[28F] With chronic pain, swelling, and dermatological symptoms

Patient Description

A 28-year-old female experiences chronic pain throughout her body, particularly in the back, fingers, and knees, with a severity of 7.8 out of 10. The pain is constant and rotates between these areas. She reports swelling in her fingers that feels thick, making it difficult to bend them, resembling calluses under the skin. This has been ongoing for a few years. Additionally, she develops a red, hot rash on her cheeks and between her eyebrows when exposed to the sun. She also has hard bumps and rough skin on her elbows, which sometimes feel like they split and burn. The patient experiences joint stiffness, especially in the mornings, along with fatigue, unexplained weight changes, and muscle weakness. There are no reported fevers. She has a family history of autoimmune diseases and had dermatomyositis as a child, which was said to have disappeared. She is allergic to cefdinir, causing hives. Current medications include Vyvanse 40mg and Wellbutrin 150mg daily. She plans to start a B vitamin supplement due to the MTHFR gene. Lotion use does not alleviate her symptoms.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  • Rheumatoid Arthritis (RA): This is an autoimmune condition that can cause chronic pain, swelling, and stiffness in the joints, particularly in the fingers, knees, and back. It can also lead to fatigue and muscle weakness.

    • Typical Treatment: Includes medications to reduce inflammation and pain, physical therapy, and sometimes lifestyle changes.

  • Lupus: An autoimmune disease that can cause a red, mask-like rash on the face, joint pain, fatigue, and other systemic symptoms.

    • Typical Treatment: May involve anti-inflammatory medications, immunosuppressants, and lifestyle adjustments.

  • Dermatomyositis: Given your history, this condition could potentially recur. It involves muscle weakness and skin rashes.

    • Typical Treatment: Often includes corticosteroids and immunosuppressive drugs.

What you can do

  1. Consult a Healthcare Provider: It's important to see a doctor for a formal diagnosis and treatment plan. They may recommend blood tests or imaging studies.

  2. Symptom Tracking: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

  3. Lifestyle Adjustments: Consider gentle exercises, a balanced diet, and stress management techniques to help manage symptoms.

  4. Sun Protection: Use sunscreen and protective clothing to prevent rashes triggered by sun exposure.

What you should look out for

  • Increased Pain or Swelling: If your symptoms worsen, seek medical attention.
  • New Symptoms: Such as fever, significant weight loss, or severe fatigue.
  • Emotional Well-being: Monitor your mental health, as chronic conditions can impact mood and anxiety levels.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a thorough evaluation and personalized care.

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2 mo ago

People Also Ask

What are the common symptoms of rheumatoid arthritis?

Common symptoms of rheumatoid arthritis include joint pain, swelling, and stiffness, particularly in the fingers, knees, and back. It can also cause fatigue, muscle weakness, and sometimes systemic symptoms like fever.

How can lupus affect the skin and what precautions should be taken?

Lupus can cause a red, mask-like rash on the face, often triggered by sun exposure. To prevent skin flare-ups, it's important to use sunscreen, wear protective clothing, and avoid direct sunlight when possible.

Can dermatomyositis recur after childhood, and what are its symptoms?

Yes, dermatomyositis can recur after childhood. Symptoms include muscle weakness, skin rashes, and sometimes joint pain. It often requires treatment with corticosteroids and immunosuppressive drugs.

What lifestyle changes can help manage chronic joint pain and fatigue?

Lifestyle changes that can help manage chronic joint pain and fatigue include engaging in gentle exercises like yoga or swimming, maintaining a balanced diet rich in anti-inflammatory foods, managing stress through techniques like meditation, and ensuring adequate rest and sleep.

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