Methotrexate and skin sensitivity to sun.

[Oxfordboy2]

There was a discussion on this last year and I am after some advice.I have been on MTX for 2 years and until last September I could be in the sun with no problem.Now that the sunshine has arrived I find that a very short time to exposure to the sun brings my forearms out in a bumpy rash.No other parts of my body are effected.What I am interested in finding out is if I hopefully go into full remission for LVV and can stop taking MTX Will my skin return to normal or will I be sensitive to the sun for ever.

[PMRpro Ambassador]

Pass! I honestly don't know and I doubt there are enough LVV patients on pred and MTX on here to be able to get a representative view. I actually found PMR and pred separately caused skin changes. I used to turn brown from March on pre-PMR. Then I had PMR undiagnosed and untreated for 5 years - couldn't spend long in the sum. It improved but I had all the skin effects of pred which most doctors insist won't reverse when you are off pred. But having got to a considerably lower dose, a lot is improving but I don't think I am browning much.

[Oxfordboy2 in reply to PMRpro]

Thanks for the reply.I did think I might be asking the impossible as there aren’t too many of us on just one medication.I was initially on pred for pmr/GCA but stopped in December 2021.MTX is now my only med.I did notice my skin thinned when on pred so maybe between that and MTX I have developed sensitivity.

[PMRpro Ambassador in reply to Oxfordboy2]

It is a known adverse effect of MTX - I suppose I was considering more whether it improves when you are off it.

There is another thread ongoing about it.

[DorsetLady PMRGCAuk volunteer]

Might be worth asking on either NRAS or Vasculitis forums… more users of MTX on there… although you will probably wait longer for a reply..😳 😊

[Oxfordboy2 in reply to DorsetLady]

Thank you,I will give that a try.

[PMRCanada]

I just responded to another current post about MTX and sun exposure.

I developed PMLE (polymorphous light eruption), basically a sensitivity to sunlight, 5 years before developing PMR and starting pred. The first sun exposure of the year I get a bumpy rash on my arms, chest and sometimes legs. As sun lover most of my life I had never experienced this prior.

2.5 years ago I started MTX as a steroid sparer. I was advised about extra sun sensitivity while taking this medication, however have not noted any changes in my skin’s reaction to the sun (except ongoing PMLE). Even a recent winter vacation to sunny, hot Puerto Vallarta, Mexico I was able to enjoy the sun, but also spent time in the shade and wore SPF 50 sunscreen the whole time. I only developed PLME symptoms the day before we departed.

Now each spring I slowly expose my skin to the sun 15-20 minutes each morning. I still sometimes get PMLE which clears up after a couple days, then my skin tans with continued exposure while wearing sunscreen (we have a pool).

I’m not sure if your recent development of skin bumps is MTX related but I do know one side effect is enhanced sensitivity to the sun and risk of sunburn. What you’ve described sounds a lot like PMLE and maybe MTX is exacerbating it?? I’m not sure if PMLE sticks around for the long term but a recent search of this condition on the internet resulted in the following info linking it to autoimmune mechanisms, and Canada is considered a ‘temperate climate’:

“Is PMLE an autoimmune disease?

Polymorphic light eruption (PMLE) is a photodermatosis whose pathogenesis is commonly linked to autoimmune mechanisms. It is a common condition, usually affecting residents of temperate latitude.”

ncbi.nlm.nih.gov

[Oxfordboy2 in reply to PMRCanada]

Thank you for the information in your reply.it makes for interesting reading.Just like PMR/GCA I had not heard of it.Its all to easy to blame everything on Methotrexate as it’s the easy option.The sun has gone away here these last 2 days and although I still have a slight rash it is not raised.If I ever get to see a GP again I will mention this.

[Doublef]

sorry I cannot help, I got talked into taking injections after refusing the tablets. I have never been so ill in my life, was in bed for a week eating v3ry little food I do have red blotches on my cheeks neck and shoulders but not sure what is causing it.