Hi again Bob,
I've read your reply carefully and am trying to give you insight. I have done some research and have some ideas and recommendations for you.
First, you have been seen by several specialists, and have not gotten a definitive diagnosis, which is good because perhaps nothing is wrong. Unfortunately it can take a long time to determine the cause of symptoms.
I would like you to see a skin specialist, a dermatologist, at your earliest convenience. Take pictures of the blotched areas when they appear so that you can show them to the doctor just in case they disappear when you have your visit (this happens quite often). Next, I recommend that you consult with an allergist to rule out any type of allergy that is causing the breakout. You can askyour doctor to do a rast profile which is a preliminary blood test that would indicate what you may be allergic to.
Next, ask your doctor (rheumatologist) if he did an arthritis profile on you and find out if you were tested yet for any auto-immune diseases such as Lupus. Some of this testing may have been done.
You described that you work alot and do manual labor, and you may be straining your pectoral muscles. I am trying to reach for different possiblities with you. Thank you for giving me some of your past history. You can consult with the doctors that you have seen, over the phone and demand more definitive answers. Find out what their plan is for you.
I hope all will be well with you!
I am here if you would like to talk further.