Rash??

Hi Dr.

I posted on 4/24/04, regarding two rashes I have.  One on my uppper right arm (brown pigmentation)  I've had this for several years (3-4).  The other is on my left buttock (reddish, but faint and I've noticed it fading (noticed it for maybe a month or so).  Went to my PCP, who didnt think they were a big deal.  I decided to go to a dermatologist.  She mentioned morphea.  Had me take a lupus panel, which came out negative.  She bioposed the two rashes and I won't know for two weeks.  She told me after I get the results she wants me to see a rheumologist.  I read about scleroderma. which is a potentially deadly disease.  I have none of the symptons, I am active.  I did have my hep B shots a couple of months ago, could this have caused the rash on my left buttock?  I haven't been able to sleep just thinking about this.  I also got my PCP involved and she doesn't think that it is scleroderma, she ran basic blood test and everything came out normal.  What does it mean by thickening of skin?  My skin does not feel thick?  Please try to answer my questions.

Thank you

[Kevin Pho, MD]

Here are some skin manifestations of scleroderma.  Skin involvement in the scleroderma-related disorders is characterized by variable sclerosis or thickening of the skin. The hands and face are generally the first areas involved and the hands typically show the most severe changes, especially in the early stages of disease.

The assessment of skin involvement includes estimation of skin thickness, pliability (hardness), and fixation or tethering to underlying structures (tethering).

Objective approaches to measuring skin disease are under investigation. Ultrasonography is able to definitively determine skin thickness and you may want to consider this if this is a concern.  

Without seeing the lesion, it is difficult to say what it is.  It may be possible that the hepatitis shot may have led to the rash.  

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.

Thanks,
Kevin, M.D.

Bibliography:
Korn.  Overview of the manifestations and diagnosis of scleroderma.  UptoDate, 2004.

[kevinmd]

I'll be away until May 10th.  Have a nice weekend everyone.

Kevin, M.D.
Medical Weblog:
kevinmd_b