Skin Changes

[aMom21]

Hi Doc,

You have helped me before and I am hoping you can once more.

I am a past heavy drinker of 10 years.  Abstinent since October 2007, when I was put on Toprol for high blood pressure.  Blood pressure is now normal off of the Toprol since July 2008.

Following are my symptoms that have arose since that time.

01/08 Skin becoming tanner maybe more yellow/orange
04/08 Eyes burn and blood vessels in eyes much more prominent
05/08 Pain under right rib cage that radiates to upper, mid and lower back
08/02 Incredible fatigue
08/02 Slight swelling and pain in ankles that radiates up to knees
09/08 Hundreds of red spots that do not fade
09/08 Yellow diarrhea daily each morning
09/08 Night sweats
10/08 Notice additional red spots that occasionally appear and disappear within 24 hours
10/08 Seem to bruise easily
11/08 Slight swelling and pain in hands
12/08 Redness in hands and feet, seems to be traveling
12/08 Some spider veins appearing on chest and shoulders
12/08 Nails of big toes are white
01/08 Heart beat felt in abdomen

The most troublesome of the symptoms is the RUQ pain and my skin which continues to become more yellow or bronze in color.  I have had 3 different sets of CBCs and LFTs all normal.  Iron levels, alpha-feta protein and thyroid have come back normal also  Had a ultrasound, 2 CT scans, HIDA scan, upper endoscope, and mamogram.  Aside from having a very very slight hiatel hernia and a twisty colon they revealed nothing out of the ordinary.

Do you have any idea what direction my doctor should go in?  My current gastro doc is going to test me for sarcoidosis, but I am not sure that addresses the issue with my skin which I believe to be a big part of this puzzle.

Thank you for time!

[aMom21]

At my last doc visit they found some small swollen lymph nodes and I am guessing with since some of my symptoms could overlap they wanted to rule that out.  I have had my iron, transferrin and ferritan tested last october and they came back fine.  I do not eat alot of carrots or take beta carotene.  However I did take a multivitamin from October 2007 until December 2008.

Just a note, the past two weekends I have had boughts of excruciating pain in my right side which I had not had in the past.  The pain was always consistant but not constant and was more of an ache and not sharp pain in the past.

Also, I forgot to mention that I have had a colonoscopy as well as a chest CT scan which did not reveal anything abnormal.

Thank you for your time Doctor!

[Thomas D Schiano, MD]

from what you write i am not really sure why they feel you could have sarcoidosis.  have the tested you for hemochromatosis? do you eat a lot carrots or take beta carotene as this can cause the pigmentation--hypercarotenemia.