[50M] Experiencing rash and blotchy skin with recent dietary changes

Patient Description

A 50-year-old male presents with a generalized, non-itchy, blanching rash on the trunk, arms, and legs, and blotchy skin on the stomach that appears minutes after waking up. These symptoms have been present for approximately one month. The rash and blotchy skin temporarily improve with rest, sitting back, or taking a warm shower. The patient has recently lost 18 pounds over 6 weeks through an intentional keto and fasting diet. Bowel movements are described as often floating and soft but not diarrhea. The patient has been experiencing high levels of work and financial-related stress and anxiety for several years. Current daily medications include Centrum vitamin, occasional folic acid supplement, Claritin, and Pepcid. The patient has a known pollen allergy but no known medication allergies. No recent travel, exposure to individuals with similar symptoms, or new medications have been reported.

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Arora's Assessment

What might be happening

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

  • Nutritional Deficiency: Rapid weight loss and a strict diet, such as a ketogenic diet, can sometimes lead to nutritional deficiencies. These deficiencies can manifest in a variety of ways, including skin changes like a rash or blotchy skin.

    • Treatment typically involves dietary modifications and supplementation to address the specific deficiencies.
  • Dermatitis: Dermatitis is a general term that describes inflammation of the skin. It can take on many forms and cause various symptoms such as redness, swelling, itching, and skin lesions. While your rash is not itchy, dermatitis can still be a possibility.

    • Treatment typically involves topical creams or ointments to reduce inflammation and soothe the skin.
  • Stress or Anxiety: High levels of stress or anxiety can sometimes manifest physically and cause symptoms like a rash or blotchy skin.

    • Treatment typically involves stress management techniques and, if necessary, medication to manage anxiety.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Consider seeking medical attention: Given the duration and nature of your symptoms, it would be a good idea to consult with a healthcare provider. They can perform a physical examination, order tests if necessary, and provide an accurate diagnosis and treatment plan.

  2. Monitor your symptoms: Keep track of when your symptoms occur, how long they last, and any potential triggers. This information can be helpful for your healthcare provider.

  3. Maintain a balanced diet: While the ketogenic diet can be effective for weight loss, it's important to ensure you're still getting all the necessary nutrients. Consider consulting with a dietitian to ensure your diet is balanced and nutritious.

  4. Manage stress and anxiety: Consider stress management techniques such as deep breathing, meditation, and yoga. If your stress and anxiety levels continue to be high, consider seeking help from a mental health professional.

What you should look out for

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

  • Difficulty breathing or swallowing
  • Swelling of your face, lips, tongue, or throat
  • Severe rash or skin changes
  • Rapid weight loss without trying
  • Blood in your stool or changes in bowel habits

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare provider.

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1 yr ago

People Also Ask


Can a ketogenic diet cause skin rashes or changes?

Yes, a ketogenic diet can sometimes lead to skin rashes or changes due to potential nutritional deficiencies or changes in the body's metabolism. It's important to ensure a balanced intake of nutrients while on such a diet.


How can stress and anxiety affect the skin?

Stress and anxiety can lead to physical symptoms, including skin changes like rashes or blotchy skin. This is due to the body's response to stress, which can affect the skin's health and appearance.


What are the signs of nutritional deficiencies that might appear on the skin?

Nutritional deficiencies can manifest as various skin symptoms, such as rashes, dryness, or changes in skin color. Common deficiencies affecting the skin include vitamins like B12, D, and minerals like zinc.


Why do some bowel movements float and what does it indicate?

Floating bowel movements can be caused by excess gas or malabsorption of nutrients, such as fats. It can be a sign of dietary changes or digestive issues, but if persistent, it should be discussed with a healthcare provider.


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