Last week a stumble against the bedroom wall whilest undressing caused her to raise her arm to prevent a fall but the friction against the wall was sufficient to tear a flap of approx. 30 sq.cm. plus an injury to her leg. Fortunately our local medical centre provided excellent first aid care and healing is progressing well.
By the year end we will be back in England after forty years of expat living. We will follow up on the recommendations for rheumatologist treatment trusting above all that there is light at the end of this very dark tunnel.
Is the condition of my wife's skin typical for pmr/pred sufferers?
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Yorkie2
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Thin skin is very common in Pred takers. Skin care is very important as in moisturising to keep the skin supple to help it stretch a bit better. The sort of injury in the pic will be 10 a penny for nurses in medical centres.It looks like they’ve got the edges well taped thoughthe top wound will have to grow its own skin.Light compression hosiery can help protect the skin and stop fluid pooling the tissues.
Unfortunately Pred makes the skin very thin and papery and prone to exactly what happened to your wife. It happened to me early days when I caught my arm on a radiator whilst on holiday in Spain - made a right mess!
The only way to deal with it is to moisturise it as much as possible with something like Double Base, that’s makes it a little more pliable; avoid soaps on the skin that makes it even drier; try and keep it covered with a light weight blouse or trousers; stay out of direct sunlight; and avoid hard surfaces!
It does improve as you reduce Pred, but unfortunately never seems to disappear altogether- I’ve been off Pred for 2 years, and still get the occasional mark, luckily not a tear like your wife’s.
Hi Yorkie2. I am down to 5 mgs from a starting dose of 80 mgs and it does happen less to me now, but it does still happen. I woke up the other morning with a new "bruise" on my arm with a cut in the middle of it and blood all over my freshly changed sheets. Argh! Best of luck to your wife. She's lucky to have you caring for her.
I am having knocks and bangs that are open ripped skin look awful and have taken she's to disappear but as I'm tapering down off the predisinone my skin is healing nicely and I have fewer bruises but the slightest bang or scape still leaves a mess behind it' I hope your wife heals well and hopefully hers will start to improve heal and disappear as well, good luck
There are some vitamins, best obtained through diet if possible, which can help improve skin health. Vitamins D, C, E and K, both Vitamin K1 (most of us get enough through our diet, don't supplement if on blood thinners) and Vitamin K2 (at least two thirds of us are deficient in this because it's lacking in modern Western food, so may need to be supplemented; apparently an oral spray is more easily absorbed than capsules or tablets).
So sorry to hear about her fall and that is one nasty skin tear. I too fell a few weeks ago onto some gravel and tore up my right leg quite bad. Here's to hoping for a healing with out any complications. As others have stated the prednisone is bad news for our bodies, but we have to take it so we can heal.
I am so sorry about your wife's skin condition. My wife has been on prednisone for 29 months and she has bruises all over her body. Every time she bumps herself against a wall, the fridge door, car door, etc., she will have huge bruises. People that don't know us see us together and when they spot those bruises, I see them looking at me, as if to think that I am abusing her. I say that rather lightly now, but it is concerning.
Just as a side comment Yorkie mate, one of my big toe nails reacted badly to steel toe cap boots. It came up really badly looking like I`d hit it with a hammer. My GP, just laughed commenting that it`s trauma and to stop wearing the boots if it`s poss, the blood nail will grow out.
P.S. the boots were made in China, I`ve given them away.... : )
I’m afraid it is par for the course with steroid treatment. I am down to 1mg pred now and still having to be careful. My hands arms and legs are covered in scars from the awful tears I have had. My skin has improved a bit now but will still slough off and bleed. That looks a horrendous tear. Your poor wife.
Sorry to learn of your wife’s arm. Unfortunately this is a side effect of Pred. I am taking K2, have been advised this may help to thicken skin, however too soon to have results yet
Your poor wife. Most of us have bruises, big to huge, but your wife’s are excessive.
Where are you living at the moment? And why the move (if I am not being impertinent)? I ask because we have been expats for 47 years (Germany), but we wouldn’t like to return to Britain - unless forced! Probably wouldn’t even be able to afford it!!
Hello...I too have had instances of skin tearing from slightest bump or snag, but not as severe as your pix show. One instance wad exiting taxi at airport where the door grazed my arm and didn't realize the result til entered airport with blood pouring from arm. Had to find first aid station asap. I now carry a bag of bandages with me at all times. Luckily, my daughter is a graduate of Chinese medicine and an herbalist who gave me 2 miraculous meds to have on hand. One is Die Da Jiao and the other Yunnan Baiyao which you make a paste of and it stops the bleeding and nourishes the healing process. Don't know if you have access to something similar but it truly works. My best wishes for her healing. It definitely is a side effect of the pred. What is her present dosage? Please keep all informed
Oh that looks nasty. Just to add to those who said to keep the skin moisturised - Eucerin lotion "10% Urea" is one of the best lotions for moisturising. It has to have the 10% Urea on the front. There are other Eucerin lotions. It might just help to keep the skin moisturised. (My son suffered with extreme eczema and this is the best lotion out of tons over the years that had the best affect). It can be even used in conjunction with other creams on an alternative basis once you get some results. It is expensive but for dryness it is really worth it. Best wishes.
