[37F] Experiencing itchy rash, blurred and double vision, and headache

Patient Description

A 37-year-old female has been experiencing a severe itchy rash for about 5 months, with red circular hives initially around the eyes and mouth, now spread to the legs, stomach, neck, and breasts. Antihistamines have not been effective. For the past 3 weeks, she has also had episodes of blurred vision, sometimes affecting both eyes, sometimes only the right eye, accompanied by double vision. These episodes do not correlate with specific activities or times of the day. Additionally, she has had a constant headache for about a month, rated 4 out of 10 in intensity, which worsens with driving. The patient also reports fatigue, occasional sleeplessness, and recent weakness in the legs, as well as eye pain associated with the blurred vision. She has no known allergies or adverse reactions to medications and is not currently on any medications. In her childhood, she experienced recurring swollen glands and high fevers. No recent injuries, travels, or new environmental exposures were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Multiple Sclerosis: This is a chronic disease that affects the central nervous system, particularly the brain and spinal cord. It can cause a variety of symptoms, including blurred vision, double vision, fatigue, and difficulty walking. The rash is not a typical symptom of MS, but it could be unrelated or due to an associated condition.

    • Diagnosis of MS typically involves a neurological exam, MRI, and sometimes a spinal fluid analysis. Treatment usually involves managing symptoms and slowing the progression of the disease with medication.
  • Lupus: This is an autoimmune disease that can affect many parts of the body, including the skin, joints, and organs. It can cause a variety of symptoms, including a rash, fatigue, and joint pain. Some people with lupus also experience neurological symptoms, although blurred vision is not a typical symptom.

    • Diagnosis of lupus typically involves a physical exam, blood tests, and sometimes a skin biopsy. Treatment usually involves managing symptoms with medication and lifestyle changes.
  • Sjögren's Syndrome: This is an autoimmune disease that primarily affects the glands that produce tears and saliva, but it can also affect other parts of the body. It can cause dry eyes, which might lead to blurred vision, as well as fatigue and joint pain. A rash is not a typical symptom of Sjögren's syndrome, but it could be unrelated or due to an associated condition.

    • Diagnosis of Sjögren's syndrome typically involves a physical exam, blood tests, and sometimes a biopsy of the salivary glands. Treatment usually involves managing symptoms with medication and lifestyle changes.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to manage your symptoms:

  1. Apply a moisturizing cream or ointment to your rash to help soothe the itchiness. Avoid scratching as much as possible, as this can make the rash worse.
  2. Rest and hydrate well to help manage your fatigue.
  3. Avoid driving if it worsens your headache or if your vision is blurred.
  4. Keep a symptom diary to track when your symptoms occur, how long they last, and any potential triggers. This can be helpful information for your doctor.

What you should look out for

Reasons to see a doctor more urgently:

  • If your vision worsens or you experience complete loss of vision
  • If your rash spreads rapidly or becomes painful
  • If you develop new symptoms such as severe headache, fever, or difficulty walking

Remember, I am an AI and not a doctor. Please consult with a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What could cause a persistent itchy rash that doesn't respond to antihistamines?

A persistent itchy rash that doesn't respond to antihistamines could be due to an autoimmune condition, such as lupus or another skin-related disorder. It is important to consult a healthcare professional for a proper diagnosis and treatment plan.


Can blurred vision and double vision be related to autoimmune diseases?

Yes, blurred vision and double vision can be related to autoimmune diseases like Multiple Sclerosis, which affects the central nervous system. However, these symptoms can also be caused by other conditions, so a thorough medical evaluation is necessary.


What are common symptoms of Multiple Sclerosis?

Common symptoms of Multiple Sclerosis include fatigue, difficulty walking, numbness or tingling, muscle weakness, vision problems (such as blurred or double vision), and balance issues. Symptoms can vary widely among individuals.


How can fatigue and headaches be managed while waiting for a diagnosis?

To manage fatigue and headaches while waiting for a diagnosis, ensure adequate rest, stay hydrated, and avoid activities that exacerbate symptoms, such as driving if it worsens headaches. Keeping a symptom diary can also help track patterns and triggers, which can be useful for healthcare providers.


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