Eczema dermatitis

[811Yoga]

I was diagnosed with pmr April 24 and put on 15 milligrams of predisolone I have been reducing ever since and and now on 2 mg. I developed eczema and dermatitis about four weeks ago and have been on steroid cream for about 10 days and now on Aproderm as a moisturiser. I have had severe itching feeling over the rest of my body but only the rash on my legs and arms. The pain from the itching feeling was severe and kept me awake at night particularly on the back and buttocks. It is improving now that I am still on fexofenadine one per day 180 milligrams. I have a host of other problems as well but was wondering if anyone had else had experienced this problem.

[Greenlife]

Having been on Pred since January 22, (currently on 6.5mg) also developed similar dermatitis about a month ago, so can sympathise with you. Mine is mainly on upper back, chest, arms and lower legs, and my GP put it down to dry skin, which I have never suffered from before. She prescribed a number of unguents to use, including Eumovate steroid cream (only to be used for one week) as well as the Fexofenadine anti histamine tablets once a day. By far the most effective of these creams is Menthoderm, which is wonderfully cooling, but the effect only lasts for a short time. At the moment it is not as bad as it was initially, but it is still uncomfortable and makes my skin look lumpy and red, I continue to hope that eventually the antihistamine will calm it down, but not sure how long to leave it before going back to the GP. Would be interested to hear whether anyone else has found a more effective treatment.

[811Yoga in reply to Greenlife]

Thank you for your reply. No I've not suffered like this before. My problem started some five or six weeks ago. I have to say that the pain from body itch on back and arms was quite severe and kept me awake at night. However the patches of eczema which only appeared on arms and legs are now dry and scaly and the pain is mild. I tried Epimax as a prescribed moisturiser but that made pain worse and dr prescribed Aproderm which is similar to Aveeno which does seem to be doing the job of calming it all down. Slight tingle on skin when it goes on arms but effective and I apply twice per day.

There is no rash on my back and buttocks but just that itchy sensation but as I say thankfully under control. I have been taking fenofexadine too but may stop that and see how it goes.

Do hope you feel better soon from this additional problem.

[AtopicGuy]

People can develop eczema at any age. Already having an autoimmune disease increases the risk. There's also a thing called a rebound flare, which means that symptoms can appear or worsen when the steroid dose falls too quickly. It's one of the reasons we taper gently rather than stopping suddenly.

The antihistamine (fexofenadine) is a good way to reduce the itch. It's very safe, so there's no rush to get off it. I take antihistamine's all year round and have done for years.

You don't say which steroid cream has been prescribed. They differ massively in potency. The aim is to get the 'rash' to clear up by using a strong steroid cream, then tapering it down and relying more on emollients to keep the skin healthy and keep the eczema at bay. I dilute a pea-sized dab of steroid cream and a pea-sized dab of Savlon (antiseptic cream) in a much larger squirt of E45 (emollient) and spread that on areas prone to breakouts daily. I only use pure steroid cream during a flare, and will reduce the quantity and frequency as things improve.

Emollients don't work well on broken skin and can make things worse. They are best used once the steroid cream has healed the skin and is dry, rather than weepy. They're perfectly safe, so don't rush to cease their use. Moisturised skin is much less likely to break out; and it is better to avoid flares than treat them.

[811Yoga in reply to AtopicGuy]

Thank you for your email. All good advice and I have found Aproderm works well as a moisturiser. Just hoping for the best but could have done without this additional problem. As you indicate moisturise to avoid flares.

[Greenlife in reply to AtopicGuy]

Thanks for all that advice - will certainly follow your lead to dilute steroid cream with savlon and emollient - that way I wont be too afraid of the side effects of steroid cream. The one I have been prescribed is Eumovate, so not sure how potent that is but seems to be having some effect on the lumpy skin on my arms. Eczema on lower legs seems to have calmed down and now using a thick emollient prescribed by GP which appears to be keeping them moisturised. Now that summer is nearly over at least they will be covered up for the next. 8 months!

[AtopicGuy]

Eumovate is a trade name for clobetasone butyrate 0.05% cream and is rated as Moderately potent (see link below). It is often available over-the-counter, meaning it is safe, so long as the printed instructions are followed.

For comparison:

Hydrocortisone 0.1%, 0.5%, 1.0%, and 2.5% are all less potent (ie. Mild);

Betamethasone valerate 0.025% (Betnovate-RD®) is similarly Moderate;

Lots of stronger creams are rated Potent and Very Potent.

cks.nice.org.uk/topics/ecze...