600 the time before). Aldolase 24.1
SGOT: 74.1, SGPT:87, LDH in XXXXXXX was 423

5. Not sure what the EMG refers to.

6. Not as yet--trying to find the best place (muscle group) to do it. Doing an MRI of shoulder and pelvic area tomorrow. Surgeon wanted to open me up, move my bowels aside to get to a muscle deep in the pelvic girdle that shows the most inflammation but that is too invasive.

Not sure how to attach a photo--will work on this.

Thanks
doctor
Answered by Dr. Naval Mendiratta (4 hours later)
Brief Answer:
It is myositis

Detailed Answer:
Good evening

Thanks for your reply

Well, your muscle enzymes are quite high and the rashes you are referring to can go in with DErmatomyositis. Although I will have to see them to determine it.
I am sure your doctors have had a thorough look at it, so just wanted to know their impression.

EMG refers to electrical myogram...It is used for determining what sort of muscle inflammation is going on and what pattern it is.. That will be helpful to sort out the area for biopsy as well

Well, yes that is way too invasive..Rather than that, better to get treated...At times it happens the muscle enzymes are raised, rash is seen but you dont have muscle weakness..This is known as Amyopathic Dermatomyositis...( RAshes have to be classical for it). It may evolve into muscle weakness over time, but either way we need to treat it at this stage...If it responds, we know we are on the right track

There is an option to upload pictures on this page. You may use it. Alternatively you can mail it to YYYY@YYYY with subject as "Attn: Dr. Naval"

Also discuss with your Doctor about EMG test...IF EMG is positive, we don't need a biopsy

Hope the information was useful

Do let me know for more queries

rEgards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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What Causes Shortness Of Breath, Red Itchy Skin Rashes On Legs And Arms?

Brief Answer: Myositis Detailed Answer: Good evening thank you for writing on health care magic Well, the history of shortness of breath, rashes, dry scaly skin over the hands along with High CPK and aldolase does go in favor of a muscle disease.I am not sure where the delay is. I would like to ask you a few queries to give me a clearer picture.. 1. How bad is your muscle weakness...Are you able to comb your hair or get up from squatting position??/ 2. Do the rashes worsen on sun exposure?? 3. ANy rash over the face or forehead?? 4. How high are the CPK and ALdolase..What about SGot, SGPT and LDH levels?/ 5. has EMG been performed on you to give us the myositis pattern? 6. DId they plan on doing muscle biopsy??? DO let me know these queries.. A Lot of times all autoantibodies are negative in Muscle disease..But a constellation of symptoms do point towards the myositis diagnosis...If you could attach the picture of the rashes, that would be helpful as well Await your reply REgards Dr naval