question-icon

What causes red rash on thigh followed by joint pains in wrists and fingers?

default
Posted on Sat, 16 May 2015
Question: Hello! Nearly a couple of months ago i visited the dermqtologist due to a red rash on my thigh that i got after running/hot yoga. They said it was contact dermatitis. Within a week after this i started having considerable joint pain in my wrists, fingers, pain in my forearms, elbows and sometimes knees and feet. I went back to the dermatologist who did a cbc on me and tested for lupus...all was normal. About a week or so after that, still having joint pain i developed 2 small rashes on my neck that looked like misquito bites but didnt itch and came and went within a couplr days. I went back to the doctor who did another comprehensive cbc test on me and tested for mono, etc...all was normal again. I was referred to a rheumatologist. The rheumatologist checked my back and neck...said i had muscle spasms in my neck and arthritis in my spine. He also did bloodwork and found that i had a vitamin d deficiency. Mine was 17, normal level is 32 to 100. I was prescribed 50,000 iu of vitamin d twice weekly. This week will be my fifth week of taking the vitamin d. I have started feeling better with the joint pain diminishing. However, recently my left palm on the side by my pinky and below the joint over there has become sore to touch but no swelling...this has been consistent for a fee days now. Additionally, i am getting what looks to be reddish raised bites almost like misquito bites in different spots that come and go. For instance i had one on my shoulder and on my lower back near my hip that were very itchy but came and went over night for the most part. I am concerned that my vitamin d level is still low and that is why this is all happening. I am also worried there is something more serious going on as the rheumatologist i saw said although he didnt think anything serious was wrong that vitamin d can be associated with different cancers, etc. i know vitamin d deficiency can cause weird skin eruptions and all that. Anyway, your thoughts on this matter would be greatly appreciated as i am pretty worried. I dont go back to the rheumatologist until XXXXXXX to have another comprehensive cbc done and to check if my vitamin d level went back up. I am a 27 year old female.
doctor
Answered by Dr. Naval Mendiratta (2 hours later)
Brief Answer:
is it lupus

Detailed Answer:
Good evening

Thank you for writing on health care magic

I have gone through your history. Well the skin eruptions and rashes you have mentioned, look unrelated to vitamin d defiency. Vitamin d deficiency can cause the joint pains and the muscle weakness you are experiencing but not the rashes.

Before j can comment further, could you throw some more light on why it was diagnosed as lupus initially. Was it related to the blood tests or the rashes you got. And why did the rheumatologist rule it out?

Any other symptoms you have been experiencing like oral ulcers photosenstivity dry eyes dry mouth

If you could attach the picture of rashes would be helpful

Await.you reply

Regards
Dr naval
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
default
Follow up: Dr. Naval Mendiratta (34 minutes later)
Hi there! Thanks for your prompt answer. There was no lupus diagnosis...the test came back negative for that. Ive always had abseth ulcers or whatever way before this...i am not having problems with dry eyesbor dry mouth on a very regulr basis. I was having an eye problem when this began but i had it looked it and it was nothing. I am now having soreness in my left palm when i touch it or put my hand on a surface...it is in the area between and right below my pinky and ring fingers. Otherwise i do have joint pain that comes and goes but nothing like what it was. I still have an appetite and everything else is normal beyond the itchy, bite like spots i get that come and go. As i said im just worried this is related to some sort of blood disorder or cancer, etc.
doctor
Answered by Dr. Naval Mendiratta (7 hours later)
Brief Answer:
Urticarial rashes

Detailed Answer:
Good evening

Well that is a good thing that the lupus was negative. I have gone through the previous history as well..The rashes if they are persisting and there is no evidence of lupus, it could be just allergic rashes. Something like urticaria which comes and goes but without any significant problem in the organs. I believe you have been extensively evaluated but it came out normal. Did you manage to get these rashes examined by dermatologist??Did they have any impression?

Dont worry about cancer. You have been worked up for it and it has been ok so far.

Do let me know what the dermatologist says

REgards
Dr NAval
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Naval Mendiratta (15 hours later)
I had them looked at by a dermatologist and they didnt think it was anyrhing concerning either. I am more worried about the left side of my palm which is sore to touch underneath and between my pinky and right finger knuckles. Im worried that it is due to something worrisome like a spinal tumor or something bc the soreness sometimes goes away depending on which way i am laying down for a few minutes...otherwise it is always there...its been like that for about 4 days now.
doctor
Answered by Dr. Naval Mendiratta (19 hours later)
Brief Answer:
Carpal Tunnel

Detailed Answer:
Good evening

Well, the sort of symptoms you are describing for the palm , do look like a nerve compression. Probably that s why when you put pressure on that side, it gets compressed and you feel the soreness. It is known as carpal tunnel syndrome, which normally happens due to overuse of the hand. Spinal tumour wont cause such symptoms localised to the palm. If the soreness originates due to spinal tumour, it normally will involve the whole hand and arm as well.

