[22F] Experiencing finger swelling, discoloration, and pain

Patient Description

A 22-year-old female has been experiencing significant swelling, redness, deep blue to purple discoloration, intense itching, and pain in her fingers, excluding her pinkies and thumbs, for about a month. The symptoms are not symmetrical across both hands, with the left hand showing intermittent swelling, while the right hand has constant swelling for at least 5 days. The patient reports difficulty bending the fingers, sometimes being unable to make a fist, especially when the fingers are very swollen and inflamed. Additionally, there are hard, red, painful bumps on the fingers, tender to the touch, ranging from a quarter to half an inch in size. The patient experiences chills and has a history of mental health issues and hypermobility. She is currently taking Vyvanse (40 mg), Citalopram (20 mg), and Bupropion (150 mg) daily upon waking, which has a side effect of reduced circulation in fingers and toes, typically causing them to be cold. The patient has not experienced similar symptoms before and has no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Rheumatoid Arthritis: This is an autoimmune disease that can cause pain, swelling, and stiffness in the joints, often in the hands and fingers. The fact that you have hard, painful bumps in your fingers and difficulty bending them could be indicative of this condition.

    • Treatment typically involves medications to reduce inflammation and slow the disease's progression, physical therapy, and in some cases, surgery.
  • Raynaud's Disease: This condition causes some areas of your body, like your fingers, to feel numb and cold in response to cold temperatures or stress. The blue discoloration you mentioned, especially when your fingers are submerged in water, could be a sign of this disease.

    • Treatment usually involves lifestyle changes to manage symptoms, such as avoiding cold temperatures and managing stress, and in severe cases, medications to improve blood flow.
  • Dermatitis: This is a general term that describes inflammation of the skin. It can lead to itchy, red, and swollen skin, which you have described.

    • Treatment usually involves identifying and avoiding substances that irritate your skin, using creams to control itching and repair the skin, and taking oral medications for severe cases.

Please note that these are just possibilities and not a definitive diagnosis. It's also possible that the symptoms you're experiencing are side effects of your medications.

What you can do

You should definitely consult a healthcare professional about your symptoms. They can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to manage your symptoms:

  1. Apply a cold compress to your fingers to help reduce swelling and inflammation.
  2. Try over-the-counter anti-inflammatory medication, like ibuprofen, to help with the pain and swelling.
  3. Keep your hands elevated as much as possible to help reduce swelling.
  4. Avoid cold temperatures and try to manage stress, as these can trigger Raynaud's disease symptoms.

What you should look out for

Please seek immediate medical attention if you experience:

  • Sudden worsening of symptoms
  • Difficulty moving your fingers
  • Severe pain
  • Symptoms spreading to other parts of your body

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare professional for a definitive diagnosis and treatment.

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9 mo ago

People Also Ask


What are the common symptoms of Rheumatoid Arthritis in young adults?

Common symptoms of Rheumatoid Arthritis in young adults include joint pain, swelling, stiffness, and the presence of hard nodules under the skin, particularly in the hands and fingers. These symptoms can lead to difficulty in performing daily tasks due to reduced joint mobility.


How can Raynaud's Disease affect daily life and what are its triggers?

Raynaud's Disease can cause fingers and toes to feel numb and cold, often turning white or blue in response to cold temperatures or stress. This can make it challenging to perform tasks in cold environments and may require lifestyle adjustments to manage symptoms.


What are the potential side effects of medications like Vyvanse, Citalopram, and Bupropion on circulation?

Vyvanse, Citalopram, and Bupropion can have side effects that include reduced circulation, leading to cold fingers and toes. This is due to their impact on blood vessels and neurotransmitter levels, which can affect blood flow.


How can dermatitis be managed at home before seeing a doctor?

Dermatitis can be managed at home by avoiding known irritants, using moisturizers to keep the skin hydrated, applying anti-itch creams, and taking antihistamines if necessary. It's important to keep the affected area clean and avoid scratching to prevent further irritation.


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