Hey everyone! I’m a 25-year-old guy in the UK, about 180 cm/86 kg, dealing with what my rheumatologist suspects might be an autoimmune condition. I have chronic joint pain (knees, hips, lower back especially) and I’ve been getting a burning red rash on my cheeks and nose that looks like a malar rash—lasts a few days, then fades. Blood tests show borderline low C4 complement, borderline low kidney function (GFR around 63), and protein in my urine. My RBC, hematocrit, and hemoglobin dipped during a flare, too. We initially thought psoriatic arthritis (there’s some family history of psoriasis), but now there’s talk of lupus or another connective tissue disease, especially with this butterfly-like rash, possible photosensitivity (I’ve had severe sun reactions in the past), and weird fatigue flares that knock me out for a day or two, I'm unable to feed myself and do any of my normal daily tasks. My ANA and HLA-B27 are both negative, but I’ve heard that sometimes lupus can still sneak by those tests.
I’m on ibuprofen and a few other meds (omeprazole, hydrocortisone cream, salbutamol inhaler, cetirizine) but feel like things are getting progressively worse: joint pain, rashes on my forearms and scalp, random bouts of exhaustion, gut inflammation, and even some eye redness and burning. My rheumy is open to more tests but isn’t sure yet if I should do a skin biopsy, repeat immunological panels, or more kidney screenings. Anyone here ever deal with something similar, or know if a biopsy might help confirm if it’s lupus or psoriasis? I’d really appreciate any advice—feels like I’m stuck in limbo waiting for a solid diagnosis. Thanks in advance!