Hello doctor, I have a daily clock like work since four years. I finished remodeling a manufactured home and college working full time. Every night starting around 9 pm I start to get stiff and then it slowly worsens by 11 pm. I can barely lift an arm or stand up without pain. Opening a bottle and buttoning pants during this time is a lot of effort too. This stiffness and inflammation also happens in the morning, while getting out of my bed and washing my hair is a real job for me to get done. The key points being by elbows, hands, and knees. Another problem I had that happened as soon as I moved out into my manufactured home is these scratches that do not heal, they look as if they are scars but then there are some that develop that are not from scratches. But it is more like a rash that itch (manageably) and they started on my underarms and the back of my hands, where now they continue to reside there. Now it spread to my legs, stomach and armpits. I have a sore throat now but I do not know if it associated with these problems. Please see the attached photos for the rash I am dealing with. I come from a polish background and my grandmother had RA, but not until her 60s and my parents never have had problems like what I am experiencing now. I am currently on birth control and Zoloft 50 mg daily. i did a thyroid test at the age of 17 and it was negative.
Hello. I have gone through your pictures. (attachment removed to protect patient identity).  The rashes do look like urticarial. It may be induced by environmental changes or it may be due to some other problem coming up. But, they do happen due to some form of inflammation going on. The pattern of your pain is a bit unusual as it happens in the night only. It may be due to your muscles getting fatigued over the long day of work. But, early morning stiffness, does point out towards another inflammatory disease. I am going to advise you on a few tests which you should carry out and meanwhile start on anti-allergics for these rashes. Do update me. Also, I would like to know details on symptoms like oral ulcers, hair fall, joint swelling, worsening of rash on sun exposure, dry eyes, dry mouth,etc.? The reason for you are on Zoloft (Sertraline) is still unclear. Autoimmune. 1. ANA (antinuclear antibody test), 2. ESR (erythrocyte sedimentation rate), 3. CRP (C-reactive protein), 4. CBC (complete blood count), 5. LFT (liver function test). Urticaria. Anti-allergic.