RASHES WITH RA

[Knip]

Hi, I managed to see the nurse at my GP practice yesterday. I am wondering if any one else on Methotrexate, has vascular dermatitis or vascular eczema on their lower legs and ankles. It comprises of tiny red spots which are very sore and follow the line of the tiny capillaries just under the skin, which is very thin. I have been careful not to expose my skin to the sun because I know that MTX causes a sun allergy. Also building up over the last three weeks, since I upped my Methotrexate, my back has developed lot of red, dry, itchy patches, some of which are quite large about 3 x 2 inches or so. The nurse thinks this is eczema and that it's not caused by Methotrexate. I am now trying Audavate RD cream which she said they switched to rather than prescribing steroid creams. I am to apply this twice a day for five days, and then have a two day break before reapplying and so on. I had been using hydrocortisone before but she said the above would be better. I have a Rheumatoid Telephone appointment in a month or so, but didn't want to leave it until then because of how quickly it is developing. Just wondered, because so often on this site I have found others who have, or have had, these things and can offer helpful advice and give guidance. Fortunately because of the pain in my fingers and wrists I'm not tempted to scratch... that's finding a positive!

[smilelines]

Hi …. was just reading Angie4now’s post and it seems she was a rash, too. Methotrexate Reaction is the title. It is very frustrating to try to figure out if symptoms are caused by the medication, the disease or something else. It is quite awful.

[Knip in reply to smilelines]

Thank you for your reply Smilelines. I have just read Angie4now's post and I have to say my rash is nothing like hers and not as severe. I just can't imagine what that is like. It must be driving her crazy. I hope she gets some specialist help and relief quickly.

[Rachmaninov2]

I’m taking Methotrexate and developed a rash on my arms and legs. I had a phone consultation with a Dermatologist who diagnosed leaking capillaries.

[Knip in reply to Rachmaninov2]

That fits with what the nurse said about the rah on my legs. Did the Dermatologist give you any cream to put on it? My skin is so thin now, that I'm really wary of using anything that is steroid based. I am applying the Audavate RD cream very cautiously. The nurse said there is a high risk of ulcers or infection if it isn't treated. I really appreciate your reply; it confirms what I was told. Thank you. 🙂

[Rachmaninov2 in reply to Knip]

Yes I was given Elocon ointment and Epimax cream following a diagnosis of Prednisolone induced ecchymosis. The rash wasn’t itchy or painful, it was red in colour and non-blanching. My skin is very thin too, and I have red blotches on my arms, which are different to the rash. I have photos of the rashes. Hope it helps. 🙂

[Knip in reply to Rachmaninov2]

Gosh, thank you. I really appreciate your reply.

[oldtimer]

You said that the nurse said 'Audavate RD cream which she said they switched to rather than prescribing steroid creams'. It is a steroid cream, specifically it contains beclomethasone which is a stronger steroid than hydrocortisone.

It should only be used short term as a result.

Regular applications of a moisturising cream that suits your skin is also needed. Dry it carefully too.

Keep out of the sun (not that keeping out of the sun is a problem currently here - it's raining again).

[Knip in reply to oldtimer]

Thank you Oldtimer. Your reply has been very helpful. I am still feeling reluctant to use the cream on my legs, more so after reading your post. It was given mainly for the rash on my back, which is different, but the nurse told me I should also use it on my legs, because of the risk of ulceration and infection. I have been told to use it for five days and then stop for two days before resuming it and repeating the pattern. As regards a moisturiser I use Double Base cream and slather it on my whole body...as prescribed many years ago by my GP. I am really careful to keep my skin covered in the sun and even though I wear a hat and use a baby's factor 50 sun cream I still get a rash on part of my face from it! Take care, and thanks again for your reply. 👍

[bienassis]

Hello Knip.

I take methotrexate and developed vascular eczema a few years ago. I was told by a doctor in a dermatology clinic that it is common in old age and not connected with the methotrexate which I've been taking since 1998. It has to do with the thinness and dryness of the skin. I accepted that verdict (I'm 86 on Friday!) and make sure my lower legs are well moisturised - I use E45.

I also now have a biologic - Infliximab- which does cause skin problems, including eczema. I had a nasty outbreak on my lower legs of discoid eczema. It was treated with a hydrocortisone cream and mostly cleared up, and the moisturising regime also helps.

Having said that, many drugs cause rashes of some kind or the other - it's a common side effect. And in some ways difficult to treat. There are so many different types of eczema in particular. If you are getting large separate itchy lesions that could be quite a separate sort of problem from a rash.

I wish you luck - skin problems can be such a pain (in both senses) but sometimes after what seems ages they can clear up suddenly.

bienassis

[Knip in reply to bienassis]

Thank you for your very helpful reply. I do appreciate it.

[Jig-saw]

Hi, I just came across your post, I developed skin lesions (I posted and added a photo on My Skin) In my ears, nose round hairline, back and top of arms, was told not caused by methotrexate, told it was eczema in 2018 recently had a skin biopsy which showed it could be lupus or gluten rash, waiting for my blood screening to come back now, while I'm waiting I make sure I have my medical history and medication info ready and take note of any changes to my skin, hope you get it resolved.

[Knip]

Thank you Jig-saw for replying to me. The Audavate is keeping the 'back rash' well under control at present although it has not yet disappeared. It consisted of large red patches with smooth outlines from my upper back down to my buttocks. My son, who has psoriasis and psoriatic arthritis immediately said it looked like psoriasis...but the smooth kind...his is rough and scaly and very widespread. I don't know if it is possible to have that at the same time as RA. I moisturise my skin well every morning and evening using the Double Base Gel, prescribed for me many years ago by my GP. I intend to send photographs of the rash to my RA Department before my next appt in three weeks along with a note of what I have been using to treat it. I hope that you will get your skin biopsy results soon. I am totally gluten free because I have Chron's and it makes that very unstable indeed. May be you could share your results on this site when you do. Good luck and thanks again for your reply.🙂