[35F] Experiencing a range of systemic symptoms

Patient Description

A 35-year-old female presents with a complex array of symptoms persisting for various durations, the most prominent being deep fatigue and malaise present for 2 years, unaffected by sleep quality and worsened by work stress. The patient reports constant, dull joint pain in the hips, knees, and occasionally hands, also persisting for 2 years, without associated swelling. The patient has experienced acne, predominantly along the jawline, for 10 years. Flushing episodes, affecting the cheeks, nose bridge, and neck, have been occurring for 4 years and are triggered randomly or by nervousness. The patient describes having very cold hands and feet, a condition persisting for 10 years, with feet prone to chilblains and redness upon standing, indicating poor circulation. Swelling of the feet has been an issue for 20 years, exacerbated by standing. The patient also experiences costochondritis, presenting as chest pain and difficulty breathing. No known allergies, current medications, or pre-existing conditions were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, there are a few possible conditions that could explain your symptoms:

  • Systemic Lupus Erythematosus (SLE): This is an autoimmune disease that can cause a wide range of symptoms, including fatigue, joint pain, skin rashes, and issues with circulation. The positive ANA (antinuclear antibody) test and leukopenia (low white blood cell count) are common in people with SLE. However, this is a complex condition that requires a thorough evaluation by a healthcare provider to diagnose.

    • Treatment typically involves medications to manage symptoms and prevent flare-ups. This can include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antimalarial drugs, and immunosuppressants.
  • Raynaud's Disease: This condition causes some areas of your body — such as your fingers and toes — to feel numb and cold in response to cold temperatures or stress. This could explain your cold hands and feet.

    • Treatment can involve medications to widen blood vessels and promote circulation. Lifestyle changes, such as avoiding cold and stress, can also help manage symptoms.
  • Rosacea: This is a common skin condition that causes redness and visible blood vessels in your face. It may also produce small, red, pus-filled bumps, which could explain your acne and flushing.

    • Treatment can involve medications to reduce redness and inflammation, as well as lifestyle changes to avoid triggers.

Please note that these are just possibilities based on the symptoms you've described. It's important to consult with a healthcare provider for a formal diagnosis and treatment plan.

What you can do

While waiting for your appointment with your healthcare provider, here are some things you can do to manage your symptoms:

  1. Rest and take care of yourself: Make sure you're getting enough sleep and eating a balanced diet. Try to manage stress as best as you can, as stress can exacerbate many of the symptoms you're experiencing.

  2. Keep warm: If you have Raynaud's disease, keeping your hands and feet warm can help manage symptoms. Wear warm gloves and socks, and try to avoid exposure to cold temperatures when possible.

  3. Avoid triggers: If you have rosacea, certain things can trigger or worsen symptoms. Common triggers include hot drinks, spicy foods, alcohol, temperature extremes, sunlight, stress, and certain cosmetics. Try to identify and avoid your personal triggers.

  4. Over-the-counter treatments: For your acne, you might find over-the-counter treatments helpful. These can include products containing salicylic acid, benzoyl peroxide, or sulfur.

What you should look out for

If you notice any of the following, you should seek medical attention immediately:

  • Severe chest pain or difficulty breathing
  • Symptoms that are rapidly getting worse
  • New symptoms that you haven't experienced before

Remember, I'm an AI and this advice is based on the information you've provided. It's important to consult with a healthcare provider for a formal diagnosis and treatment plan.

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11 mo ago

People Also Ask


What are the common symptoms of Systemic Lupus Erythematosus (SLE)?

Common symptoms of Systemic Lupus Erythematosus (SLE) include fatigue, joint pain, skin rashes, and issues with circulation. Other symptoms can include fever, hair loss, and sensitivity to sunlight. It's important to consult a healthcare provider for a proper diagnosis.


How can Raynaud's Disease affect daily life and what are some management strategies?

Raynaud's Disease can cause areas of the body, such as fingers and toes, to feel numb and cold in response to cold temperatures or stress. Management strategies include keeping warm, avoiding stress, and possibly taking medications to improve circulation.


What are the typical triggers for rosacea and how can they be avoided?

Typical triggers for rosacea include hot drinks, spicy foods, alcohol, temperature extremes, sunlight, stress, and certain cosmetics. Avoiding these triggers can help manage symptoms, and identifying personal triggers is crucial.


What are some effective over-the-counter treatments for acne?

Effective over-the-counter treatments for acne include products containing salicylic acid, benzoyl peroxide, or sulfur. These ingredients help reduce inflammation and clear blocked pores. It's important to follow the product instructions and consult a dermatologist if needed.


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