Hello and welcome !
I am wondering if you have any symptoms of systemic disease such as arthritis, episodes of pleurisy or similar lung problems, pericarditis, anemia, hair loss, mouth or nose ulcers, undue fatigue, Raynaud's which is cold extremities that change colour - red white blue -abnormal white blood cells, swollen lymph nodes, protein in urine, fever and general flu like symptoms for example. This doesn't need to be all the time - symptoms can come and go and vary.
The ANA should be repeated and if it is positive further testing for auto antibodies should be done in fact there should be thorough testing if it is shown to be lupus related skin even if ANA is negative. Try to find out what the ANA titre was before.
A dermatologist is the obvious place to start for confirmation and if it is subacute he would either do all the necessary specialist testing and then refer you if necessary, or would refer you to a rheumatologist for further care.
Some dermatologists are more careful than others.
However, I suggest that if you have any of the symptoms mentioned above that you see a rheumatologist first all, depending on who you can get an appointment with soonest. Cover both bases sort of thing if possible. If you can make an appointment first with dermy go for it but make an appointment with a rheumy too which you can cancel if you are fully satisfied with the dermy. There's often a quite long waiting list for rheumies especially the good ones.
They vary very much how concerned they are about skin
If it is subacute, it is very possible that a dermatologist will start you on Plaquenil which is the first oral medicine for skin as well as systemic disease. If he doesn't start you on it that could be a sign of inadequate treatment.
Subacute skin is very likely to have some systemic symptoms along with it even if there are no antibodies.
It's impossible to be quite sure oneself what the ski problem really is because skin conditions can look very much like each other. Sometimes a biopsy is necessary However if the first dermy you saw thought it was subacute that would certainly fit in with DILE because that medicine is known to cause subacute.
If these current lesions are the same, it suggests that the drug triggered clinical lupus. There are a few lupus skin experts around in the USA whom you might be able to access depending where you live.
I am not sure what you mean about the chilblains. Are they in separate places, such as fingers or toes, from the subacute or mixed in with.
Well, a dermy can tell - I am just curious especially as from time to time I had a sort mixed in with my other subacute facial lesions which resembled blisters. I never thought of them as chilblains because I always think of chilblains as being on toes or fingers. They were sore swollen flat topped raised with clear liquid in them, red and very itchy, very fragile. They would often subside after a few days not larger than 0.25 " x 0.75". Sometimes the skin would come off, if it got rubbed or pillow pressure. They typically appeared just before my period.
Chilblains on fingers and toes are associated with systemic disease.
Just make sure that thorough testing is done. Your GP can do CBC and urine as well as ANA
Let us know please how you get along - we'll help you all we can so just ask.
Bye for now
Clare