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Suggest Treatment For Rashes Around Lips And White Spots On The Scalp

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Posted on Fri, 20 Jan 2017
Question: Dr. Naval Mendiratta,
http://doctor.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=201053
Since I moved house and I am now seeing a new GP, my new Doctor's are taken this case very serious. A few days ago I was diagnosed with pleurisy even though I didn't have an x-ray. My blood pressure was up to 149/89 also I weird rash appeared on my torso plus my mouth and tightened, both side of lips were sore to open mouth wide, ( see photo).It's not just the sun that seems to have an affect but the cold, when there's a sudden change in temperature to now being cold, my toes and fingers go very cold to touch, like I've had them in ice. Then that joint pain and tingling sensation. The pain in my nails is very sore as if someone was putting a needle through them. I get organ pain as you know. I find it hard to walk, like the bottom of my shins, or the top of my feet is restricted from movement. My GP had asked me if I have ever had problems swollen and I said YES, I have to drink water to help me get my food down as it gets stuck in my esophagus. I've sent you more photos, please take a look! My GP is send me to see a rheumatologist a.s.a.p.
GP also took note that I had both toe nails off at the same time which was due to ingrown toenails on the big toe. He went through my family history and seemed to take interest in my dad's side of autoimmune diseases, (dad has pernicious anemia and his mum who died of scleroderma and his aunty had rheumatoid arthritis). I was in touch with a doctor previous to my last visit and is going to help me arrange to do a special urine test for Porphyria! What ever disease this is I am getting sicker and believe it will show it's true colours. The disease doesn't seem to leave anything out even my urethra gets affected, like it's got norrower and my flow of urine isn't how it should be! Please look at photos and tell me what you think?
Forgot to mention, on the photos that I have sent to you please look and zoom in on rash on arm, so should see wee white spots and also the photo of my scalp there is also a white spot. My GP took special interest in those photos. That's what I get all over scalp and a white chalk like substance comes out when I pick at them and that's why one of the photo's on scalp is abit bloody. The rash on arm was very itchy and appeared like that after 30 seconds of scratching! Hope this information helps?
Sorry Dr Naval but I didn't mention that, two GPs think it's scleroderma this is the first time anyone has mentioned this , please could I have your thoughts on this. I know that I haven't shown you the photos before of rash on arm and the scalp. I did mention that the GP took notice of my ingrown toenail that had been removed at the same time and said this is a common XXXXXXX of scleroderma, is this true? Before I had seen this Doctor, another Doctor was going to get things ready to test me for Porphyria and said it's best to do the test during flair and no light is to touch the urine test!! So glad I am getting help now! Thanks for your expertise! Any other advice would be much appreciated!

http://doctor.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=201053

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Answered by Dr. Naval Mendiratta (48 hours later)
Brief Answer:
Is it scleroderma

Detailed Answer:
Good evening XXXXXXX

My sincere apology for the late reply... Somehow your query didn't show up and I have been out of town for a while and so couldn't check my HCM

Well, that is a good thing people are taking your case seriously and at least working on few parameters rather than labelling you as fibromyalgia or something with no disease...

I have gone through the images...It doesnt look like scleroderma though..That is something I wont go behind and evaluate you further for it...The rash in scleroderma is very different and you get lot of skin tightening and pigmentation along with it.

I have been thinking more on the lines of Porphyria cutaneous tarda.. Moreover, the time you get this rash, it is the time you should ask your GP to arrange a Biopsy of it..That would be something gold standard and will at least tell us if it is an inflammatory disease or something else we are dealing with...

When you say, you had pleurisy attack, was it pain and shortness of breath again or something different this time??

It is all a bit confusing..But at least if we work up on it and pick it up during the flare times, we can at least reach a confusion...

The rare thing I was thinking since you keep getting pleurisy attacks is, Familial Meditarrean Fever and it s variants( Autoinflammatory diseases)...But it s a very rare rare entity

DO let me know for more queries...And again my apology

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. Remy Koshy
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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Suggest Treatment For Rashes Around Lips And White Spots On The Scalp

Brief Answer: Is it scleroderma Detailed Answer: Good evening XXXXXXX My sincere apology for the late reply... Somehow your query didn't show up and I have been out of town for a while and so couldn't check my HCM Well, that is a good thing people are taking your case seriously and at least working on few parameters rather than labelling you as fibromyalgia or something with no disease... I have gone through the images...It doesnt look like scleroderma though..That is something I wont go behind and evaluate you further for it...The rash in scleroderma is very different and you get lot of skin tightening and pigmentation along with it. I have been thinking more on the lines of Porphyria cutaneous tarda.. Moreover, the time you get this rash, it is the time you should ask your GP to arrange a Biopsy of it..That would be something gold standard and will at least tell us if it is an inflammatory disease or something else we are dealing with... When you say, you had pleurisy attack, was it pain and shortness of breath again or something different this time?? It is all a bit confusing..But at least if we work up on it and pick it up during the flare times, we can at least reach a confusion... The rare thing I was thinking since you keep getting pleurisy attacks is, Familial Meditarrean Fever and it s variants( Autoinflammatory diseases)...But it s a very rare rare entity DO let me know for more queries...And again my apology Regards Dr Naval