Skin blotches: Has anyone gotten reddish purplish... - PMRGCAuk


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Skin blotches

Alebeau profile image

Has anyone gotten reddish purplish blotches on their hands and arms? I see that prednisone can cause this at some point. The blotches appear magically and are roundish and small like the size of a shirt button. They take several days to gradually fade then disappear.

Just wondering if it is something to tell the rheumatologist about.


48 Replies

Not sure why but I have had them for some considerable time,they just appear for no reason that I know of other than due to Pred' other people may be along soon with far more knowledge regarding this subject.

PMRpro profile image

Purpurae - smaller ones are called petechiae

For us they are almost always due to the pred making the skin more delicate and the tiny capillaries in the upper skin layers are more delicate so they are damaged more easily and leak. I get them even just from letting the handles of my handbag or shopping bag slide down my arm! Or my wristwatch strap pinches a bit of skin. Often the bigger ones leave a dark patch of skin like a big freckle or an age spot and that is more likely to develop another one.

Alebeau profile image
Alebeau in reply to PMRpro

Thanks, that's a good explanation for these mystery spots. I appreciate your continued helpful feedback.

Rachmaninov2 profile image
Rachmaninov2 in reply to PMRpro

Mine were diagnosed by a dermatologist using photos. He said they were caused by prednisolone. I’ve been given an emollient and some steroid cream to use on them but they still keep appearing. I now have an appointment for a consultation with a dermatologist next week. 🙂

You shouldn't get them on a low dose

I have Inflammatory Arthritis, I was taking 15mg a week for six months, and have been reducing by 1mg a week now down to 8mg. I am also taking methotrexate. Have been getting other symptoms in my feet and legs, so beginning to think there is something else happening. 🙂

PMRpro profile image
PMRproAmbassador in reply to Rachmaninov2

Moisturing your skin - by using a good emollient and NOT using soap or anything else that foams to remove the natural oils from the skin - will help but not prevent them forming.

Rachmaninov2 profile image
Rachmaninov2 in reply to PMRpro

Thank you for the info. PMRpro, much appreciated.

PMRpro profile image
PMRproAmbassador in reply to diana1998

Some people do - especially once they started at a high dose, the capillaries in the area of the "scars" remain quite delicate. It is the same with ordinary bruises too.

Carver63 profile image
Carver63 in reply to diana1998

i still get them at 7 mg. actually its seems that the longer i am on it (PRED) the more sensitive my skin has become

diana1998 profile image
diana1998 in reply to Carver63

Mine appeared overnight on doses over 4mg not because I'd knocked myself. Don't get them now 👏

herdysheep profile image
herdysheep in reply to diana1998

Depends what you call a low dose. I am down to 5 1/2 and get them readily.

diana1998 profile image
diana1998 in reply to herdysheep

3.5mg... Nothing now

Alchemy8 profile image
Alchemy8 in reply to PMRpro

It seems rather ironic in the article that steroids are recommended in some cases as the treatment of choice!

Yes, I've regularly had these since I started taking pred, on my legs as well as my arms and hands. I also bruise extremely easily. Once I walked into my coffee table and tapped my left leg very lightly, and was left with a bruise that looked as if somebody had bashed me hard across my calf with a baseball bat.

Alebeau profile image
Alebeau in reply to Marijo1951

I can relate to that I have continual gashes on my shins from the simplest of knocks against things like recycle bins in the garage.

My eyes have serious cataracts so that doesn't help with my navigation skills. Another gift from prednisone still waiting my turn for treatment

Marijo1951 profile image
Marijo1951 in reply to Alebeau

The worst thing that happened to my legs was when I fell at a friend's house (August 2019, so pre-covid) and gashed my left calf wide open, needing two layers of stitches. It took ages to heal. it wasn't a serious fall, just a trip over her back step. Normally I don't think the skin would have broken.

Good luck with your cataract ops. I had mine fixed nearly 10 years ago, long before I was struck by GCA and PMR. You'll find the improvement amazing. I can remember standing at my living room window and finding I could count the bricks in the wall of the block of flats opposite. Previously it had just been a looming mass.

Carver63 profile image
Carver63 in reply to Alebeau


That and skin scrapes and grazes are a side effect - that an ageing of course 👍😅

I have hives come up usually on my arms but other places sometimes ,started getting them just before symptoms of pmr appeared but before I was on pred.

I had these - when I was on high dose pred for GCA- and had not only purple spots, but purple zebra stripes on my abdomen, which was a pretty extreme response but not pretty! As I reduced, they all disappeared and I was just congratulating myself on that when I got stuck at 4mg bcos some inflammation showed in blood test. Still on 4 three months later, and lo, a little purple spot appeared on my arm last week just to remind me it’s not over till it’s over. Think the cause is as Pro says, below, but also that high doses and, it seems the overall load over time, keep them going. Nothing to worry abt really. 😉

Alebeau profile image
Alebeau in reply to Carriemetz

Thanks, good that these things are painless and not itchy, u don't know where and when the next one is coming👍

piglette profile image
piglette in reply to Alebeau

Quite exciting looking for them and then seeing how long they last! I find they even appear on my fingers.

