Hard spots around joints and swollen limbs

[noelle2007]

I am 27 and have a history of alopecia areata and asthma. Do you have any idea if this could be autoimmune? I get purple spots, some that swell, some that look more like bruises when they fade but they are all the size of a pencil eraser. I have had extreme swelling in a leg, random fingers, wrist, arm and all at different times. I have been dizzy when I stand up with numbness and tingling in extremities and have had discoloration in my hands and feet. When the swelling subsides, the area never returns to normal and I have limited mobility. (It feels like the skin or muscles are too tight even though the swelling is gone.) Then I got little hard spots under my skin around my joints that feel like little pebbles. I also get very bright blue veins and the area around it seems to swell and then turn light brown as it fades. I was told this was lactic acid. But, once it is gone, the vessels never seem to disappear. They always stay more prominent than every where else. I also get tiny little red spots across my chest and upper arms. I have been given norvasc, imdur and nitrostat for raynauds with very little relief.I had an mri on my brain and blood tests that showed only a slightly elevated white count. I saw a rheumatologist that suggested having them rerun as they were completed before most of my symptoms appeared. I had a nerve conduction test.Is it possible that this is not autoimmune?

[Kevin Pho, MD]

The symptoms you describe are non-specific and can be due to a variety of causes.

I agree with the rheumatology evaluation.  This should include an ANA level and rheumatoid factor.  

Regarding the dizziness, a referral to a neurologist and appropriate brain imaging should be done to evaluate for masses or other neurological diseases.  

The swelling may be due to cardiac, vascular, or kidney diseases.  Blood tests to evaluate for kidney function as well as an echocardiogram to evaluate the heart can be considered.  

As for the alopecia and the skin lesions, appropriate biopsy of the lesions can be considered.  A referral to a dermatologist can be considered to explore this avenue.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[noelle2007]

I should have added this has all happened over a period of 6 months.