Could my skin rash at 43 be lupus or dermatomyositis?

Question

Hello doctor,

I am a 43-year-old female, and I have had itchy, red, and burning rashes. It all started as a few bumps on my right arm, above my eyebrow, right upper nose area, all over the jaw and chin area, right chest, and upper back reacting badly to the sun, and it is getting worse.

I have had a lot of blood work done, which were all negative for lupus and other things, although I had a high hs-CRP. I have only one grandmother with a history of severe neurodermatitis, and I had asthma when I was younger.

I am worried because a sun-exposed rash which was finally biopsied showed an interface dermatitis with mucin and suggests either lupus, tumid lupus, dermatomyositis, a connective tissue, or collagen vascular disorder, even though no vasculitis is seen. I am worried sick.

Is a biopsy conclusive for these diseases?
Do I have any one of these diseases?

I feel that these rashes are hormonal, but it does not go away and gets worse during PMS and if I consume alcohol. I have no family history of lupus or any other one of these. I have no muscle issues. However, there is some red discoloration on my fingers. I do take Cipro on and off for diverticulitis. Applying any form of steroid cream helps with the itching, and then makes it even worse.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

The rashes that you are describing along with the biopsy findings can go in favor of a connective tissue disease. Although I would like to see the reports in detail, as you mentioned interface dermatitis, goes more in favor of lupus over dermatomyositis. But, we need to see a few more things before coming to a conclusion.

I am not sure about your lab workup, but I will recommend you get a few tests that will help us distinguish between the two. For lupus, you do not need to have a family history. Rashes are one of the first symptoms to appear and we just need to see where it is heading.

Even if it is dermatomyositis, sometimes a rash can appear a few months before muscle weakness. Moreover, the treatment remains the same for both conditions. I suggest you avoid sun exposure and use sunscreen with SPF 50.

If you could attach the pictures of the rashes, especially the finger ones, and the labs, it would be useful for me.

Did you have any history of oral ulcers or hair fall, joint swelling and pains, weight loss, and appetite loss?

I hope this helps.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

You are most welcome.