I have found Organic coconut oil is very effective - has helped with my iatrogenic Lipodermatosclerosis. Best to apply on warm skin, following a shower.
I am so sorry but as everyone has said, it’s par for the course. In addition to constant moisturizing, I have learned to keep my skin covered. I mostly use compression sleeves like many athletes use. I also wear gloves with open fingertips. My forearms and hands seem to get the worst of it. Mind you the sleeves and gloves don’t prevent bruising but they seem to help to prevent the tearing that I often get with the slightest bump. I also keep plenty of steristrips on hand and have become expert at putting myself back together by cleaning the area, putting the flaps back and securing them with the steristrips. In about three days the strips start to fall off and the skin begins to reattach.
Sorry to hear about your wife’s arm. However I have to say although I am the one with PMR I have lived with this for over 20 years as my husband who has used steroid creams for 50 years has skin which is constantly tearing/ bleeding/ bruising at the slightest bump and has had stiches on several occasions. It happens and he and I cope and it doesn’t stop us in any activity - cycling, walking - ‘bramble’ picking! He is 74 - fortunately my skin is ok so far?!
Ooh Yorkie 2 - your poor wife, it looks so painful. I also suffer from fragile skin due to pred. |Last few months have been awful, the slightest brush against walls, doors or even cardboard boxes results in torn and damaged skin. luckily, not as bad as your OH. I'm on 10mg pred at present but as I have diabetes 2 this aggrevates condition and takes weeks to heal. Last bad leg wound from end of May only just healed! Glad she was well looked after at hospital.
Oh, I hope you wife is starting to feel alittle better, that looks so painful and my heart goes out to her.
I read Herons message and it is spot on.
Many different illnesses cause skin health issues, and whether you are on steroids or not can cause skin thinning and dryness.
One of the best ways to help improve you skin health is from the inside and with your diet, and as you are still in Spain, surrounded by the best in Mediterranean ingredients you have an advantage on many of us.
As well as Vits D, E, K and C , the best nutrients to get inside you are Vit A ( retinol), Zinc, Selenium, Magnesium and Collagen boosting foods.
Oily fish, like those wonderful Spanish sardines and salmon, mackerel are great.
Yummy shellfish ( get that paella pan out!) great for boosting your minerals.
Chicken and very lean meat too.
Eggs, once again not a diet taboo , thank goodness! are great for collagen.
Liver, green vegetables and a good variety of fruits, all wonderfully used in Spanish cooking.
And garlic is wonderful to help healing and circulation of the blood in the skin and body.
And the master Spanish olives, oil and almonds and Spanish honey.
Fab Olive oil , if you are not intolerant , it is good for skin on the outside too ( not your extra virgin of course) , especially rubbed on very dry areas like elbows and knees. Cheaper natural coconut oil ( solid form) with addition of vitamin oil drops and your favoured essential oil is a great skin boosting moisturiser on undamaged skin.
Natural shop bought moisturiser with no heavy preservatives or perfumes are good too.
A coconut oil supplement is good to take .
If you are vegan it is alot harder to get the added VitA ( retinol) as it is animal based and Collagen in the diet to help skin health. Seaweeds mixed in stews or soups help with the boost in minerals and boost collagen production, but a really good vegan collagen booster supplement helps too.
Your in the world of tapas, a country that understands eating small portions and often. This is a great tip for diet on Pred. Little portions five times a day and little healthy snacks like fruit or nuts and plenty of water and green tea , packed with the above foods , salads , fresh fruit help to improve your skin but also stave the steroid hunger and reduce weight gain from eating too many calories when you are hungry or inactive.
Obviously with your wife's injury , no cream or ointment should be used except for the ones provided at the moment.
The best way to help healing is by keeping it dry to stop infection and scarring, and boost the vitamins in your food. Get some of those water resistant adhesive dressings like Techaderm, used after surgery, you can keep it bone dry in a shower .
However a good Zinc cream ( there are medical versions) rubbed on the areas on the rest of the arm will help speed healing , and when it is healed over completely will speed healing near and on the actual area of injury.
Very gently massaging the skin on the other side of the arm , the hands and wrist and parts of the arm upto 2 inches near the site helps boost and maintain the circulation in the areas of injury which also speeds up healing and helps stop infection or ulceration of the wound areas. It will also soothe some of those extra joint aches and pains from the nasty fall.
This is really handy for any types of skin injuries or spots and lesions that happen on thinning skin.
On a day to day basis, when there is no injury, the diet and good natural moisturiser ( twice a day in hot or dry climates or after swimming) will help, and extra moisturiser , vaseline or good intensive cream on dry patches , elbows , knees , hands and feet just before swimming, any exercise or when you get back to Blighty and have to put on all those extra layers of clothing because of the cold winter weather. Epsom salt baths are also great for the skin as well as the joints once a week, you can add a spoon of powdered milk and a spoon of standard honey, and a few drops of rose and lavender in the water too to add to skin softening.
I hope this helps not just with your present situation but with your wife's general skin health when she is fully healed , and I am sure everyone on this site want you to send them their electronic hugs.
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