Im a healthy 34 year old white male. Developed a hard patch on my left index finger a few months ago similar to callus (callus was rulled out, i am right handed, when history was reviewed). Next my finger and hand developed a few lighter flat patches with irregular boarders....

Off to Derm.

Derm decided the hypopigmented areas were vitilligo - removed and biopsied a halo nevus and ran a ANA. (they didnt know what to make of the hard patch itself - but that area, tho not visably hyoppigmented, lit up under the black light along with the others). Biopsy was normal, ANA came back high (1:320)...

Off to Rheumatology.

First saw a fellowship student here who reviewed my hx then told me we were going to run a bunch of lab test. She left me to talk to the attending. When they came back they told me that since my main symptom was back pain they were not going to run the blood work but would do a back xray instead. The Attending stated that she didnt know why derm would order an ANA and that she didnt know why it was high.

I searched my old medical records and found that i had NORMAL ANA 4 years ago....

I have daily lower back pain (worse in the am) and a lot of general achyness in my joints that people my age dont seem to have. My tendons tend to get infamed easily if i dont spend alot of time stretching them before exersice ( i had to give up bike riding as i would get pretty nasty tendonitis in both my formarms & runnin is awfull on my knees and exacerbates my back pain). As a side note i was diagnosed with both tension head aches and migranes a few years ago. Other then that im in perfect health and take no meds.

It seems to me that Dermatology ran an ANA for a reason - and that since vitilligo is an autoimmue disorder i would imagine that increases the likelyhood that the elevated ANA is not a normal finding for me. That coupled with a previous ANA that was normal years before.

Im frusterated. Does a diagnosis jump off the screen? Should i insist they run more blood work in seach of a cause or should i just keep an eye out for development of new symptoms as they suggested?

Thanks so much !