[29F] With rash, hair thinning, jaw clenching, and dizziness

Patient Description

A 29-year-old female presents with a gradually appearing rash located on the top of both feet near the ankle bone, buttocks, inside the elbow, stomach, and under the left breast. The rash consists of small, red, raised spots and patches, with some areas slightly discolored with a reddish-brown or purplish hue. The patient reports no itching or pain in the affected areas. Additionally, the patient has noticed significant hair loss over the past few weeks, with an increased amount of hair in the hairbrush compared to before, despite taking good care of her hair. The patient also experiences clenching of the jaw and extreme sensitivity when biting. Over the past 2-3 years, the patient has had frequent dizzy spells that have gradually started to produce small seizure-like episodes. The patient denies any recent fever, exposure to new substances, joint pain, or swelling. Current medications include Adderall 20mg twice daily, Effexor 225mg daily, Mirtazapine 30mg daily, and Lamictal 150mg daily. No known drug allergies. No over-the-counter medications, supplements, or herbal remedies are being taken.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, several potential conditions could be contributing to your issues. Here are some possibilities:

Rash and Skin Spots

  • Contact Dermatitis: This could be due to an allergic reaction or irritation from a substance that has come into contact with your skin. Common triggers include soaps, lotions, or detergents.
  • Psoriasis: This is a chronic skin condition that causes red, scaly patches. It can appear on various parts of the body, including the elbows, buttocks, and feet.
  • Eczema: This condition causes red, itchy, and inflamed skin. It can be triggered by stress, allergens, or irritants.

Hair Thinning

  • Telogen Effluvium: This is a temporary form of hair loss that can occur after stress, a shock, or a traumatic event. It can also be triggered by changes in medication or diet.
  • Alopecia Areata: This is an autoimmune condition that causes hair to fall out in small patches.

Dizziness and Seizure-like Episodes

  • Epilepsy: Given your history of small seizure-like episodes, epilepsy could be a possibility. This condition requires a thorough evaluation by a neurologist.
  • Orthostatic Hypotension: This condition causes dizziness when standing up due to a sudden drop in blood pressure.

Jaw Clenching and Sensitivity

  • Temporomandibular Joint Disorder (TMJ): This condition affects the jaw joint and can cause pain, clenching, and sensitivity.

Pain Under Rib Cage

  • Gallbladder Issues: Given your history of an overactive gallbladder, this pain could be related to gallbladder dysfunction or gallstones.

Leg Pain

  • Sciatica: This condition occurs when the sciatic nerve is compressed, causing pain that radiates from the lower back down to the legs.
  • Peripheral Neuropathy: This condition involves damage to the peripheral nerves and can cause pain, burning, and weakness in the legs.

Gastrointestinal Issues

  • Irritable Bowel Syndrome (IBS): This condition can cause chronic diarrhea, abdominal pain, and changes in bowel habits.
  • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause chronic diarrhea and abdominal pain.

What you can do

Rash and Skin Spots

  • Avoid Irritants: Identify and avoid any potential irritants or allergens that may be causing the rash.
  • Moisturize: Use a gentle, fragrance-free moisturizer to keep your skin hydrated.
  • Over-the-Counter Creams: Consider using over-the-counter hydrocortisone cream to reduce inflammation and itching.

Hair Thinning

  • Gentle Hair Care: Avoid harsh hair treatments and use gentle shampoos and conditioners.
  • Nutrition: Ensure you are getting adequate nutrition, including vitamins and minerals that support hair health.

Dizziness and Seizure-like Episodes

  • Medical Evaluation: Consult a neurologist for a thorough evaluation and possible diagnostic tests.
  • Monitor Symptoms: Keep a journal of your symptoms, including any triggers or patterns.

Jaw Clenching and Sensitivity

  • Jaw Exercises: Perform gentle jaw exercises to relieve tension.
  • Avoid Hard Foods: Avoid chewing hard foods that can exacerbate the pain.

Pain Under Rib Cage

  • Medical Consultation: Follow up with your healthcare provider to discuss your gallbladder issues and any necessary treatments.

Leg Pain

  • Rest: Rest and avoid activities that exacerbate the pain.
  • Stretching: Perform gentle stretching exercises to relieve tension in the lower back and legs.

Gastrointestinal Issues

  • Dietary Changes: Consider dietary changes, such as avoiding trigger foods and eating smaller, more frequent meals.
  • Hydration: Stay hydrated, especially if you are experiencing frequent diarrhea.

What you should look out for

Given the range of symptoms you are experiencing, it is important to seek medical care to rule out any serious conditions. Here are some reasons to seek care more urgently:

  • Severe or Worsening Symptoms: If any of your symptoms become severe or worsen, seek medical attention.
  • New Symptoms: If you develop new symptoms, such as shortness of breath, chest pain, or severe abdominal pain, seek immediate medical care.
  • Neurological Symptoms: If you experience new or worsening neurological symptoms, such as seizures, severe dizziness, or loss of consciousness, seek urgent medical care.

Remember, while I can provide information and suggestions, it is important to consult with a healthcare professional for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal your symptoms, track progress,

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4 mo ago


People Also Ask


What could be causing the rash on multiple parts of my body?

The rash could be due to conditions like contact dermatitis, psoriasis, or eczema. These can be triggered by allergens, irritants, or stress. It's important to identify any potential irritants and avoid them.


Why am I experiencing significant hair loss despite taking good care of my hair?

Significant hair loss could be due to telogen effluvium, which is often triggered by stress or changes in medication, or alopecia areata, an autoimmune condition. Ensuring proper nutrition and gentle hair care can help manage this.


What might be the reason for my frequent dizzy spells and seizure-like episodes?

Frequent dizzy spells and seizure-like episodes could be related to conditions such as epilepsy or orthostatic hypotension. A thorough evaluation by a neurologist is recommended to determine the cause.


What could be causing my jaw clenching and sensitivity when biting?

Jaw clenching and sensitivity could be due to temporomandibular joint disorder (TMJ), which affects the jaw joint. Avoiding hard foods and performing jaw exercises may help alleviate symptoms.


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