[30F] Experiencing skin rash, weakness, and mental confusion

Patient Description

A 30-year-old female presents with a skin rash described as carbuncles, predominantly on the face, persisting for 5 months. The patient reports no period for 2 years following liver failure and has recently discontinued oral contraceptives. Additionally, the patient experiences weakness, rated as 7 out of 10 in severity, which particularly affects standing up, and mental confusion, including visual hallucinations, for the past 3 months. There is a history of cirrhosis diagnosed in June. The patient also reports severe abdominal pain, shortness of breath, chest pain, and leg pain. No known allergies. Current medication includes Concerta. No recent travel or exposure to others with similar symptoms. No other pre-existing conditions or chronic illnesses were reported.

Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

Hormonal Imbalance: The absence of your period for two years, especially after liver failure, could be due to a hormonal imbalance. The liver plays a crucial role in regulating hormones, including those involved in the menstrual cycle.
- Treatment typically involves hormone therapy or medication to help regulate your hormones.
Blood Clots: You mentioned experiencing blood clots after stopping the pill. Oral contraceptives can increase the risk of blood clots, and stopping them can temporarily elevate this risk as your body adjusts.
- Treatment may involve blood thinners or other medications.
Chronic Liver Disease (Cirrhosis): Many of your symptoms, including weakness, unintentional weight loss, and mental confusion, can be associated with advanced liver disease.
- Treatment usually involves managing the symptoms and complications, and in severe cases, a liver transplant may be necessary.
Skin Infections: The carbuncles you described are often caused by bacterial infections, such as Staphylococcus aureus.
- Treatment typically involves antibiotics, and in some cases, surgical drainage.

Please remember that these are just possibilities and not a definitive diagnosis.

What you can do

Schedule an appointment with your healthcare provider as soon as possible to discuss your symptoms. They may need to run some tests to determine the cause of your symptoms.
Keep a symptom diary. Note down when each of your symptoms occur, how long they last, and any potential triggers. This can help your healthcare provider in making a diagnosis.
Stay hydrated and maintain a balanced diet. This can help manage your symptoms and support your overall health.