[33F] Experiencing a range of symptoms including psoriasis and severe fatigue

Patient Description

A 33-year-old female is reporting several symptoms that have been persisting for 3-5 months, including severe fatigue that is constant throughout the day and not relieved by rest, joint pain in the hip and arms rated at a severity of 5/10 that worsens in the evening, and numbness in toes and fingers occurring at night or when sitting for long periods. The patient also has psoriasis on the scalp, neck, shoulder, and ears, which is itchy and scaly and exacerbated by cold weather and stress. Additionally, there is a dry cough that becomes severe when not on antibiotics and is accompanied by mucus when sick. The patient experiences chills and a low-grade fever at night ranging from 99-100°F. There is also shortness of breath but no chest pain or swelling. No recent weight changes, injuries, or new stressors were reported. There is no improvement in symptoms with rest or changes in location. The patient has not been around others with similar skin conditions and has no family history of autoimmune diseases.

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Arora's Assessment

What might be happening

Based on the information you provided, the following conditions might be considered:

  • Psoriatic Arthritis: This is a type of arthritis that affects some people who have psoriasis. Symptoms include joint pain, stiffness, and swelling, which you've mentioned. Fatigue is also a common symptom.

    • Treatment typically involves medications to control inflammation and prevent joint damage.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. It's often triggered by a stressful event, including physical stress or emotional (psychological) stress.

    • Treatment often involves a combination of medications, exercise, stress-management measures, and healthy lifestyle habits.
  • Chronic Fatigue Syndrome (CFS): This is a complicated disorder characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest.

    • Treatment typically focuses on symptom relief.
  • Sarcoidosis: This is a disease involving abnormal collections of inflammatory cells that form lumps known as granulomas. The disease usually begins in the lungs, skin, or lymph nodes. Symptoms can include fatigue, joint pain, dry cough, and others.

    • Treatment typically involves medications to control inflammation.

What you can do

It's important to consult with a healthcare provider for a formal diagnosis and treatment options. In the meantime, here are some general suggestions:

  1. Try to maintain a balanced diet and regular sleep schedule. This can help manage your fatigue.
  2. Regular, gentle exercise can help improve your energy levels and reduce joint pain. Consider activities such as walking, swimming, or yoga.
  3. Over-the-counter pain relievers may help manage your joint pain. However, it's important to use these as directed and discuss their use with a healthcare provider.
  4. For your psoriasis, try using a moisturizer to soothe your skin. Avoid scratching the affected areas, as this can worsen your symptoms.

What you should look out for

Please seek immediate medical attention if you experience:

  • Severe joint pain or swelling
  • Difficulty breathing or shortness of breath that's getting worse
  • A fever that's high (over 101°F) or lasts for more than a few days
  • Any new or worsening symptoms

Remember, this advice is intended to be general in nature, and specific causes may need different approaches. Always consult with a healthcare provider for appropriate examination, testing, and care.

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8 mo ago


People Also Ask


What are the common symptoms of psoriatic arthritis?

Common symptoms of psoriatic arthritis include joint pain, stiffness, and swelling, often accompanied by fatigue. It can also cause changes in the nails and a reduced range of motion in the affected joints.


How is fibromyalgia diagnosed and treated?

Fibromyalgia is diagnosed based on a history of widespread pain lasting more than three months, along with other symptoms like fatigue and sleep disturbances. Treatment often includes medications, physical therapy, exercise, and stress management techniques.


What lifestyle changes can help manage chronic fatigue syndrome?

Lifestyle changes that can help manage chronic fatigue syndrome include maintaining a regular sleep schedule, engaging in gentle exercise, managing stress, and eating a balanced diet. It's important to pace activities to avoid overexertion.


What are the potential causes of a persistent dry cough?

A persistent dry cough can be caused by various factors, including allergies, asthma, infections, or chronic conditions like sarcoidosis. It's important to consult a healthcare provider for an accurate diagnosis and appropriate treatment.

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