Weird vascular flares

[ellie1]

Dear Doctor,

THank you for offering this forum.  I have been having rashes that pop up on my chest and neck.  Some leave little red dots after they go away (usually the ones on the neck that look like hickies but they aren't) and one left some type of ridge area.  Of the ones that my dermatologist biopsied they came back as non specific.  He calls them vascular flares.  I recently had one come up on my stomach which was red and slightly raised and again it came back as superficial mononuclear inflammatory infilatrate that is predominately perivascular.  The epidermis is thin and the follicular units are unremarable.  He said that it was perivascular dermatitis.  I have had fever for months over 100 and no infection can be detected.  Do you know what causes perivascular dermatitis and anything that can make these rashes not come? The rashes usually dont last more than a day or two. Most of the time I never know they are there until a coworker says something to me when they see them on my neck or chest.  My doctor is puzzled.

Thank you in advance.

[LPCCSM]

A related discussion, What is it? was started.

[Alan Rockoff, MD]

Not really.  Sorry.  Dr. Rockoff

[ellie1]

Thank you for your advise Dr. Rockoff.  I don't have a red neck and I do not like turtlenecks so that is out of the question. I have also gotten the rashes on my arms and stomach and a couple of times on my face.  I guess I didn't really didn't clarify what I wanted to ask.  In light of low complement c4, positive ana, dry eyes and mouth being an unknown disorder that I have going on which causes these rashes while having a "flare" of whatever this is in addition to having mg, are there any disorders that you can think of that are associated with perivascular dermatitis without any other positive tests at this time?

Thank you in advance.

[Alan Rockoff, MD]

"Perivascular dermatitis" is just dermatitis, which always shows up under the microspcope around the blood vessels ('perivascular.")  Nonspecific rashes like yours generally don't come from anything in particular, so you can't prevent them.  The best thing to do is ignore them.  Strategies include: wearing turtlenecks; and thanking solicitous co-workers for their concern, and assuring them that the rash is not catchy, and would they please look elsewhere.  Some people (perhaps you're one) get red on the upper neck whenever they're upset or self-conscious.  This is embarrassing but meaningless (like blushing, of which this is a variation.  Hiding the redness is pretty much what you can do.

Best.

Dr. Rockoff