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    cold spots on skin
    leecat41 posted:
    I've been having some trouble lately. My body parts are varying drastically in temperature. Is this normal? I've got spots that feel like an ice pack has been set on them for a while and right next to that will feel like I have a fever. I've been feeling very fatigue lately and have had a nearly constant head ache for a couple of weeks now. I just finished with my routines at the rheumy last month and I was ok. Does the cold spots have anything to do with this? Should I contact my rheumy or a doctor at all?
    To do what is right is not always easy, to do what is easy is not always right.
    R Swamy Venuturupalli, MD, FACR responded:
    In lupus, as in other autoimmune diseases and even in fibromyalgia, we often come across something called autonomic dysfunction. In this condition, the temperature regulating center of the the brain (located in the hypothalamus) does not function well, leading to drastic changes in temperature sensations. Other possibilities include circulatory issues, resulting in lack of oxygen- however, this is usually a painful condition and is seen more in the extremities and is called Raynaud's syndrome. Another condition that might cause similar findings is small fiber neuropathy, which may be associated with temperature changes. This will need to be investigated. I recommend keeping the area affected active through gentle stretching exercises to get the blood flowing through the tissues. Occasionally, we use medications such as elavil, anti-depressants such as zoloft etc. to manage these symptoms.
    leecat41 replied to R Swamy Venuturupalli, MD, FACR's response:
    Dr A told me that I had Raynaud's but that has always, as you said, affected my hands and feet mostly. So if the cold spots are on my chest and such would i just do normall stretching excercises? What is small fiber neuropathy? These places kind of burn a little but they aren't what I would call painful. I'm gong to call my rheumy. Thanks!
    To do what is right is not always easy, to do what is easy is not always right.

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