Unus Rash 
M-healthy 23yo.A month ago, small red/itchy bumps (like mosquitoes bites) came up on my legs. A week later, all these "pruritic redbased papules&pustules" outbroke&itchy. The derm said it's bugs bites infected & rx'ed 9d prednisone (60x3,40x3,20x3), clobetasol, po bactrim+allegra. The culture swabbed was -ve. 9d steroid suppressed it, but it recurred 3d after pred finished: Feel itchy somewhere on my leg/arm, then a small red spot appear, the red area start getting bigger to a 1/4size a quarter; if scratch, it sort of breaks up into little dots around the main one (just like a pen tip breaks up a water drop on the table surface). After clobetasol use for 2d, the itch went away but the skin got white & there is a depression characteristic (in the center there are waves/lines of vessles, like those in eye-white).. the derm then did 2 biopsies. I started another pred for 5 days & again after 2 days it stop the rashes. But after 5 days, due to pred SE I stop pred. 1 week later, the biopsies resulted "lymphocytic vasculitis" ¬ bites & the derm explained that it could be due to several things and started me on Doxy200mg qd. All blood tests of metabolic/UA, Rhfactor, antinuclear Ab/complement, Sjogren Smith RNP/DNA DS Ab, NeutrophilicIgG,herpes are normal except the anticardiolipin IgM (normal is <10, mine is exactly 10). 1 week later it sort of coming back with on/off itching. Last night, I realize after drinking coffee about 30' these bumps appear. But I was fine drinking it ever since college. I had my apt checked for bugs (nothing); change my beddings/soap/detergents. I remember that there were days during this I took my protein shake (NO explode) that has caffein(that might explain the on-off nature of it). Now my derm says I need to see the rheu (apptmnt after xmas). The anti-Phospholipid causes livedo rash-I don't have. I already stop caffeinated products starting today. This ques is with a picture in the derm forum, please see the pix. Thanks   

PS can a person be allergic to something that s/he's been taking for years and then sudden 1 day finds out s/he allergic to it? I'm afraid I'm in that case with caffein. I've been drinking starbuck espresso and taking the protein shake (different kinds-but most of them have caffein) for years since college. Can I just suddenly be allergic to it now? Does allergic to coffee cause this type of rash? Thanks so much for your advice 

medhelp.org/posts/show/715676   -   need_help123

12-18-08 

Doctor Reply - MedHelp:  "Your description does not match any disease that I'm familiar with, unless it's a virus of some sort, in which case it will go away by itself over time.  Certainly the biopsies and other tests don't suggest any serious diseases.  It sounds to me as though your dermatologist is proceeding in a sensible manner.  I would follow up on his recommendation for a consultation with a rheumatologist.  I know it is frustrating to have to live with uncertainty, but sometimes diagnoses aren't clear right away even after testing.  You are not going to find some straightforward answer on the internet.  Please stick with the doctors you see in person."

Best.

Dr. Rockoff
My Thoughts:
"lymphocytic vasculitis" I have never heard of this before, when the forum link comes up, the forum suggests these also:

"lymphocyticAcute lymphocytic leukemia (all)
Acute lymphocytic leukemia - photomicrograph
Chronic lymphocytic leukemia (cll)
Chronic lymphocytic leukemia - microscopic view
Chronic thyroiditis (hashimoto’s disease)
Non-hodgkin's lymphoma
Silent thyroiditis vasculitisNecrotizing vasculitis"

I think I may have ONE such rash. It was sort of leathery like with no breaks in the skin at first ... slightly itchy. I put hydrogen peroxide on and and sure thing ... no break in the skin.

This, however, is the type of thing that I would suspect for exposure to butyl or in the most common form, 2-butoxyethanol. It is 'the kind of thing' this chemical would do: leukemias, tumors of all kinds, damage to kidneys/liver and I strong suspect it is the cause of NHL rising so quickly as a predominant form of cancer.

I notice when I am exposed to it, because I've taken a serious look at this chemical for years. Exposure looks like the flu. In less serious exposure it looks like 'uncontrollable farting' (flatulence), with 'the sniffles (loosening of the sinuses) and for me ... especially diarrhea.

You can get exposed by someone coming around who is over exposed, and for a time they will breath this chemical out in their breath, so it can expose others as it gets into the eyes of others. (Second hand solvent exposure). Can make your eyes itch and burn, as these vapors getting in your eyes if a serious exposure more than others.

