Skin side effects

[jezzard]

Since diagnosis with PMR 12 months ago and now on predosilone7mg pd, I have developed many skin eruptions.They begin small with an itch and become larger and painful to the touch, then become crusty, They don't seem to go away. Common or what?

[piglette]

I have a lot of problems with thin skin and have had some quite nasty lesions. They do heal eventually though, although my legs look like a car accident. When you say they don’t go away do you mean each eruption is still there or does it heal and go away?

[PMRpro Ambassador]

Did they start recently or have they been appearing since soon after starting pred? Have you changed the supplier of your pred at any point before them appearing? Any other medications over the same period?

[jezzard in reply to PMRpro]

Been with me from the beginning but increasingly severe. Pred unchanged but reducing now 7mg. Other meds: statins apixaban/Bisoprolol /candesartan/vit D /omoprazoleSkin erupts in raised, less than 5

piece in size,cauliflower-textured lesions on head, and legs mainly. Very sensitive to the touch.

[PMRpro Ambassador in reply to jezzard]

How strange - has your rheumy considered that maybe it isn't PMR at all but a polymyalgic presentation of something else? Higher doses of pred can mask a lot of things. Have you seen a dermatologist?

[jezzard in reply to PMRpro]

Very useful comment! Thank you. I'll take it further..

[Poshdog]

Had what sounds similar and was prescribed imiquinod cream. Told it was similar to Bowen's disease and immuno system not coping. Had about 5 lesions which turned into what looked like small ulcers which with use of cream scabbed over and went away. Now use lashings of moisturiser (Neutrogena hydro boost) and so far (6 months) have been clear. So hope this helps as pmr is enough to cope with.

[Crommie in reply to Poshdog]

I had loads of spots and small dry scabs and first, but getting better now. A good face oil and moisturiser help.

[LBM1953]

Hi. I have had skin issues but not as severe as yours. My hair follicles have gone all spiky and I feel a bit like a hedgehog!! I also have small spots which do not get to any great size, don't itch annd disappear after a week or two. I also had a severe rash for about four weeks which did itch like hell which I am fairly sure was hives (but my doctor didn't). After copious amounts of Balneum cream it did eventually go away.

[Nightingales]

This is very interesting to me because I seem to have a similar mystery! I am waiting for a phone appointment with my GP about a referral to a dermatologist. I have similar lumps and rough patches on my head. They are itchy and sometimes painful. I have been tested for a GCA . My GP has tried steroid lotion and antibiotics to no avail and seems to be shrugging his shoulders although usually he is good. But I am one of those patients that keep him busy with all manner of diagnosis.☹️Also, I had skin discolouration and skin changes on my breasts. I had an urgent breast clinic apt and the dr said he thought it was another autoimmune disease and would write to my GP for a referral to a dermatologist for a skin biopsy. Now I have a ringworm, I think, on my chin and am treating it with cream from the chemist. So I need a dermatologist! I looked up Bowen’s disease and it sounded a possibility as I lived for many years in a hot climate. I am nearly six years into taking pred because I got down to 3mg, then had a major flare and went back to square one. If I ever get a referral I will keep you posted.

[PMRpro Ambassador in reply to Nightingales]

Questions, questions ...

Why do you think it is ringworm? Is it worse in the sun? Do I take it you don't have a rheumatologist? Is discoid lupus a possibility?

[Nightingales in reply to PMRpro]

Thank you for writing PMRpro. I have been a paediatric nurse all my life so I recognise it and we are more susceptible on steroids. I put “I think “ because I am beginning to doubt everything! Bowen’s is a kind of skin cancer that is more common in hot climates because of sunburn. I haven’t seen my rheumatologist since Feb and although I have told him repeatedly about these lumps he has not seen them or made any comment. I will look up discus lupus. I should have pushed for a dermatologist before now but I have had so much going on, possible GCA, cat scans, TMJ, cataract op due in ten days, it never ends. Hopefully, I will get something in place when I talk to my GP next Thursday. I actually feel quite a lot better as far as fatigue and PMR pain is concerned but it's spoiled by all these other issues, abdominal pain from Metformin, neck and head pain from pinched cervical nerve. Sorry for such a long reply. Just juggling along. 🤪

[PMRpro Ambassador in reply to Nightingales]

I'm sure you recognise ringworm better than average then - though even it has mimics as I know you will know! Yes, I know what Bowen's is as well. And I know the "how to fit it all in" feeling - there are some phone calls to make though I have done quite well this week!!!! Is there no other option besides metformin? I know of quite a few who have struggled with it. Several people here who were threatened with it got their Hba1c levels down purely by cutting carbs - which I'm sure you have noticed we bang on about a lot.

[Nightingales in reply to PMRpro]

Yes. I am like a proud kid with my HbA1c. I am down to 42 and lost 19 pounds on low carb so I am on 2 Metformin and hoping to drop next blood test but they didn’t do it last time because of blood tube shortage....you see...always a complication! I looked up discoid lupus and some of the lesions looked like this new “ringworm” but other symptoms didn’t really fit. Even more important that I see a dermatologist. I will go privately if I can’t get in soon. Thank you so much for your concern and advise, always appreciated.

[PMRpro Ambassador in reply to Nightingales]

That is really good! Almost makes up for metformin not being the kindest of drugs!!!

The lupus forum here is really good (in between their cute pics which started during Covid and have continued) with some people who really know their stuff. Their admins from LupusUK are also great.