Conversation: The conversation between human and AI assistant.
[|Human|] Hello, I have been dealing with a rash on hands, legs, back, arms and now bottom of my feet for the last 7yrs.  I was prescribed 2 steroid creams and they have not worked for 7yrs. I asked my doctor to test me for lupus and she put me on prednisone which I was on 2 times before and it makes the rash go away for a little while. I was sent to a skin specialist 5yrs ago and they gave me the same 2 creams and still nothing works. I do have a copy of my blood test in which it says --- SEDWEST is 42, CRP is 2.5, RF is <4 , ANA is positive, ANAT1 is 1:320 and ANAP1 homogenous. So I guess my question is do I have lupus?  my rash starts out like a blister and then itches then turns yellowish green then brown. I do not have a blister rash on my face but, I do have redness on cheeks and nose. sometimes I do run a low grade fever, tired, achy and my eyes are always dry.
[|AI|]  Hello there!  The classic presentation of a triad of fever, joint pain, and rash all points towards the lupus. So does the positive homogeneous Anyhow many of these complaints you have? Constitutional (e.g., fatigue, fever, arthralgia, weight changes)Musculoskeletal (e.g., arthralgia, arthropathy, myalgic, frank arthritis, avascular necrosis)Dermatologist (e.g., Malay rash, photosensitivity, discoid lupus)Renal (e.g., acute or chronic renal failure, acute nephritic disease)Neuropsychiatric (e.g., seizure, psychosis)Pulmonary (e.g., pleurisy, pleural effusion, pneumonitis, pulmonary hypertension, interstitial lung disease)Gastrointestinal (e.g., nausea, dyspepsia, abdominal pain)Cardiac (e.g., pericarditis, myocarditis)Hematologic (e.g., cyclopedias such as leukemia, nymphomania, anemia, or thrombocytopenia)the more you have, the more the Odds for lupus. As your ANA is positive Homogeneous It has pointed lupus further, but ANA is not that specific. You need to do Anti-Double stranded DNA and Anti Smith antibodies to confirm. You need a detailed workup for SHE, Anticardiolipin, Lupus AnticoagulantComplete blood count (CBC) with differentialSerum creatinineUrinalysis with microscopyErythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)Complement levelsLiver function testsCreatine kinase assays protein/spot creatinine ratio Brain MR scans joint effusions arthrocentesis and last but not the least RENAL BIOPSY to Assess the severity of lupus nephritis. You need a whole panel of RheumatologistInfectious disease specialistNeurologistPulmonologistCardiologistGastroenterologistNephrologistDermatologistHematologistHigh-risk obstetrician(if female with plan to pregnancy)A simple steroid won't help. So what are you waiting for. Grab your coat and see the nearby rheumatologist to start it. You need to control the progression and care for your vital organs if you need to survive. Take care of yourselfRegards Chat Doctor.