I have noticed that I am repeatedly being exposed, so I have wondered, what next bad thing will show up for me. I think abnormal blood sugar, abnormal blood pressure, abnormal body temp are the more easy things to find (autoimmune hypothalamus issues) than the ANEMIA of CFIDS, CFS, FM that is not generally found.

I think it would have to be AUTOIMMUNE if it was from this chemical exposure. AND I think it would not be a stand alone item. Many things are autoimmune. www.valdezlink.com/pages/autoimmune.htm

Do you have someone new coming over .... who was not coming over a couple of months before this started up? Are you using a new cleaning product at home or doing remodeling in which you get paint fumes in your eyes? (I surely hope you are not working as a maid doing housekeeping in a hotel or cleaning janitorial work at the schools, etc)

So AVOID this chemical. Any cleaning product that has an EPA registration number is most probably some kind of pesticide. This chemical is a pesticide, a solvent, a poison, a neurotoxin, a teratogen chemical. There are various groups of people who I suspect are more harmed by this than by any other chemical exposure: Exxon Valdez oil spill bioremediation workers and the US Coast Guard who monitored the experiment in 1989. AND the WWII Vets, the Vietnam VETS *, the Korean Vets, the 'gulf war syndrome' VETS  and most especially today's vets *  (3 soldiers die 2005 after 'flu), and many, many civilians going about their every day lives. Listen to your body.

I think this chemical is the WORST pesticide
www.valdezlink.com/re/worstpesticide.htm

I write web pages to express my thoughts; not to be considered any authority on any subject.

Look into glycobiology for help. I don't know, but I think it may be the best help for stopping our systems from becoming autoimmune. As it deals with cell to cell communication.

Thanks for sharing
It all started about a month ago when the city I stayed had a huge hurricane passing by from another state. I didn't evacuate and stayed during that whole 3 days, the city was OK as we were just the collateral. First I started seeing some small white bumps that later turned red (like mosquitoes bites) coming up on my legs (ankles and thighs). I thought it was just some allergy or the changes in the water after the hurricane and ignored. These were really itchy. A week later, all these "pruritic red based papules and pustules" (as described by my dermatalogist) continued to come up and really itchy. I used betamethasone for a few days while waiting for the derm appointment. When I saw him, he said it might be bed bugs bites that got infected and prescribed 9 days of prednisone (60mg x 3d, 40 x 3d, then 20mg x3d), bactrim oral, and allegra oral. He also swab some stuffs off the lesions to culture. The culture returned negative (nothing was able to grow). After 9 days the steroid really suppressed it, but it recurred 3 days after I finished the steroid: 1/2-a-coin bumps that turned red after appearing and got really itchy. I used the betamethasone on them together with the lanacane OTC to help itching; after the itching stop, the skin where it appeared becomes sort of depressed and the inside of the depression showed some very small lines/waves just like blood vessels. I came back to derm, he took 2 biopsies of my big toes' lesions where the bumps appeared. He gave me clobetasol which he said the strongest available. I asked to start another pred regimen. I started on the pred for about 5 days and again after 2 days it suppressed the rashes. But after 5 days, I got miserable with the pred SE like heart rate, CNS effects, and terrible acnes and stopped the pred. So I came back to the derm (1 week later, at this time I already stopped the pred after 5 days taking it). The biopsies return as "lymphocytic vasculitis" and not bites at all (the MD did the test said "thruout dermis mononuclear infiltrates found and eosinophils were absent, a viral process and less likely insect bites could be examined"); and the derm explained to me that it (lympgocytic vasculitis) could be due to several things like herpes, Pleva, Lupus, etc. He started me on Doxycycline and other topical like differin + benzoyal perozide for the acne. At this time, the rash was sort of subsized a bit so we decided to not chase after it.