I have big ones and small ones. It is a side effect of pred and there is nothing much you can do about them. Sometimes it looks like I have been fighting with wild animals. As you say they just appear and then disappear. When I go swimming I count them up!! Sad lonely person I am!

Alebeau profile image
Alebeau in reply to piglette

Thanks piglette, I find your posts interesting so don't feel sad and lonely, we are all a team on this PMR journey tackling the same hurdles. Nice to have a place to share concerns about our symptoms and we always get positive feedback. 😊

piglette profile image
piglette in reply to Alebeau

Most people don’t swim a few lengths then look at their arms to count up the number of purpura on the other hand!! I reckon one appeared in the middle of a length.

Yes I definitely have them. Still getting them on 4.5mg.

I get them. They disappear much more quickly when you moisturize the skin. I would not use a steroid cream as someone has posted here they do as I believe in the long run that simply excerbates skin problems, having had some experience in the past (pre-PMR for another skin problem) with using hydrocortisone ointment and having trouble "withdrawing " from it and difficulty avoiding a flare up worse than the original problem. Just a good skin cream or lotion, preferably without potential allergens like "parfum", is best. Some people recommend arnica but I have no personal experience with it.

ancientprune profile image
ancientprune in reply to HeronNS

Arnica is wonderful for bumps and bruises as well as muscle pain.It's called the sportsman's friend.I've been using it for years homeopathical;y and recommend it to all my family when needed.Itcomes as a cream or in pellet form to use orally.I even sometimes use it to ease muscles now on occasion now while tapering my pred.

Alchemy8 profile image
Alchemy8 in reply to HeronNS

A nurse who was dressing my latest wound recommended yellow petroleum jelly which you can get on Amazon. I am also using coconut oil mixed with iodinewhich also seems to be helping.

Alebeau profile image
Alebeau in reply to Alchemy8


I’ve had the same for the past two years. Mine usually appear overnight - I think it’s when I turn over in bed and rub my arm. It concerned me at first but I’m used to it now.

Yes I get them too. Not so much on lower dose 4mg but mine (4 of them on leg and arm) didn't go away so was prescribed Efudix cream and the annoying little things turned into scabs and then went away. Not sure they are quite the same thing as yours but glad they go away! Hope the cataracts get done soon. My OH had them done and said it was like a miracle,

I get them on my arms and hands when they have been exposed to sun.

Yes I have them, mainly on my arms and legs. I am on 5mg.

I have had them for 2 years now, even though I have reduced to 9mg.Doctor explained that the Prednisolone is to blame and told me to keep my arms (and legs) moisturised every day.

As a 6 year sufferer with the Polymyalgia I am very familiar with those blotches. With me they are sometimes the size and colour of huge strawberries. (Not that I am bragging!) Apparently the Prednisolone sucks out the subcutaneous fat from the arms which would otherwise provide a cushion against the knocks and mild abrasions of life.

But for me there is light at the end of the tunnel ; I am now successfully down to 4mg of Prednisolone PER WEEK. And then the fat should start naturally returning to the skin.

I have them constantly and my consultant said they are from the pred. Appart from looking not so nice - there is nothing to worry about. Welcome to the pred club! I have been told that I have typical steroid user’s arms. Skin have darker patches on arms too. Same thing xxx

I get them. They just appear.

I've had these blotches since before PMR, and think mine are due to taking blood thinners (clopidogrol) . They do seem to be a bit worse since taking Pred, so maybe that does exacerbate them?

I have shirtbutton bruises, but have had them before either PMR or Prednisone. Haven't seen a doctor about it. Didn't seem important enough.

Hello I definitely have this and bruise easily .I was worried so sent pictures to Docs she said keep an eye on them and moisturise .I did and they went on 6 mgs. Of Predisoline . Still getting them but less concerned sounds like it is common by your replies. All the best .

Alebeau profile image
Alebeau in reply to Barbaracole

Thanks to everyone for answering. I at least know what to call it now "purpura" and not to worry as it is quite a common occurrence with steroid usage.

Yes I’ve got loads on my arms.

Prednisone can exacerbate the tendency to develop Bateman’s purpura (also called senile purpura, which is an unkind term, especially since I have it, and I don’t think I’m senile (yet)). Don’t use a topical steroid on it, because that will also exacerbate purpura. An ammonium lactate lotion applied regularly can improve skin resilience and integrity. Urea and retinol creams may also be beneficial, and there is no reason that combinations of all three cannot be used, since there are different mechanisms of action, and there may be a beneficial synergies.

Alebeau profile image
Alebeau in reply to Gibguy

Thanks for those suggestions, worth a trial to see if there is any improvement.

On a very rare event these days I was using the vacuum cleaner (upright) and it fell on to my elbow. What a bruise. Still there more than a week later. Be warned. Housework is dangerous.

The purple spots and areas are called purpura. I’ve mentioned them to my rheumatologist a couple of times and she seems to think they’re no big deal. Some days I get them more than other days. They never hurt, but they are very noticeable. I definitely think the prednisone contributes to them.

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