bright red/purplish rash

I have a bright red/purplish rash mostly on my knees, elbows, neck, feet and hands. When I get cold, the rash on my feet and knuckles turn purplish/blue. I tested negative for ANA and the only abnormal count on my CBC is MCV - 105.5 and MCH 38.7. My Vit D was low at 11.  My biopsy was negative, a pap smear was negative and my mammogram was negative. My CT did show moderate centrilobular emphysema ( I am a smoker). My dermatologist does not feel that the emphysema is causing the rash.

Photos here:

http://s1234.photobucket.com/albums/ff418/finnigan11/

Any ideas.

[casey9]

My doctor was just here and he feels that I might have an inflammation of my capillaries but need another biopsy to determine the cause.

Someone please respond

[casey9]

Can someone please respond. I am now getting cold hands and feet and itching everywhere, even where there is no rash.

[Bhupinder Kaur, MD]

Hello,
From your symptoms Raynaud’s disease and peripheral vascular disease needs to be ruled out. Raynaud’s disease is a vascular disorder that affects blood flow to the extremities which include the fingers, toes, nose and ears when exposed to temperature changes or stress. This causes redness, blueness or swelling of the skin.

To confirm the diagnosis, I would suggest you to consult a vascular surgeon. Different investigations like blood sugar levels,Hb A1c levels of blood, vascular ultrasound or vascular Doppler may be needed to confirm the diagnosis. Treatment will depend on the confirmation of diagnosis.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[casey9]

Thanks for your help. It is greatly appreciated. Had more blood tests and another biopsy - waiting for results. Will pass on your thoughts to my dermatologist. Again thank you for your time and consideration.