[24F] Experiencing nail pain, blisters, and swelling post-cocaine use

Patient Description

A 24-year-old female presents with throbbing pain in the fingernails and toenails, rated 5 out of 10, which has gradually worsened over the past few days. She also reports blisters on her toes and fingers, with one blister on the toe leaking clear liquid and causing significant pain. Additionally, there is swelling in the legs and feet, with redness around the areas of swelling and blisters, which has been spreading. The patient has not had any recent injuries or changes in activity but mentioned recent cocaine use. She is experiencing palpitations, shortness of breath, and chest pain since using cocaine. There is no fever, chills, dizziness, or changes in the color or temperature of the fingers or toes. The patient has an allergy to the antibiotic Ceftin and is currently taking Hydroxyzine (25 mg) and Lexapro (50 mg) daily. No other medications, supplements, or herbal remedies are reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential explanations for what you might be experiencing:

  1. Infection: The redness, swelling, and discharge from the blisters on your toes and fingers suggest a possible skin infection. This could be a bacterial infection, such as cellulitis, which can occur when bacteria enter through a break in the skin. The throbbing pain and spreading redness are also consistent with an infection.

  2. Drug-related effects: The use of cocaine can lead to cardiovascular symptoms such as palpitations, chest pain, and shortness of breath. These symptoms are concerning and should be evaluated by a healthcare professional. Cocaine use can also affect your immune system, potentially making you more susceptible to infections.

  3. Anxiety and fatigue: These symptoms could be related to your recent experiences, including the abortion and cocaine use, or they could be side effects of your medications. It's important to discuss these symptoms with your healthcare provider to determine the underlying cause.

What you can do

Infection:

  • It's important to see a healthcare provider as soon as possible to evaluate the possibility of a skin infection. They may prescribe antibiotics or other treatments to address the infection.
  • Keep the affected areas clean and dry. Avoid popping or picking at the blisters, as this can worsen the infection.
  • Over-the-counter pain relievers, such as ibuprofen, may help alleviate pain and reduce inflammation.

Drug-related effects:

  • Seek medical attention for the palpitations, chest pain, and shortness of breath, as these symptoms can be serious.
  • Consider reaching out to a healthcare professional or support group for help with substance use.

Anxiety and fatigue:

  • Practice stress-reducing techniques such as deep breathing, meditation, or gentle exercise.
  • Ensure you are getting adequate rest and maintaining a balanced diet.
  • Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

What you should look out for

  • If you experience worsening redness, swelling, or pain, or if you develop a fever, seek medical attention promptly, as these could be signs of a more serious infection.
  • If you experience severe chest pain, difficulty breathing, or fainting, seek emergency medical care immediately, as these could be signs of a serious cardiovascular issue.
  • Monitor your symptoms and seek medical advice if you notice any new or worsening symptoms.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and appropriate treatment.

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20 d ago

People Also Ask

What could be causing the throbbing pain and blisters on my fingers and toes?

The throbbing pain and blisters on your fingers and toes could be due to a skin infection, such as cellulitis, which occurs when bacteria enter through a break in the skin. The symptoms of redness, swelling, and discharge are consistent with an infection.

How does cocaine use affect my cardiovascular health?

Cocaine use can lead to cardiovascular symptoms such as palpitations, chest pain, and shortness of breath. It can also increase the risk of heart attack and other serious cardiovascular issues. These symptoms should be evaluated by a healthcare professional.

What should I do if I suspect I have a skin infection?

If you suspect a skin infection, it's important to see a healthcare provider for evaluation. They may prescribe antibiotics or other treatments. Keep the affected areas clean and dry, and avoid popping or picking at the blisters to prevent worsening the infection.

Can my current medications contribute to anxiety and fatigue?

Yes, your current medications, Hydroxyzine and Lexapro, can contribute to symptoms of anxiety and fatigue. It's important to discuss these symptoms with your healthcare provider to determine if they are side effects of your medications or related to other factors.

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