Question: Hello, I have recently received 2 biopsies from my face - one indicating osteoma cutis 9 purportedly quite rare and once suggestive of dermatomyositis. Both were taken via the punch method when I had a significant rash on my face. I also have had over 15 episodes of vasodilation triggered by the sun when I have blood pressure readings in the range of 60 over 42 and I begin to go into shock accompanied by tachycardia. I have muscle weakness and had an electromyography that indicated early recruitment in my right arm. I can not hold my arms up long enough to blow my hair dry because of weakness -then I have to bring them down. I itch all the time. Nodules on the underside of my feet. Blisters on the top of my knuckles and hands that look like spider bites. Pustules on my arms, back, face, scalp (blisters and scales) wrist and ankle pain as well as many kinds of fluorescent lights are also a trigger for an attack. Also have difficulty with swallowing from time to time - especially after sun exposure. Recently, my left thumb became very flaccid. 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. The rheumatologist only found an elevated XXXXXXX of 80. All the other tests were directed by the dermatologist. 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.

I have had a CPK that was normal. The cardiac condition you refer to has never been mentioned other than the rapid heartbeat that happens when I vasodialate. I forgot to mention 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. If it is dermatomyositis - why would I only register an XXXXXXX of 80? Any other thoughts?

Thank you,