skin flare up - drug side effects? Or just auto immune?

[AW600]

I take 20mg MTX and 5mg Folic Acid once a week for RA. Also on just ibuprofen (naproxen affected my tummy too much even though I’m taking omeprazole) and paracetamol for pain. I also have auto immune chronic urticaria so take 360-720mg fexofenadine, 10-20mg rupatidine and 20mg montelukast daily. My skin has been pretty much under control but I’m 6 months into the RA drugs now - I’m weening off Prednisolone (started on 10mg daily in October and have been reducing by 1mg a fortnight for a few weeks, so I’ve only 2 more weeks of them now. . My face has flared up with what I thought was my urticaria, but it seems a bit different to what I’ve had before, like spots, a bit lumpy and rash like. Hot and itchy at times. I asked my dermatologist for some rosacea cream as wondered if it could be that, although I haven’t had it before. My usual steroid urticaria cream hasn’t shifted it. I just wondered if anyone else has had skin problems with MTX or from coming down off Prednisolone?

[Pythagorus]

Methotrexate does make us more susceptible to the rays of the sun. Do you think our recent hot weather may have affected you.?It sounds like you have quite a lot to put up with without this additional problem.

[AW600 in reply to Pythagorus]

interestingly, if I have a day in the sun my face more or less clears up

[Fg45]

hi. I’m on hydroxychloroquone and methotrexate and started having flare ups on neck and face since last august. Anti histamines help a bit. Steroid cream helps a bit. It’s not hives , excema , rosacea or psoriasis , I thought it was a contact dermatitis at first. Eventually went to gp who has referred me to an auto immune dermatologist as he thinks it might be a connective tissue disorder! I just wanted stronger cream lol. I’m hoping he’s being overly cautious but will have to wait and see. Certainly my skin during flare is totally different to anything I’ve had before , and very like you describe.

[TheBoys]

hi

I get hive flare ups all the time- well, most weeks.

I use a liberal dose of Acnecide ( otc from pharmacy) now - i usually get lumps on my back or chest/tummy . It quickly disappears.

[Dobcross1]

Yes, you have my sympathy! I posted the other day about a rash on my face which is driving me mad! I don't know if MTX has made my skin so sensitive (on 25mg) or is it Lupus or something else but just don't know. I've asked Rheumatology and sent photos but they haven't got back to me yet. I really hope you are able to get some answers and treatment which helps soon.

[AW600 in reply to Dobcross1]

I am seeing my Rheumatologist next week so hopefully he can advise too. My skin was sensitive enough before starting MTX 🤦‍♀️

[Blodynhaul]

I did used to have bouts of itching & sensitive skin when on MTX for many years and similar effects when on steroids, but didn't have your other ailment/s or medications. Hope you get to the bottom of it!

[LuzyCLL]

My Rheumatologist has me on 2 mg folic acid per day. Take B complex too. It may help. You have a lot of meds, I can understand why that may cause problems. Be sure to take them with food, and eat lots of vegetables.

[Aporiac]

I believe the reason for tapering prednisolone is it shuts down natural corticosteroid production in your body, which only gradually restarts as the prednisolone is reduced. Even though a 1mg/week taper is very gradual, you could ask if you can pause or go back to the dose before you got the flare and see if that makes the problem go away. If it does, ask about holding that dose for a few weeks before re-attempting an even slower reduction. If the problem is the mtx, but it's effective at controlling the RA, you could ask about reducing the dose (possibly in conjunction with a switch to injectable form). Good luck!

[AW600 in reply to Aporiac]

Thanks, I am seeing my rheumatologist this week so have lots to report to him. My pain and movement is also worse since coming down off steroids, I’m wondering if 20mg MTX isn’t enough 🤔