Dr. Naval Mendiratta
Rheumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 50-year-old male. I was having photosensitivity (not too bad), went to a dermatologist, had a blood test, and tested positive for ANA 1:160. I was getting eczema on my hands and feet with the sun at the beach (tiny tiny little itchy blisters), but my forearms and calves start to itch with a very slight rash. I was told I essentially had very dry skin. He was not even going to order a blood test but did it just to make sure of his blood count. I showed him a picture of a slight rash. The ANA then tested positive. I have to go see a rheumatologist now. I do not have any other symptoms of joint pain, etc. I am pretty healthy. I work out five times a week. I take Atorvastatin for cholesterol, Baby Asprin, Ezetimibe, and Vitamin D. I also have a vitamin D deficiency. I also had a physical four months ago and everything else was fine with the blood work. Everyone told me not to worry, that there are a lot of false positives. I can have an early stage of something and it needs to be monitored. But what am I most likely realistically looking at? How quickly does this get assigned?
Hello,
Welcome to icliniq.com.
According to history, it looks more like the skin is the only one troubling you. I would like to ask you a few more queries. Did your rash resolve after the sun exposure was removed? Do you experience it on a daily basis when exposed to the sun or was it just due to prolonged exposure? How about your other blood tests like complete blood count, ESR (erythrocyte sedimentation rate), and liver function test? Yes, it is true that ANA (antinuclear antibody) can be a false positive in a lot of people. But we need to be sure that it is not the start of a disease. So only ANA does not give us answers. We need to see if it is causing inflammation in the blood which will be clear from other tests. As per history, it sounds more like a polymorphous light eruption which usually should improve itself. But yes, if your skin is sensitive you should avoid getting prolonged exposures like that as they can be harmful to the skin.
Thank you.
Patient's Query
Thank you doctor,
The condition does resolve when I am out of the sun and it happens after prolonged exposure (a couple to a few days). I do not think the other things were tested but in had a full physical with standard blood work, then which I assume would pick up the liver function. Any additional thoughts?
Hello,
Welcome back to icliniq.com.
Yes, I guess that should be all tested if they did the whole thing. I guess you probably have PMLE (polymorphous light eruption). But that means your skin is sensitive to UV (ultraviolet) light and you should avoid prolonged exposure as they can be harmful. My only final test would be to do ENA (extractable nuclear antigen) profile to be sure there is no underlying connective tissue disease. ENA tests for all the subsets of antibodies under ANA. Since your routine test is good you do not need any treatment. Just do routine monitoring if anything comes up in the ENA profile.
Thank you.
Patient's Query
Thank you doctor,
You were able to explain this very succinctly and provided responses that were able to take away much of my anxiety. Yours is a great service.
Hi,
Welcome back to icliniq.com.
You are welcome. Keep in touch for further doubts.
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Rheumatology
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