Itchy skin after Immunotherapy

[Begonia04]

Can anyone recommend a treatment for itching. I finished my Immunotherapy in October last year which was a month less than the year because I had rashes and terribly itching everywear. I thought the itch would ease at some point. My doctor's have tried lots of different creams, steroid ointment, amitriptyline but nothing works apart from steroid tablets which they only let me take them for a few weeks at a time. It's now been 9 months. Can't relax and losing sleep, my skins a mess with all the scratching. Help!

[Hidden]

Hi there. I don’t use this community much but just had a scroll and saw your post.

It occurs to me that your itch might be inflammatory or autoimmune - which immunotherapy can trigger due to the immune system being activated in order to attack the premalignant cells or skin cancer.

Once the treatment has done its job most people’s immune systems will return to normal. But, especially if you are predisposed to autoimmune diseases, the immune system can become hyperactive and in need of dampening down, usually with steroids or immmunesupressants. This could explain why your itching may subside with steroids only to return when you taper off them.

If you have no rashes now then what you may be left with is a condition called small fibre neuropathy/ SFN. This can be idiopathic be an idiopathic form of small fibre neuropathy - likely triggered by gene mutations or environmental or lifestyle factors, chemicals or mast cell activation disorder, which is being spoken about a lot just now in relation to long Covid.

It may be worth you looking up small fibre neuropathy/SFN and seeing if it sounds like a good fit fit your itch. It can affect people who’ve had shingles, people with diabetes and alcoholics but it can also be triggered by chemotherapy and autoimmune diseases such as Sjögren’s, Sarcoidosis, Lupus and Vasculitis.

Unfortunately there are very few treatments for SFN although it can be confirmed by skin biopsy. If they can confirm it is SFN and find the underlying cause then they may be able to trial you on targeted treatments. You’ve tried Amitriptyline but there are others.

The creams I’ve found most soothing with a neuropathic itch are Dermacool and Aquadrate (urea) which are both available on prescription. Some swear by capsicum cream, others by Epsom salts. I do hope yours eases up soon.

Best of luck.

[Begonia04 in reply to Hidden]

Thank you for your reply. By pure coincidence I spoke with my doctor this week and she is going to do a biopsy. Thanks again for your very informative reply.

[Hidden in reply to Begonia04]

That’s great news. Hope you find your answers. My dermatologist is a complete gem so I’ve learnt a lot from her. 😊

[Begonia04 in reply to Hidden]

Thank you. Take care