And now it’s eczema!!

[Janann25]

After 7 very interesting years, I finally arrived at 3.5mg Pred which the rheumatologist has been “happy” for me to keep as a maintenance dose. However, several months ago I developed a rash on my arms, legs and back. There followed two biopsies and eventually, some three weeks ago, the diagnosis of a type of eczema. This doesn’t itch but has developed into large angry-looking spots which make my skin feel as if it’s on fire. The dermatologist prescribed Audovate RD Cream plus Prednisolone of 30mg for 10 days then a reduction of 5mg per day until I got back to my usual 3.5mg. I actually re-started the 3.5mg 5 days ago but have felt really poorly since then. I feel unsteady on my feet and so very tired, although the burning from the eczema stops me from sleeping. Anyway, after all that, my question is, how do I get safely back to 3.5mg. Do I take an extra 5mg to help me feel better and, if so, for how long and do I need to taper slowly?

I find it hard to get my head round the fact that this has happened. I can’t get any explanation as to why I’ve started eczema at the age of 83 and even more concerned about the fact that the steroids don’t even seem to have helped!! I obviously realise that this forum isn’t able to help with my eczema questions but just hope someone can help with my tapering problems.

Im trying hard not to get upset about this but, having spent 7 years living with PMR, I’m just feeling a bit sorry for myself at the moment😢

Thank you

Jan

[DorsetLady PMRGCAuk volunteer]

Sounds as if your adrenals are struggling - hence the fatigue and feeling poorly.

Just as a matter of interest, did you have those symptoms before the extra burst of 30mg or were you pottering along okay on 3.5mg?

It’s a bit difficult know whether it’s a flare or just adrenals… or both.

If a flare then you try the flare protocol -so add 5mg for 7 days then back to say 4mg rather than 3.5mg…

If it’s just adrenals, then you could just ride it out- and hope it settles…

Or 3rd option go to 5mg and use that as new dose - and then taper slowly again when you feel okay.

Sorry, I seem to have given you too many choices.. which probably hasn’t helped.

[Janann25 in reply to DorsetLady]

Thank you so much for your reply - and please don’t apologise for the choices. It’s so good to be able to ask your advice.

In answer to your question, yes I was doing fine before this so it’s got to be the result of the temporary high dose. I think I’ll have to see how I feel over the next couple of days - I have a dread of developing an adrenal crisis so I panic a bit!

[DorsetLady PMRGCAuk volunteer in reply to Janann25]

Ok - see how you go, and if you feel worse then up dose and if necessary seek medical advice..

hope that won’t be necessary..

[PMRpro Ambassador]

I agree with DL's suggestions - the 10 days at 30mg shouldn't have affected your adrenal function but you will likely to feel the change in dose as you go down.

[AtopicGuy]

Any idea which type of eczema? The US National Eczema Association describes seven in this link:

nationaleczema.org/eczema/t...

As per the link below and the attached table, the active ingredient in Audaval RD is 0.025% betamethasone valerate. That makes it a low-potency steroid cream.

hpra.ie/img/uploaded/swedoc...

A table showing the relative potency of various topical steroid creams and ointments.

[Pjso]

I developed Discoid eczema and so I can empathize with you. I was referred to the hospital. I was encouraged to try several different moisturising creams to use on my body. In the end I have one that I use instead of soap and one that I use to cream twice a day or as often as I need to. Both are on prescription. I also have a very strong steroid cream that I rarely use unless I have a bad flare up. I have changed my soap powder, looked at my diet etc. When I was on oral steroids (off for 7 months) they did not help my eczema. It was the moisturising creams that helped. I have a cool bath each day as the consultant said water moisturises the skin and the creams keep 'it in'. I pat my skin dry. I learnt that I have to treat my skin condition separately to any other health complaints that I might have. I also have a very supportive GP and go back when things do not work.

[Janann25 in reply to Pjso]

Thank you so much for your reply and your helpful comments. I’ve not been referred to a hospital as we have a GP at my surgery who specialises in dermatology. I haven’t been told which type of eczema I have but whichever one it is, nothing is helping at the moment. The moisturising cream stops my skin from flaking but the actual eczema hasn’t changed. I have a checkup in two weeks so hopefully there will be something which can be done. In the meantime I seem to have settled back on 4mg Pred so that’s a relief!

[Pjso in reply to Janann25]

It took a while for mine to settle down and I tried a lot of creams to find the ones that work for me. Some creams made my eczema worse and I would scratch until the sites would bleed. It is frustrating but you get there in the end.