On methotrexate and pred, have been exposed to fungal skin infection. First aid advice please.

[Dontwannabesick]

Hi I am currently on 23 mg pred and 25 mg methotrexate subcutaneous and I'm doing fine. But today I had a visit from a very dear friend whom I've not seen in ages. His skin on his face looked like the results of bad sunburn, red and flaky. Later in conversation it comes out that it is a fungal infection. I have given up hope of making people understand my vulnerability. But it's early hours in UK Sunday. Can anyone advise please if there steps I can take to prevent catching this infection? (Already been on the receiving end of hugs and kisses)

[Blearyeyed]

The only thing you can do at the moment is do what you have probably already done , had a shower or wash.

Clean your teeth and gargle with mouthwash and hope .

You could also increase your Vitamin/ Mineral supplement and fluid intake the next few days.

Don't eat any fungal or yeast products or sugar for a week and this could help prevent increasing or feeding any fungal activity in your system.

Keep an eye out for and hot , itchy and red skin or hot , itchy , swelling in the mouth of the lips.

If you feel this on your skin you can try using a zinc based cream first then if it is worse see the GP or get hold of some Canesten or Fucidin ointment .

Allow any ointment to dry well on application .

Between applications wear light clothes or allow the area free to the air as the air does help healing.

Wash without soaps and pat dry and allow some dry healing before adding new ointment.

You can relieve bad itching , just like with sunburn, by putting cold probiotic yoghurt on the area leaving it for 15 mins then washing it off in a cool shower.

Try not to get areas damp warm as this helps fungal growth.

Use talculm powder if you need to to reduce sweating.

If you feel it is beginning in the mouth , you may be able to stop the infection early on before signs of thrush ( white paste on the tongue or dry flaky skin at the corner of the mouth ) emerge by taking a one dose Canesten tablet , as long as this doesn't interact with any of your medications.

You can check this by showing the list to the Chemist.

If you get anything in the mouth , regular gargling with warm green tea with a little ginger , and eating probiotic yoghurt helps reduce fungus in the mouth and stomach, garlic supplements also help fight infection .

Don't clean your teeth within half an hour if eating but do the gargling to remove food and sugars.

Mouthwash before flossing and then again before cleaning with a soft brush to prevent encouraging bacteria or fungus into the gums.

If you have any worries see the GP , and if you do get something don't forget the lower immunity may mean that it can take longer to heal than before and you may need more than one course of medication.

Touch wood you won't need anything though.

[Dontwannabesick in reply to Blearyeyed]

Thank you

[SheffieldJane]

I wonder if your GP can prescribe something preventative for you? I hope you don't catch it. I’ve had narrow escapes too. I am not really sure how fungal infections are passed on, I guess they are contagious.

[SnazzyD]

Had it been diagnosed? Were they vulnerable to infection too?

Fungus is everywhere in particular fungal spores, it’s difficult to escape. You should see microscopic photos of your scalp! Garden compost, pets, foods, towels (especially if washed on low heat to keep them nice) etc. Things like ringworm need fairly direct contact with the person.

This US body has a good site that covers the bases and has a link at the bottom for advice and all things fungal.

cdc.gov/features/fungalinfe...

This is from that link

cdc.gov/fungal/index.html

[Hidden]

Pred, dmard and diabetes. Fed up of fungal things!! Everything that is laid out above.

Wash all the clothing and towels that contacted him on as hotter was as they can take. Wash towels in hot wash after every use. And you have to get what people think is "rude" sometimes. I don't shake hands these days, my family know better than to hug me if full of cold. It's not the cold that does me in...it just lasts an age. I am a bit bonkers now. I wipe handles of supermarket trollies etc. Won't help with virus or fungal things but helps me!

You can't keep yourself in a bubble so these things will happen. I keep a fungal cream in, a spray for shoes and feet, I found a tube of fucidin helped everything heal better...just a dab. I can take oral dose of anti fungal.

Hopefully, it'll be fine. But agree it can be aggravating, but people don't think anything is wrong with them really when they have these things.

[Hidden]

Ring the Out of Hours Number from your GP Surgery & ask for advice. Emphasis you are on both Prednisolone & Methotrexate.

They may well stop your Methotrexate this week but you can run that past your Rheumatology Team tomorrow unless you are due to take it today in which case l wouldn’t but wait to see that R.Team say tomorrow.

I know how you feel, l used to get heartily sick of people wanting to kiss & hug me!

Fingers Crossed it doesn’t have any impact on you!

Kind Regards

MrsN

[Hidden in reply to Hidden]

Thanks MrsN meant to say my Rheumy nurse told me after I had suffered a cold for 3 weeks I should stop the dmards for a week if I got something. I still forget.

[Hidden]

Did you ring Out of Hours, what did they advise?

[artfingers]

The 15 year old son of my massage therapist has cistic fibrosis and talk about the protective regimen! At school his teachers wipe down desks and things with antibacterial wipes and he has to be super careful who he is around. I guess I didn't realize we need to also be careful with colds and such. Not much use for me as I teach and am around 4 and 5 year olds (I teach the entire school art) who refuse to practice sneezing into their arms, and they are walking germ factories. Lucky for me after my second year of teaching, my immunity is pretty strong so I typically only get about one cold a year. I'll be more careful with fungal infections having read the above! So hot and steamy here in Michigan with our current high levels or rain, heat and humidity. Ugh!

[PMRpro Ambassador in reply to artfingers]

Sounds a bit OTT - my niece has cystic fibrosis. She has survived to over 40 mixing with horses and a veritable menagerie at home!