Adalimumab and psoriasis side effect?

[Julia31]

Hi

I've been on adalimumab for about ten weeks and two days after my last injection I came out in a rash on my feet and calves. I've had it swabbed and it's negative for virus and bacteria and the consensus seems to be that it might be psoriasis,which I've never had before but which can apparently be triggered by adalimumab. I'm using a steroid ointment from the GP while waiting to see a dermatologist but the consultant recommended carrying on with the biologic and trying to manage the psoriasis. I'm feeling very unsure about this as it's a really nasty rash with pustules. I'm seeing my rheumy nurse on Thursday but just wondered if anyone else has had this as a side effect of adalimumab? I also take leflunamide but have been fine on that.

Many thanks.

[Lizzery]

Hi, I’ve been taking leflunomide for around 10 years or so, and 2 years ago, a rash appeared on my foot, which sounds similar to what you describe. It has been confined as palmoplantar psoriasis. I had read (can’t remember where) that this may be a side effect of leflunomide. I’ve been using dermovate on it for quite a while now, and it’s very reluctant to clear up, so am seeing a dermatologist with a view to having light treatment. It’s a do, as one thing helps one health issue, and it may trigger something else, but it’s probably all just a balancing act!Hope you get some answers from the dermatologist.

[Julia31 in reply to Lizzery]

Hi Lizzery, thank you so much for your reply. I know I shouldn't use Google but mine looks like palmoplantar psoriasis to me too.I hadn't thought of the leflunamide. Maybe it's a side effect of that rather than the biologic. It's so hard to know isn't it without stopping the meds which we are so reliant on for our RA. As you say, a balancing act. I hope you find that the light treatment works for you.

[oldtimer2]

Wait until you have seen the dermatologist. There are several other things it could be looking as you describe it. You need a definite diagnosis so that you can can take a considered decision - it is so easy just to blame our medication (or our condition) and forget that we may get other conditions unrelated.

[Julia31 in reply to oldtimer2]

Thanks oldtimer2, that's true. It's looking like a very long wait to see the dermatologist but I have an appointment with the rheumatology nurse on Thursday so at least someone from the department will be able to look at it.

[Lolabridge]

I agree with oldtimer2 that it’s best to wait for a proper diagnosis. However, I thought Adalimumab is often prescribed as a treatment for psoriatic arthritis so I would be surprised if it’s the culprit.

[Julia31 in reply to Lolabridge]

Thanks for your reply Lolabridge . Yes, I spoke to the rheumatology nurse on the phone. She said that it is prescribed for psoriatic arthritis but paradoxically sometimes can trigger psoriasis in someone who hasn't previously had it. But you're right I need a proper diagnosis.

[notsochunky]

Hi JuliaI had the same problem. Had to stop Adalimumab, and rash eventually cleared up, after two courses of antibiotics.

It felt like it was travelling down my leg looking for new skin to attack.

I switched to Jyselica, but it hasn't been as good at dealing with my RA so wish I could go back on Adalimumab to see if it was a one off.

[Julia31 in reply to notsochunky]

Thank you notsochunky. Yes, mine seems to be spreading up my legs and also on my bum but my feet are the worst. They look really angry and are itchy and sore now. I've never heard of Jyselica. Is it another biologic? I'm sorry it's not working for you as well as adalimumab. Would the consultant not agree to you giving it another try if that's what you'd like to do?

[medway-lady]

It is difficult and I got Discoid Excema when using Abatercept. But because it coincided with getting Covid I wasn't sure it was the Discoid. Anyway I stopped it for q month and used the awful stuff the GP prescribed and it did go so I restarted the Abatercept and so far its not come back. If it helps the big green bottle stuff the GP prescribed actually made my rash worse! The label has come off so don't remember what its called but anyway I found that Clinique Cream body wash and body cream worked a lot better. I think that the green bottle stuff might have contained lanolin and I know I have a reaction that.

[Julia31 in reply to medway-lady]

Thanks for your reply medway-lady. I'm glad the eczema hasn't returned. That's interesting about the Clinique products. It's great when you find something that suits you. Since getting this rash I've bought soap free washes as I feel that soap dries my skin more. I'll be mindful of the green bottle stuff if it's prescribed me.

[medway-lady in reply to Julia31]

I just wish the label had not come off. lol Soap free washes are good and Clinique is soap free but I was religious in applying the body cream after every shower. The thing was I always used their facial skin cleanser and realised that if I used it on my arms it sort of felt better. So thats when I thought about and did buy the body cream wash, Aveeno also do a great body washes and moisturiser.

[Julia31 in reply to medway-lady]

Oh that's a coincidence and good to know as I've just picked up an Aveeno moisture cream and body oil wash from the chemist! Fingers crossed it helps. Rheumatology nurse tomorrow so I'm hoping she will be able to advise me more on RA medication.

[medway-lady]

Best of luck x I'm sure now it was the post Covid skin.

[Julia31 in reply to medway-lady]

Thank you. I'm really glad your rash went away x