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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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43 Year Old Women Have Ongoing Issues With Lumps, Scars And Head Pain

Hello, Thank you for your time. I am a 43 year old women as of yesterday, over past 3 years have been dx with necrobiotic lipodecia on left calf, granuloma annular over ankles, shin bones, hands and arms, had lipoma removed from left knee , have subcutaneous nodules in shins undiagnosed but suspected to be subcutaneous granuloma, Recently had Cranial CT done in ER due to headache and fever, joint pain , have periods of night sweats but at times they resolve for a few weeks. I had a ER CT done recently due to headache and fever and strep throat; CT procedure utilized axial images 5mm slice thickness from skull base to vertex, with and without contrast, findings: images obtained at bone windows demonstrate an air-fluid level in left maxillary sinus and opacification in posterior ethmoid sinuses, no evidence of acute/ chronic mastoiditis. Treated for sinus infection, 1 month post treatment, I have been getting frequent headaches, no runny nose or other cold symptoms have a small depression (2cm) in my frontal bone of head, superior to inner right eye at hairline, this is sore to touch or comb hair, depression has a narrowing groove that extends from hairline diagonally down to space between eyes less depth in groove as it gets closer to space between eyes. The last few times I have had lab work, I have normal abc, but slightly elevated neutrophils 87.1 with slightly low lymphs 6.0, Neut ABS 7.77 Lymphs ABS 6.0 as of most recent CBC. This lab finding has been consistent with the exception that the Lymph ABS continues to lower, prior was 0.9 3 months ago. Is there something that comes to mind that could explain any of this or any specific tests or type of doctor I should say, my GP just says its a strange collection of issues and isn t sure where to go from here.
Wed, 24 Aug 2011
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Orthopaedic Surgeon 's  Response
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The CT finding is suggestive of left maxillary sinusitis for which you need antibiotics and possible drainage procedure if it is chronic, which explains the headaches. Subcutaneous lipoma is common in public, not to worry about them, get those removed which bother you or are cosmetically disfuguring. Necrobiosis lipoidica is associated with Diabetes mellitus, Rheumatoid arthritis and Sarcoidosis. You could be having infection which can be due to possible Diabetes. Please get your blood sugar checked. The forehead depression could be congenital and not significant. Lowering of lymphocytes could be due to associated immune disorder like HIV, Rheumatoid arthritis or Sarcoidosis. Get checked for the above mentioned. You are at risk for immune suppression which explains even sinusitis. Avoid fatty, sett, high carbohydrate diet. Eat plenty of fresh fruits and green leafy vegetables. Drink enough water. Exercise daily. Consult your Doctor to evaluate you on the above mentioned pathology for your benefit.
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43 Year Old Women Have Ongoing Issues With Lumps, Scars And Head Pain

Welcome to Healthcare Magic The CT finding is suggestive of left maxillary sinusitis for which you need antibiotics and possible drainage procedure if it is chronic, which explains the headaches. Subcutaneous lipoma is common in public, not to worry about them, get those removed which bother you or are cosmetically disfuguring. Necrobiosis lipoidica is associated with Diabetes mellitus, Rheumatoid arthritis and Sarcoidosis. You could be having infection which can be due to possible Diabetes. Please get your blood sugar checked. The forehead depression could be congenital and not significant. Lowering of lymphocytes could be due to associated immune disorder like HIV, Rheumatoid arthritis or Sarcoidosis. Get checked for the above mentioned. You are at risk for immune suppression which explains even sinusitis. Avoid fatty, sett, high carbohydrate diet. Eat plenty of fresh fruits and green leafy vegetables. Drink enough water. Exercise daily. Consult your Doctor to evaluate you on the above mentioned pathology for your benefit.