Health concerns, several issues

Hello, I'm a 20 year old male. I'm not easily persuaded to see my doctor, I'm pretty stubborn, which is why I'm posting here instead of visiting him. Anyways, there's been a few issues that have concerned me recently.

I've noticed a small (about the size of the head of a thumbtack) red rash on my skin that has spread all over my body. It's nothing extreme that has people noticing, in fact there's only 2 spots that aren't hidden under a regular t-shirt and jeans (on my forearm near the opposite of my elbow). The texture is slightly rough, and looks like the skin is drying. The only area where this rash is numerous and all over the place is my back. A couple of the first spots I noticed on my hip area are fading away, which had me relieved until I saw the breakout on my back. What could it be? Is it something potentially serious that I should seek treatment for?

There have been some symptoms that accompany the above problem. About 1-2 weeks ago, when I first noticed the rash, I developed a hoarse cough that has come and gone since then. It was really bad at first and has gotten better, until today; when I cough both my sides, primarily the right side, get really sore, and it hurts when I breath deep.

During this span I've had what I believe to be insomnia, waking up in the morning way too early and feeling like I was woken up prematurely (inexplicable given my sleeping area is peaceful and dark in the morning), for example I will go to bed at 11 pm, be unable to fall asleep until maybe midnight or 1 am, and suddenly wake up unaided at 4 or 5 in the morning. I'm always nauseous  when I wake up with a poor nights sleep (which is often lately), and chewing a couple antacids (Tums) relieves the feeling.

These are some pretty frustrating issues and I'm sorry if I went in all directions explaining it. Hopefully you can provide some insight into some of the things that may be happening with my body, so that I can go to my doctor prepared with information to help reach the right diagnosis, or rest easy knowing it's nothing to worry about. Thanks.

[Kevin Pho, MD]

It is difficult to say what the rash is without evaluation.  Possible causes would be bacterial infection (i.e folliculitis), a fungal rash (i.e. ringworm) or an allergic dermatitis.  A physical exam can help with the diagnosis and guide appropriate treatment.

The most likely cause of the chest pain would be a pulled intercostal muscle from the cough.  However, before attributing it to this, you want to ensure there isn't anything more serious (i.e. a blood clot for instance).  This can be discussed with your personal physician.

The insomnia should be evaluated as well.  Before considering sleep medications, an evaluation of sleep hygeine and sleep habits can be done and any correctable factors treated.

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.
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