But then about 4 days later, it came back with the same characteristic bumps, this time they were smaller like dots (red and itchy) and not as many as the initial break-out. I came back to the derm and he did a lot of blood tests on: complete metabolic + urinalysis, Rh factor, anti-nuclear Ab, complement, Sjogren's Ab, Smith Ab, RNP Ab, DNA DS Ab, Neutrophilic cyto IgG, herpes panel. All returned normal except the anticardiolipin IgM (normal is <10, mine is exactly 10). A week later (I was still on doxy 200mg qd during this whole time) I came back to see the blood test results and told him that for about 3 days after these tests, it was gone-I was so happy. He explained the results that it might be clinically insignificant as I am so healthy with other tests (I have no STD no HIV, no chronic disease no anything) so this anticardiolipin thing might just be something irrelevant (plus it's IgM-initial exposure not IgG). He referred me to a rheumatologist for antiphospholipid syndrome evaluation and said that if it was pleva then it was responding to the doxy. I came home and set up the appoint with rheu for after xmas.

Now, 1 week later it sort of coming back with on and off itching, I always used clobetasol to suppress it (cause I can't go back to pred as it made me so miserable). It's just like this: I feel itchy at a place on my leg or arm, I rub a bit and then a small red spot appear, I put some clobetasol on it, the red area start getting bigger to a 1/4 size of a quarter, if I scratch the dot it sort of breaks up into small little dots (like a tip of the pencil) around the main one (just like you use a pencil tip to break up a water drop on the table surface). After I put the clobetasol on for 2 days, the itch went away but of course the skin got so white due to the steroid and again there is a depression characteristic to the picture (in the center there are waves/lines of vessels, like those you see in your eye white part).

Last night, I started realize that whenever i drank coffee, I got these itchy things coming up. I realized that during this whole course, I had a lot of starbuck blackeyes every day. This morning, I had to drink a lot of coffee to stay awake to take final exam (I'm in professional school) and when I came home, 2 more small dots coming up on my ankles near the old one (the 2 new one are the red spots to the right of the picture, the old ones are at the bottom of the picture with that characteristic depression), again I put clobetasol on it.

I have no idea if I'm allergic to coffee or not. But I don't understand why as I was drinking starbuck ever since I've been in college 4 years ago until now when I'm in professional school. During this whole course, I had my apartment clean/checked for bugs (nothing was there); change all my beddings/soap/detergents/deodorants/cologne. I started thinking that there were days during this course I took my protein shake (NO explode) for my weight lifting and it has caffeine in it (that might explained the on-off natures of it). I am not sure if because of coffee/caffeine that causes these bumps (but again, I've been drinking coffee forever and now all of a sudden I can't drink it?). A friend of mine in med school did the glass test (press the glass against the skin) and said it was not clotting/bleeding inside the skin. I looked up everything like pleva and that antiphospholipid syndrome but not sure if I had those. Now I can't go back to my derm as he says I need to see the rhematologist for antiphospholipid syndrome evaluation ( and I he also stated that there was no other things I could do more). But from what I know that syndrome causes sort of livedo rash on the thigh which I don't have. My rheu appointment is not until after xmas and I'm so desperate now--no longer looking forward to the holidays. I decide to stop all caffeinated products starting today to see if anything changes. Any help or opinions would be truly appreciated. I'm still on the doxy 200mg qd and allegra 180mg qd (of course with the clobetasol on hand in case it comes up again). thanks in advance.          

I think we have the answer to why lymphocytic vasculitis

You said this occurred shortly after a hurricane passed through. I remember when we watched the reports on Hurricane Katrina, I thought to myself ... "Wow, these people are going to be exposed to 'the butyl' chemical." Different things were broken, with chemicals in the water, in the air. I don't remember right now what caught my attention, but I look for health changes after possible exposure to this chemical and the worse exposure is getting the vapors in your eyes

Do you also feel more tired than you used to?

This chemical will cause an anemia without alerting the doctors to it,
as several things start going wrong & it messes up what the numbers would otherwise mean if you only have one thing going wrong, and 2-butoxyethanol can cause any of the medical 'numbers' to go high or to go low ... Best thing to do is to have the lab tech LOOK at the RED BLOOD cells and tell the doctor everything they can find out about them: age, membranes, size, shape, etc  *      medhelp.org/posts/show/715542

What about seizures?  ...   And HELP if it is from ANEMIA?  *

"Because vasculitis can occur in any part of the body, any tissue or organ can be at risk"

  Russian champion figure skater, Irina Slutskaya - VASCULITIS

Irina Slutskaya, champion figure skater from Russia, was forced to miss the entire 2003 season after being diagnosed with vasculitis. ...

Do we have some 'wrong medical views' today?   -   Why Horrible Headaches?  *