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September 17, 2015 1:56 PM Subscribe
Minor medical concern is making me more of a hypochondriac than usual. I already made an appointment with a doctor but if you could help me mellow out until then, I'd really appreciate it.
Since April, I've had annoying splotches on my lower legs. They're flat, not raised, not itchy, not scaly, not weeping or bleeding or crying or drooling. They were around dime-size (some bigger, most smaller). I had a larger one on my upper leg and they were salmon colored so when I saw my dermatologist in June or July, he said he thought it was pityriasis rosea. He gave me a prescription for a topical cream (I think a steroid cream), which has helped lighten them. But it hasn't really gone away - I thought it had but it seems like it hasn't. Now the blotches look more like burst capillaries. They're more red and smaller. Occasionally I'll put some of the cream on them and they'll seem to lighten up but they come back. There aren't many of them, maybe eight.
My mother had lupus so I worry that's what it is, especially since I'm interested in starting a family soon. And lupus symptoms are so vague that there's a significant chance I'm concerned over nothing but I am a little concerned. I have idiopathic daytime hypersomnia (I'm tired all day for no clear reason) and take a prescription to help me with that. I've been taking bupropion for depression for years. Am I just treating lupus symptoms or is this just how I roll?
I don't think I've ever had the butterfly rash. I don't think I'm photosensitive and I don't get fevers. But I get headaches. I feel achy frequently - it seems like my feet hurt more often than they did before - but I also have taken to running or biking to work most days so I've been more active. Does biking or running 4-5 days a week sound like something a person with lupus does?
As I said, I made an appointment with that dermatologist again. I had a physical recently and as far as I know, my blood work was normal. Is there a test for lupus? Even if I have it, are there treatments that help? What questions should I be asking? I realize I'm probably overreacting. But if you have any thoughts, I'd appreciate hearing them. Thanks!
Since April, I've had annoying splotches on my lower legs. They're flat, not raised, not itchy, not scaly, not weeping or bleeding or crying or drooling. They were around dime-size (some bigger, most smaller). I had a larger one on my upper leg and they were salmon colored so when I saw my dermatologist in June or July, he said he thought it was pityriasis rosea. He gave me a prescription for a topical cream (I think a steroid cream), which has helped lighten them. But it hasn't really gone away - I thought it had but it seems like it hasn't. Now the blotches look more like burst capillaries. They're more red and smaller. Occasionally I'll put some of the cream on them and they'll seem to lighten up but they come back. There aren't many of them, maybe eight.
My mother had lupus so I worry that's what it is, especially since I'm interested in starting a family soon. And lupus symptoms are so vague that there's a significant chance I'm concerned over nothing but I am a little concerned. I have idiopathic daytime hypersomnia (I'm tired all day for no clear reason) and take a prescription to help me with that. I've been taking bupropion for depression for years. Am I just treating lupus symptoms or is this just how I roll?
I don't think I've ever had the butterfly rash. I don't think I'm photosensitive and I don't get fevers. But I get headaches. I feel achy frequently - it seems like my feet hurt more often than they did before - but I also have taken to running or biking to work most days so I've been more active. Does biking or running 4-5 days a week sound like something a person with lupus does?
As I said, I made an appointment with that dermatologist again. I had a physical recently and as far as I know, my blood work was normal. Is there a test for lupus? Even if I have it, are there treatments that help? What questions should I be asking? I realize I'm probably overreacting. But if you have any thoughts, I'd appreciate hearing them. Thanks!
Do keep in mind that skin stuff and headaches/tiredness can all be caused by regular old allergies, too, which are a lot more common than lupus.
posted by you're a kitty! at 3:26 PM on September 17, 2015
posted by you're a kitty! at 3:26 PM on September 17, 2015
Those things bothering you are pretty common accross a range of benign conditions. Truly, I wouldn't worry about lupus (I'm not a doctor but I do have autoimmune disease). But I hear you on worrying about things like this.
If you want reassurance, when you see your doctor can you ask for a referral to a rheumatologist? When I was going through testing they did a bunch of blood tests and I remember my doc saying that I didn't have lupus (which, whew as I wasn't considering that one anyway) and presumably it was from one or more of the tests they did. I don't think there's one test that rules lupus in or out but rather they look at the various inflammatory markers (I feel like maybe ANA is the one for lupus?). I don't think they test for these things in regular blood tests.
I feel like being told that you definitely don't have it would be worth the cost since you have valid concerns (with your mother having it, it's closer to you than just House) and yet headaches and sore feet and tired just sounds like regular life to me and stressing about them being worse than they are is probably doing you more ill than anything.
posted by kitten magic at 4:10 PM on September 17, 2015
If you want reassurance, when you see your doctor can you ask for a referral to a rheumatologist? When I was going through testing they did a bunch of blood tests and I remember my doc saying that I didn't have lupus (which, whew as I wasn't considering that one anyway) and presumably it was from one or more of the tests they did. I don't think there's one test that rules lupus in or out but rather they look at the various inflammatory markers (I feel like maybe ANA is the one for lupus?). I don't think they test for these things in regular blood tests.
I feel like being told that you definitely don't have it would be worth the cost since you have valid concerns (with your mother having it, it's closer to you than just House) and yet headaches and sore feet and tired just sounds like regular life to me and stressing about them being worse than they are is probably doing you more ill than anything.
posted by kitten magic at 4:10 PM on September 17, 2015
Why are you going back to the same doctor if he failed to diagnose your skin issue correctly the first time? It's not like he'll suddenly know what it is seeing it a second time.
Think about getting a different opinion.
posted by jbenben at 4:27 PM on September 17, 2015
Think about getting a different opinion.
posted by jbenben at 4:27 PM on September 17, 2015
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Lupus and its kin seem hard to definitively diagnose. That's why on House, it's always lupus! Right up until it ISN'T.
It doesn't help that many of the connective-tissue-related autoimmune syndromes overlap, and that it's possible to have more than one. In my experience, diagnosing them is more of an art than a science. For instance, from this website, I have enough symptoms to be diagnosed with lupus. And yet, I do not have lupus - I have amyopathic dermatomyositis. They're cousins!
In fact, they are such close cousins that when the results of my diagnostic biopsy came back, they were consistent with dermatomyositis OR lupus. And yet somehow my doctor was able to determine, through his arcane arts, that instead of bog-standard lupus, I have the super weird rare form of dermatomyositis (which thankfully is less serious in general than the normal kind).
Some things you can pretty easily self-diagnose in collaboration with Dr. Google (sprained ankle! Nail through the hand! Spider bite!) but autoimmune issues are not among them. What I can tell you, however, is that many, many people who do NOT have lupus also get headaches and sore feet and are tired a lot. I don't mean to minimize your symptoms - just to remind you that they could also be symptoms of things like riding and biking too much too fast, not getting enough sleep, having a shitty job, etc.
As far as advice goes, if you're really concerned about lupus, you'll probably need to be assessed by a rheumatologist, not a dermatologist. Bring it up with your dermatologist and see what she says. Be sure to mention ALL the symptoms you've noted here, so they have a full picture and know that you're not just concerned about a skin problem.
There are definitely treatments for lupus, though there's no cure currently. But you probably are overreacting! I'm a proven over-reactor to medical things myself, and you show all the symptoms of random-symptom-induced hypochondria. There's at LEAST an even chance that all you have is a bad case of random weird spots on your legs.
posted by kythuen at 2:56 PM on September 17, 2015