I am a 21 year old female. I have hypertension and I am treated with hyzaar 25/100 for it. I am overweight and previously had a very poor diet with no exercise. I have high cholesterol and high triglycerides also. I take wellbutrin XL 150 mg, vyvanse 50 mg and and strattera 80 mg. I developed swelling in my fingers in both hands this winter. It is perfectly symmetrical and located in the fatty tissue before my knuckle where my finger meets my hand. They are reddish plaque looking areas. The doctor referred to them as red, erythematous swelling (I included a picture for you to see). The first time I saw my general practitioner he dismissed it as water retention and told me to change my diet. The finger swelling persisted and a reddish mottled rash symmetrical radiated on both of my arms. I began to get very nervous because my hands were freezing and tingling. (I have had always freezing cold hands and feet despite the temperature of the rest of my body). When I returned to the doctor he told me that this might be an allergic reaction but he was going to do blood work to rule out systemic causes. I went home and had to wait for the blood work to return. I decided to go to a dermatologist who then told me it looks like cold urticaria and Raynaud's phenomenon. He said it is unusual to have swelling in the fingers and not in the ankles. My fingers would ache and throb because they were swollen. I noticed that the red plaques/swellings would change color according to temperature. They were also shiny and would alternate from bright red to pink to almost a tinge of violet. The dermatologist instructed me to put on some gloves and dress appropriately for the climate and then see what happens. My blood work came back revealing a normal ANA titer (which the doctor said works in favor of it not being autoimmune) but a slightly elevated Rheumatoid factor. I went to a very prestigious rheumatologist. I was scared of it being Lupus or Scleroderma from what I read on the internet. The rheumatologist said it was absolutely not rheumatoid arthritis because arthritis is joint swelling and I had swelling of the fatty tissue. He explained that the positive rheumatoid factor is a meaningless component of a large picture and that anything can elevate it. He could not do blood work at the time because my veins were all bruised from being in the hospital with the flu and receiving IV. I asked him if he felt I had lupus or scleroderma and he said no. He told me I had Raynaud's phenomenon and that when the weather gets warm this should resolve. From my research it seemed like my red swellings were chilblains. I did not notice an improvement even on warmer days. My fingers still throbbed and the swellings persisted. I went to an allergist to rule out an allergic reaction, she gave me an ice cube test for cold urticaria and it was negative. She had no answers beyond that. The swelling then spread to my toes on both feet. I developed round, raised swellings on all my toes. I assumed this was part of the chilblains. I also had terrible circulation to begin with so wondered if this was related to my poor lifestyle in general. I began to work out and eat better. I then began to develop odd urticaria like rashes, exacerbated by temperature. If I would put the water in the shower too hot then I would develop hives all over my legs. When I break out from a rash after eating seafood the swelling on my toes and fingers became further severe and almost itchy. So this leads me to my point, I am hopeless, emotionally distraught, frustrated and futile. It is now 80 degrees and this swelling is still going on, however, it just began to get hot. Perhaps it needs time to heal in the warmer climate? A holistic nutritionist dismissed it as inflammation of unknown ideology (most likely from poor diet) and has me doing anti-inflammatory supplements, diet and shakes. Someone please help me with answers. Does this sound like an autoimmune disease such as Lupus or Scleroderma? I am frantic. The ANA was negative but why is this happening? Could this be just a repercussion of my reckless lifestyle and being overweight? Poor circulation in general? Please tell me what you think this may be. I included a photo of what is going on with my hands so you can look and make a decision. Thank you so much!
Welcome to the MedHelp forum!
Some other conditions too should be ruled out. These include: hypothyroidism, eating disorders like anorexia, Vit B12 deficiency, Addison’s disease, adrenal causes like pheochromocytoma, anemia, Buerger’s disease, chronic fatigue syndrome and Raynaud’s disease. You will need some tests like treadmill test, color Doppler, angiography, ultrasonography and MRI (magnetic resonance imaging).
Since I cannot examine you nor is a detailed history possible on net, I have listed the various other possibilities that should be looked into. Please consult your PCP for primary examination. Take care!
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