I would suggest you avoid lifting any heavy stuff from that hand. Try wearing a wrist band when you go to work, so it will give rest to the area and let it heal. Definite diagnosis can only be done by NCV studies of the hand which will localize the exact cause of it.

Hope the information was useful

Do let me know for more queries

REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
default
Follow up: Dr. Naval Mendiratta (6 hours later)
Thanks for your answer. The soreness in my palm has gon away and my joint pain has been decreasing since taking the vitamin d supplements. My only problem is the itchy/bug bite like spots i am getting which i am not sure where they come from. However, i am more concerned about my lymphnodes being bigger on the left side of my neck then the right side...they arent huge but it is a noticeable difference by touch. I had a cold over a month ago and thats when it started, since then i have had 2 stomach bugs but nothing major. I feel fine now but my lymphnodes are still a little bigger on that side. I am worried that this is lymphoma or something serious. Thanks.
doctor
Answered by Dr. Naval Mendiratta (7 hours later)
Brief Answer:
Lymph node evaluation

Detailed Answer:
Good evening

Well that s good that your joint symptoms are improving with Vitamin D therapy and the nerve symptoms are less as well.

About the lymph nodes, I believe you had undergone an FNAC which was suggestive of reactive lymph nodes.? But if you feel the size is increasing, it is always advisable to undergo a BIopsy of the nodes to be sure we are not missing out on anything. Isolated lymph node enlargement aint a normal thing. IT could be associated with Lupus or Sjogrens syndrome considering the accompanying rashes you are having as well.

Please check on the FNAC report and let me know.

REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
default
Follow up: Dr. Naval Mendiratta (48 hours later)
Thank you for your reply. The lymphnodes on the left side of my neck are larger than on the right side. It is the one right under my left ear and then the one right under that that is a little bit bigger than the right side...they arent sore. I havebeen tested for lupus and it came back negative...they may have also looked for sjordens but im not positive. I am worried that i have lymphoma or something else serious. I was sick last week but ny lymphnodes have been a little puffy on that side for awhile now, even before that. I realize it isnt normal. Beyond the occassional joint pain i feel fine...i havea normal amount of energy and still have an appetite. I am just worried that something is really wrong. I am only 27. The doctor noticed my lymphnodes on that side and thyroid were larger when i saw him in march but didnt think too much of it. He tested me for thyroid function and that was normal too. Thanks.
doctor
Answered by Dr. Naval Mendiratta (9 hours later)
Brief Answer:
Lymph Node enlargement

Detailed Answer:
Good evening

Well the lymph node swellings which are persisting need to be evaluated. Just superficial examination is never conclusive. I thought they had performed a FNAC/Biopsy and Ultrasound of the lymph nodes. If the size is significant, it has to be evaluated. Kindly consult your doctor and request him for a Biopsy which would be more conclusive. But before biopsy, I would recommend you get an ultrasound of the neck done to see how many nodes are present and the exact size. Once we have the biggest size, we can perform biopsy on it.

If the biopsy comes Reactive, it can be ignored. But if it something else we would know about it. I hope your viral markers like Hepatitis B/Hepatitis C and HIV have also been looked at.

In XXXXXXX we normally consider it as infective (tuberculosis) but considering your geographic distribution, it is less likely a cause

All said and done, Ultrasound Neck and Biopsy i will recommend. It will remove your fears as well if it comes out normal

Hope the information was useful

Do let me know for more queries

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Naval Mendiratta (41 hours later)
Hello there! Thank you for your reply. I was examined by a doctor in the neck area and all is fine. However, i have started breaking out more in a rash that is on my leg. It appears like bug bites that are some what itchy after awhile. However, i do not know where they are coming from or how i am getting them as my husband, son and daughter do not have them, only me. It started last week with 2 on one leg, then i woke up saturday morning with about 7 more. I also noticed 2 morebon my inner thigh this afternoon. I went to the dermatologist who said they look like bug bites but they didnt know for sure what was causing the bites or rashes. I am worried they arent bites at all and are some sort of autoimmune disease or cancer. I have attached pictures. Your input is appreciated. I am worried that it isnt bug bites as i just found the third picture (2 spots on my inner thigh) that werent there this morning...i have been inside a building all day at work and then in a parking garage and my car so i dont know where a bug would have gotten me in my inner thigh. Thanks!
doctor
Answered by Dr. Naval Mendiratta (19 hours later)
Brief Answer:
skin lesions

Detailed Answer:
Good evening..

