Purpura or Shingles?

[Baner]

I have had purpura rashes before but this one is bigger. It’s on my arm better elbow & wrist.A friend said could it be shingles. That hadn’t occurred to me, anyone got any thoughts. It was a bit itchy when it first appeared yesterday but ok now.. Thanks

[SnazzyD]

Pred can certainly cause this kind of bruise. I can say from experience that shingles that is very visible isn’t just a bit itchy for a bit. It’s more like an itch with intense or electric shock-like pain.

[Baner in reply to SnazzyD]

Thank you, I didn’t think it was shingles, but my friend wanted me to check with GP. Haven’t got the patience for that, three weeks for an appointment if not urgent. Thought it would be quicker to ask here 😊

[SnazzyD in reply to Baner]

Shingles also looks like a collection of tiny blister-type eruptions that can group together on the skin.

nhs.uk/conditions/shingles/

[Koalajane in reply to Baner]

Do you have e-consult at your surgery. I used it the other day and was sent a link to it by the receptionist. I sent a photo and received a phone call from the GP within 3 hours

[Baner in reply to Koalajane]

No our surgery doesn’t have e-consult I’m afraid. They do have a duty doctor for urgent matters, although you have to phone at 10am and usually there is a long queue, last time I used it was 40 mins before I was front of queue. My rash has diminished overnight so pretty sure it’s not shingles. I have an Rheumatology appointment on 21 October so will ask about there. I have never been told about purpura, only know about it from what I have read about on this forum.

[Koalajane in reply to Baner]

Yes I can get them quite bad without realising I have knocked my arms. The skin is thin so I get skin tears that bleed too. I get them on my arms and hands but strangely not my legs and I wear shorts throughout the spring and summer.

[Baner in reply to Koalajane]

Funnily enough I get them more on my legs, think this is first one on my arm that I can remember. Think that’s why it scared me a bit as I can see it all the time. Ones on legs I don’t see so much. Just something else to explain to deal with.

[DorsetLady PMRGCAuk volunteer]

From past experience would go for purpura - doesn't look very shingly to me!

[Blearyeyed in reply to DorsetLady]

Me too, looks like Purpura or a bruise rather than Shingles.

[piglette]

I have had purpura that looked like that. Sometimes it looked as if I had been attacked by wild animals!!

[PMRpro Ambassador]

Does shingles affect the arms? Apparently it can but far less common. If it is shingles it will turn into a blister. And a 3 week apppointment isn't much use is it given you have about 3 days to start antivirals!!!

If you scrape your arm you can get purpurae that are larger and look like that. I got them from putting a shopping bag on my arm and it then slipping down - do you know what I mean?

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Was watching Bob Mortimer and Paul Whitehouse - Gone Fishing programme -and shingles was mentioned. BM had had it quite badly -down his legs and it lasted for about 6 months. At its worst he couldn’t get up the stairs. GP mentioned body and face as usual places, no mention of affecting arms, But as you say rarer.

[PMRpro Ambassador in reply to DorsetLady]

I know it does get legs, but the nerves it affects are restricted.

[DorsetLady PMRGCAuk volunteer in reply to PMRpro]

Yes doctor did say once you’ve had CP the virus stays dormant and lives in the roots of our nerves. Also mentioned if you’re immune suppressed then get vaccinated.

[PMRpro Ambassador in reply to DorsetLady]

Yes, it does, at the top of the nerve where it leaves the spine I think. But not all nerves and when it reactivates it travels down the nerve to appear in a fairly defined area of skin, almost always on one side.

[Blearyeyed]

Looks like Purpura or a bruise from my personal experience of those but I'd suggest if you can't get a GP consult and you are concerned you could go to your local independent chemist and get their opinion. If you can use the one in your area that has the option of a pharmacy clinic room.They are used to be asked about things like this all the time and would be able to spot Shingles very easily and would ring through to your local GP immediately to get you a same day appointment for a prescription.

Have you been offered your free Shingles vaccination yet?

It's worth organising it if you have not had one in the last twelve months.

[Baner in reply to Blearyeyed]

Thanks, having a RSV & Covid jabs in next 2 weeks. My husband who is 71 and with no health issues has had a text about having a shingles jab, but I haven’t. Will ask when I go for my other jabs.

[Blearyeyed in reply to Baner]

Remind them that you are on steroids and have suppressed immunity you could ask if you can go in for your jab in the same appointment slot as your husband. That's what my husband and I do for our jabs, Who said romance was dead!😆😆😆

[Baner in reply to Blearyeyed]

Good idea 🤣

[DorsetLady PMRGCAuk volunteer in reply to Baner]

Could be age related -see this -

england.nhs.uk/2023/07/nhs-...

[Baner in reply to DorsetLady]

Thanks, haven’t seen that before. I am 76 so should have been contacted. Going for RSV jab on Saturday will take it up with doctor then.

[DorsetLady PMRGCAuk volunteer in reply to Baner]

Do discuss it -but there is some confusion about ages, and when you’ll get vaccinated.. Not quite as straightforward as it could be.. but if you don’t ask you don’t get!

[Quilterone]

I had a large rash like your photo when I started having symptoms of what has now finally been diagnosed as PMR. Doctos kept diagnosing it as poison ivy, but it didn't itch. No one even brought up purpura rash. Mega prednisone dosage to get rid of it. Hope you get the right diagnosis. Took me almost a year before my new rheumatologist said I've had PMR.

[Baner in reply to Quilterone]

My PMR diagnosis was by a PET Scan three years ago, got these bruises/rashes good while after a started pred. Doctors never mentioned Purpura, learnt about it from this forum. Isn’t itching now and redness has almost cleared. I usually get them on my legs so they are not quite so visible. This one being on lower arm is more visible. A friend saw it and was a bit alarmed, I said I didn’t think it was shingles but thought would ask here. Lovely helpful responses as usual. What a lifeline thus forum is.

[AtopicGuy]

A shingles rash typically resembles "a dewdrop on a rose petal". I can't see any of the watery blisters that form the "dewdrop" in the photo. All I can see is purpuras, which can be caused by many things. If it is shingles, it looks like your immune system got it under control before the pimples appeared.

[Janetknit]

you photo looks identical to what occurs frequently throughout my journey being on pred. I asked my rheumatologist what caused it and he told me prednisone. I have this large bruising frequency in different places, many times in the same location. It looks just like yours!