Hi All,
I've got a Rheumatology appointment tomorrow and a Dermatology appointment next week. My brand of photosensitivity is a major question.
Do any of you experience this?
1) Bright red burn of any exposed skin in 10 mins or less, which then stings like a 'real sunburn' for about an hour before both disappear completely.
2) Burning sensation on skin through clothing, including SPF50 clothing and some driving gloves.
3) Scorching, as if by a magnifying glass, through windows on bare skin and through clothing. It happens even when I put a wool blanket over my jeans(!). The sunlight still burns through creating an uncomfortable feeling, less severe than the scorching one, but one that means I have to move from any rays of sun inside or out.
I have all the precautionary stuff and I know about UV filters for windows/cars, but my UV gloves don't work fully when the light comes through windows, so just wondering if anyone else experiences this where some UV blocks don't work? If so, what tests did you have? Light testing for different rays beyond UVA/B like infrared, blue light..? Are you taking any treatment that works?
I've got a baby pram umbrella (UVA/B blocker) that does work inside/outside, but I was hoping once we got in control of the UCTD with meds (lots of symptoms gone now after 1+ years of meds) that the sun sensitivity would go too. But no such luck... It seems worse this year. So I'm wondering that it's not caused by CTD but something else entirely. I'm already medicated for Mast Cell Activation Disorder and though that's working for the rashes and urticaria, it's not touching this either.
Anyone? Feeling a bit desperate for ideas since my Rheumy has done all she can, but my Dermy might be able to do more if I have a direction. I really, really don't want to resort to having to make my own astronaut suits from old baby prams... : )
Panda x
Do you see an immunologist? The guy I saw who has researched mast cells for thirty years uses Cyclosporine with his autoimmune MCAD patients who are severely affected. What you are describing seems like a reaction to intense heat. Like you, I had rashes and that can be confusing because of our photosensitivity. But my rash turned out to be flushing. Have you had the 24 hour test and the tryptase test along with the other blood tests? Such a hard problem. Wishing you luck. K
Kay, thank you!
No immunologist in my area. But I don't see why I couldn't be referred further afield. Good idea! I will put that in my back pocket if I get no joy with the Dermatologist. I would say the above is not a rash (it is exactly like a sun burn, but it can't be that either because it disappears far too quickly). If stayed out longer, I think I would blister. I just can't stand it long enough to find out though.
I will also look into the Tryptase test and ask for it if it matches much of what I have. What is the 24 hour test? Is it for the Porphirias? Because I JUST found this information a few days ago about a Cutaneous Porphyria called EPP (Erythropoietic Protophorphyria). It's mostly in infants, but does crop up in the rare adult. I'll post it in case anyone else has something similar. It would be a LONG shot if it was this, but the symptoms are the closest I've found to mine it's identified by blood test.
"...As blood passes through the skin, the protoporphyrin absorbs the energy from sunlight and this sets off a chemical reaction that can slightly damage surrounding tissues. The nerve endings in the skin interpret this as itching or burning pain... The light that protoporphyrin absorbs is different from that which causes ordinary sunburn. Usually sunburn is caused by the shorter wavelengths of ultraviolet light (UVB), but in EPP the skin is more sensitive to longer ultraviolet wavelengths (UVA) and to visible light...
...The symptoms of EPP...typically start with abnormal sensitivity to sunlight. Exposure to sunlight causes tingling, itching or burning, which may be associated with redness and swelling. These symptoms usually occur within a few minutes of skin exposure to sunlight, and often take hours or days to resolve.... The light producing these changes need not be direct – light reflected off water and sand, or passing through window glass, including car windscreens, can also cause the symptoms....
...As EPP...affect the production of haemoglobin, it is not uncommon for people with EPP to be slightly anaemic..."
(A couple months ago my bloods were slightly anaemic.)
Full article:
britishskinfoundation.org.u...
Thanks again Kay. I've got some suggestions now which always helps when I get the blank stare or get told to use UV filters, wear the clothing, etc. Or that I simply could not be burning through jeans! But I am...
Panda x
Maybe mention getting a referral to an immunologist at both appointments. MCAD is a newly described illness, and there are very few immunologists with the experience with it. The 24 hour test involves a leucotriene test that my doctor didn’t think labs did in New York. And it isn’t just the testing but the recognition of the syndrome. Do you have GI issues, food allergies, hives?
I will look around a bit. Message the big cities you live close to.
K
Yes, smart, Kay. I will try to slip it in tomorrow with the Rheumatologist. Although I'm also broaching the HUGE breast explant topic with her. This feels like the biggest appt with her so far!
My Rheumy is on board with the idea of the Mast Cell disorder, but it got left in limbo because the junior Dermatologist who was guessing at it has moved away before any testing. He had put me on a Leukotriene inhibitor with antihistamines. And these stopped my spontaneous year long out-breaks of hives and florid urticarial vasculitis reactions. So, the Leukotriene testing sounds important for me.
Absolutely no food allergies. No hay fever or other allergies. GI troubles started just months after this all started for me. Constipation -- rabbit pellets. (Never had it before.) That's gone now with my MMF treatment, but when I was off it for a month last summer, the constipation came straight back. So I suspect it's still lurking in the background.
I feel really grateful for this immunologist thought, Kay. I think there's a teaching hospital about 5 hours away. I had looked this up long ago, but had utterly forgot about it once I was in the system.
P x
I'm on ciclosporine for SCLE..prescribed by my dermatologist n it's helping my many varied skin issues!! Alongside loads of other meds I might add!! Xx
Hi, that's great to know it's helping you! Someone I know is also on cyclosporine and it makes a real difference for him too. Do you know if Cyclosporine can be taken alongside Mycophenolate and Hydroxychloroquine? P x
I'm taking hydroxychloroquine as well..n steroids which I have problems reducing..so I'm staying at 10mgs for now!! My dermy is wanting me to increase ciclosporine n has prescribed the increase but I've got increased blood pressure at the moment which I had to check because it's a possible side effect..so now I'm taking med to bring bp down before I increase ciclosporine!! Hope that makes sense!! I did have problems taking it at first..the pills r like silver bullets n I found them really hard to swallow..but perseverance paid off n I'm ok on them now..u have to have regular blood tests during treatment to keep an eye on liver n kidney functioning. Xx
Sounds like I'd probably have to swap over my Mycophenolate for the Cyclosporine, though it's a good question for my Rheumy later this aft and/or Dermy next week. Myco has the same regular blood testing bi-weekly and the pills are horse's teeth. So I'm used to the routine.
Thanks again! Px