[Miscellaneous] I had a horrible appointment with a derm today who really pushed medications that I'm not comfortable taking due to a chronic illness and the appointment ended with me in tears. I need to vent and get some advice.

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For some background I have MCAS, or mast cell activation syndrome. Basically my mast cells, the white blood cells that are responsible for releasing histamine in your body, and overreactive and constantly release too much histamine. This causes me to have many symptoms after eating, taking most meds, exercising, stress, exposure to extreme temps, and sometimes for no reason that range from unpleasant to dangerous including swelling of my cheeks, eyes, tongue, and throat, flushing of skin, dizziness, headahces, hives, stomach issues, itching, asthma attacks...and horrible pustules and cysts all over my cheeks and jawline that itch and hurt. These cysts and pustules increase when I eat some of my "trigger foods" such as higher histamine foods. I'm on lots of antihistamines, mast cell stabilizers, and have started xolair shots to treat many of my symptoms. My specialist suggested going to derm for the acne.So today I went to the dermatologist and they pushed isotrenionin hard. With my immune system and its reactions, I'm terrified of this stuff. I've been told I would need to use condoms in addition to my iud (I react to all condoms I've tried, even non-latex) which I don't think I can do. I also have a history of depression, but my derm dismissed these concerns saying "he never sees that happen". He went on to say that "no one has allergic reactions to Accutane" and that "he's never seen anyone get hives or anything" with it. But my throat tries to close with benadryl so I'm not a typical patient. He explained more of the side effects stating that you get extreme sun sensitivity. Well I already get hives from the sun! I cannot handle more sun sensitivity. The dry skin side effects are a problem too, as most lotions irritate the hell outta my skin. When I brought up these concerns I was basically dismissed and told to call my mast cell specialist to double check I would be okay on Accutane. I was also given spironolactane as an option but that wasn't explained well. I was handed a paper on that to read but ive been too upset to try. I just feel so disheartened. I know my chronic illness complicates things and this term was probably doing his best, but I still feel like shit.Is this normal? Do derms do this when a patient has a complicating illness? And what are some other options for potenitally allergic acne and pustules/cysts? I just feel so lost.Tldr; I have an illness that makes my immune system act like I am allergic to e everything. Derm pushed Accutane despite my concerns. Upset and wondering what to even do next.
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