I am at a loss and hoping you can shed some light. Your help would be greatly appreciated more than you know! I'm very scared. :(

[ThyroidPrincess]

I have been hypothyroid for years with it under control for the past 3 or 4 years. I developed a goiter. The reason we found it was because I began getting a strange sunburn like rash around my neck that itches mercilessly. The rash is not raised nor is it bumpy or scaly. It looks like I was out in the sun all day with a necklace on and the burn has that type of pattern.

My GP is trying to research this now because it has him stumped too. He also feels it must have something to do with my thyroid and finds it odd that it seems to be around my goiter (they found nodules when I did an ultrasound last week which is why we are going for an MRI).

I would be so grateful if you could help me Dr. Lupo. I know you are a busy man but it would mean a great deal to have someone else's perspective. My Cortisol is 3.9 so I am going for an ACTH Stimulation test tomorrow (not looking forward to that). Could low Cortisol cause a sunburn like rash around the neck? I ask because I know that Cortisone injections can relieve rashes so I wondered if it could be a reverse type thing? Could nodules or goiter cause a sunburn like rash around the neck? They also found that my Vitamin D level is 8 so that concerned them and they are giving me Vitamin D 50,000 IU's each week for a month to start. Could the low level of D cause this odd type of rash? I am at my wits end because this rash seemed to come on strong before my period and leave but now it just stays all the time. We checked all my other hormones and they are normal (not near Menopause or anything)..If it were not perfectly centered around my goiter I would not have made the connection but it sure seems to be Thyroid related. Any idea's? Have you ever seen this? Will the bloody thing ever go away? Very scared actually. It's not something you can really culture either because it's very systemic and looks like a sunburn. Is this a sign of thryoid cancer?

Respectfully,
Tara

[Mark Lupo, M.D.]

Some patients get a slight rash around their goiter - particularly in autoimmune thyroid disease (like hashimoto's - the likely cause of your hypothyroidism).  Keeping the thyroid under control is probably the best that can be done.  A dermatology evaluation may be helpful as well as it may have nothing to do with thyroid.

The low Vit D brings up the possibility of celiac sprue (gluten sensitivity) -- this can cause rashes.  Low adrenal usually causes increase pigment, but can cause a rash as well - so this is important to check with the lowish cortisol.  Also would consider other non endocrine autoimmune diseases (ie lupus like scenario -- but this is not likely).

[ThyroidPrincess]

That was incredibly kind of you to take time to answer and I am very grateful. You have definitely given me some ideas and I will share them with my GP. It's just odd that it's only on my neck and feels so incredibly systemic. Had my ACTH test today so hopefully the results will give me a clue there (I actually felt good when the ACTH was put into my system so I wasn't expecting that).

My TSH at one time was 217 and they ran it twice to be sure there was no mistake so I have come a long way, however here I am again struggling with the levels rising again. They switched me to the brand because they feel that Synthroid might be the answer so we are trying that now.

I will understand if you don't have time to answer me on this, but there was one other thing that I wonder about and I could be off the mark here of course. The only different thing that I have done in the past few months about the same time the strange sunburn like rash came along only on my neck was to use Differin gel on my FACE (not neck) 3% every night. It was nowhere near my neck so I wonder if it's possible that I am getting to much absorption and that is what's causing this bizarre itchy rash. At this point I almost want to just contact a psychic and say please just tell me what it is...here's the money! It scares me because it seems like a sign of something that is not good going on. Never ever had rashes and never anything like this.

In any event bless you and thank you very much for your valuable time. :)