One consideration would be carcinoid syndrome. Episodic flushing is the clinical hallmark of the carcinoid syndrome, and occurs in 85 percent of patients. Most flushing episodes occur spontaneously, but they can be provoked by eating, drinking alcohol, defecation, emotional events, palpation of the liver, and anesthesia.
The most useful initial diagnostic test for the carcinoid syndrome is to measure 24-hour urinary excretion of 5-hydroxyindoleacetic acid (HIAA), which is the end product of serotonin metabolism. You may want to consider this.
I am not sure what is causing the white spots on the lips. You may want to consider an oral surgery referral where a biopsy can be considered if there continues to be no clear diagnosis.
Another consideration for the lip sensation would be hereditary angioedema - this can be evaluated via an allergy consult.
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:
Sitaraman, et al. The carcinoid syndrome. UptoDate, 2004.
I'll be away until May 10th. Have a nice weekend everyone.
Kevin, M.D.
Medical Weblog:
kevinmd_b
I need a little advice here. I am worried, and it's probably paranoia, but I really need some advice. (And thanks by the way!)
My monthly periods are usually fairly regular, although I have completely skipped months before. My last period began on April 1st and lasted only 3 and 1/2 to 4 days. (Which has also happened before.) It is now May 6th and no period. My cycles have been long before, so normally I wouldn't be too worried, but about 2 weeks ago during sex the condom slipped off of my boyfriend and I had to go "fishing" for it. (Sorry if that was too graphic). I showered right away after this happened. This has also happened once before (the slippage) and I've been fine, since the condoms had spermicide in them.
But I'm wondering if my later period is something else. Last night I took an over the counter test which was negative. I am planning on taking a second tomorrow morning (someone told me your hormone levels are higher in your first urination and the tests work better if you take them first thing) if my period is still not here. My breasts are larger and tender, but that is usually part of PMS for me. I have been tired and a little lightheaded lately, but my boyfriend says no more than normal, with work, weather and all. I am just worried and wanted to know if I should be. I am in no way ready to have a child yet! Thanks for getting back to me on this...
J.
I just examined where I said my lips hurt at on the ends, and on both sides there are tiny white dots scattered on the red part of the lips.. like if I fold my lip out a little to see the surface of them there a bunch of white dots like inside of my lips and they diminish in frequency towards the center.
they are mostly clustered on the ends.. where it hurts at.