Sorry for the delayed reply. I have gone through your pics. The lesions do look quite unusual and do not fit in with a particular disease. My doubt will be some form of allergic ...like urticaria. It doesn't look like bug bites as it is multiple places with slight elevation. Can't your dermatologist do a biopsy out of it? That will give us an exact clue on what these exactly are. Or else we are only doing the guess work..

Do let me know what your dermatologist say

Regards
Dr naval
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Naval Mendiratta (12 minutes later)
Thanks for your input. My dermatologist thinks they are bug bites for now but wants to do a biopsy in case it doesnt go away. Do you think this could be something really serious like a fatal disease or cancer? I know that sounds ridiculous.
doctor
Answered by Dr. Naval Mendiratta (10 hours later)
Brief Answer:
Not cancer

Detailed Answer:
Good evening

Well, it doesnt seem like cancer but yes I am concerened about autoimmune problem. Autoimmune disease can present with any types of skin rashes which may not be explained as well. Considering lymph node enlargement and these rashes, I have quite an itch to biopsy either of the 2 once.

I am really not convinced with the bug bite. How will a bug bite you at so many different places together, unless there are Beg bugs.

No, it is not ridiculous. You are just waiting for the diagnosis, and if the diagnosis doesnt come it does drive once crazy to figure what exactly is wrong.

I will stay suggest one biopsy which can give us an exact clue.

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
default
Follow up: Dr. Naval Mendiratta (5 hours later)
Thanks for your input. I did want to let you know that i did have my lymphnodes looked at and they are no longer swollen. Just the rashes i have. I woke up with three more this morning on my other leg but they arent as raised/itchy as the others just smaller red spots. Like i said, i am just worried that i have some sort of autoimmune disease that cant be cured or something.
doctor
Answered by Dr. Naval Mendiratta (9 hours later)
Brief Answer:
Skin lesions treatment

Detailed Answer:
Good evening

Well, for now if the dermatogist does not want to do a biopsy and they feel the lymph nodes have resolved, what I would suggest is you do a course of anti allergics for a few days. Maybe it is all due to allergy and see if the symptoms get better on treatment. If it is persisting even after 4 weeks consider getting a biopsy done. You can try with Allegra and Cetrizine combined to see if these lesions stop coming up.

Dont worry. Even if it autoimmune disease, it hasnt reached the other organs yet and it is controllable.

Do let me know for more queries

REgards
Dr Naval
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
default
Follow up: Dr. Naval Mendiratta (4 hours later)
Hi there! Thank you for your reply. I went back to the dermatologist today who decided to do a biopsy as i woke up with 4 more spots on my other leg. Theres about an inch diameter of purple skin around where she took the sample but it doesnt hurt to touch. I wont have the results back until friday. Like i said, im just worried i have some sort of blood cancer or autoimmune disrase. I guess i wont know until friday. I dont know if it is so normal for there to be a big purplish ring around where she scraped the skin.
doctor
Answered by Dr. Naval Mendiratta (13 hours later)
Brief Answer:
Skin BIopsy

Detailed Answer:
Good evening

Well, that's good that she finally did it. Well lets wait for the biopsy results to know what exactly are those spots. The purple skin may just be a hypersensitivity of your skin to the procedure and the local anesthetic they give. Dont worry about it.

Let me know the results once you get it

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
Answered by
Dr.
Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

premium_optimized

The User accepted the expert's answer

Share on
What causes red rash on thigh followed by joint pains in wrists and fingers?

Brief Answer: is it lupus Detailed Answer: Good evening Thank you for writing on health care magic I have gone through your history. Well the skin eruptions and rashes you have mentioned, look unrelated to vitamin d defiency. Vitamin d deficiency can cause the joint pains and the muscle weakness you are experiencing but not the rashes. Before j can comment further, could you throw some more light on why it was diagnosed as lupus initially. Was it related to the blood tests or the rashes you got. And why did the rheumatologist rule it out? Any other symptoms you have been experiencing like oral ulcers photosenstivity dry eyes dry mouth If you could attach the picture of rashes would be helpful Await.you reply Regards Dr naval