### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
okay. I have several lumps under both of my arms. They started several months ago. They look like a mix between a boil and a blister . Sometimes, some of them will come to a head and pop, like a pimple, but not very often and only about 2 - 5% of them. They are painful to touch. I am 48 years old. At 29, I was diagnosed with discoid lupus . I was told it would only affect my skin- and not be very troublesome. Over the next few years I developed, arthritis, psoraissis (sp?) and then fibromyalgia . I have celiacs, and bladder problems and the list goes on and on. My doctor doesn t know what they are. He has perscribed several creams, and in the end sent me home saying I need to be re-assessed by a lupus professional. That could take months. In the meantime I have litterally 15-20 of these bumps under EACH arm, and they are painful! Thanks anyway. I m so tired of paying for stuff online and never getting an answer or what I thought I was going to get. Hope you make tons of money. Have a great day

### output:

Hello Jan, Your long-standing history of discoid lupus becomes significant here, and I presume you are on some treatment for your psoriasis/arthritis with an immunosuppressive agent. The common ones (at the start) are HY Chat Doctor. The painful lumps could either be your discoid worsening or some form of urticaria vasculitis that needs to be excluded. For the time being, you can either increase the steroid use (if you are on steroids) or start using a long-acting antihistamine like fexofenadine 180 mg twice daily until you have seen your Lupus doctor. Thanks.