Prednisolone tapering causing rash? - Vasculitis UK

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Prednisolone tapering causing rash?

luggsey profile image
9 Replies

Mums tapering off pred, 5mg a week from 30mg and now on 10mg for the last two days. She has a rash now on her belly, back and under arm area. Is this caused by the pred tapering?

Anybody else had this?

She went onto septrin profolaxis over a week ago as well.

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luggsey profile image
luggsey
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9 Replies

Hi Luggsey,

Is your mum feeling well despite the rash. Does she have any other symptoms? Does the rash blanch under pressure? Has she had a vasculitic rash in the past?

I would have thought it was unlikely to be the prednisolone and

if she had septrin in hospital then it is unlikely to be an antibiotic reaction.

Given your mothers recent medical history and ITU admission, if she fees unwell in any way I would have a very low threshold for getting her checked over. Even if that means contacting the out of hours service or an A&E visit.

Hope you get some reassurance soon.

luggsey profile image
luggsey in reply to

Hi Keyed, Mums still in hospital and a Dr already looked at her and was not concerned. It does not look to be vasculitis related, spots that clear under pressure and they itch now so I assume it could be a reaction to something. She has come off of steroids pretty quick after being on them since March and thats the only real change thats happened recently?

She feels fine, still coughing after awful pneumonia but blood tests are all good and her vasculitus was not skin related, in fact her vasculitus has been In remission for a couple of months.

JontyW profile image
JontyW in reply to luggsey

Hi luggsey,

You say that your mum's vasculitis "has been in remission for a couple of months", so what is the reason that she is still in hospital? Have the consultants confirmed that she has reached remission status, because if she is still tapering her dose from 30 mg, now down to 10 mg, she has yet to reach a maintenance dose. Or have I got that wrong?

My understanding of remission going into maintenance status is ....

"Remission Maintenance therapy - Once the disease is controlled or in remission (indicated by improved symptoms and blood tests), the treatment is changed (usually after several months) and maintenance therapy is commenced"

luggsey profile image
luggsey in reply to JontyW

Hi Jontyw, Mum has been in hospital due to pcp pneumonia which she contracted as a result of steroids and cyclophosmide treatment. Her remission was made back In August from vasculitus but as soon as she tapered her steroids her crp started rising. This was assumed to be vasculitus so her steroid was Increased. Turned out the crp rise was pcp pneumonia...

Her consultant said due to her critical condition she needed to get off the steroid as her Immune system stopped working due to bone marrow failure. Her Immune system Is recovering as is her pneumonia and there is no sign of vasculitis, they monitor her kidneys closely as that's where the vasculitis hit first. Hope that makes sense, she was so ill they wanted her off all med that compromise immunity.

She was told that her vasculitis may never return, I certainly hope so, she has to rehab now as she cannot walk so we have months of physcio to help her with again.

Hi Luggsey,

Sorry to hear that your mum is still in hospital. It's reassuring that her bloods etc are ok. If she is itchy it may be as simple as a reaction to washing powder. Sometimes after lots of antibiotics, especially IV, patients can be prone to fungal infections which can manifest themselves as a red itchy rash.

I am sure the medics are keeping a close eye on her.

I hope she manages to get out of hospital soon.

luggsey profile image
luggsey

Her pneumonia was fungal so the antibiotics are anti-fungal and she still takes them. I see what you mean though as she had oral candisis since March and still has it due to the steroids. We had some e45 cream from the nurse earlier, we put it on a small area to see if it helps, it itched more at first and then settled down....

Time will tell I think?

AndrewT profile image
AndrewT

Hi Luggsey,

I could be wrong but my 'gut' reaction is that they, consultants/doctor etal, are tapering the Pred. too quickly. This happened to me several years ago- as was asked above, how does SHE feel in herself; always a good indicator that.

Regards the itching, how are her kidneys? Do hope I'm wrong on this but has the vasculitis gone anywhere near them? I was on dialysis, for three and a half years- had a transplant now-please do have this one checked; if only to tell me that I don't know what I'm rabbiting on about (I hope).

In any event do wish her well. I also send you my best wishes, and prayers.

AndrewT

Abdul profile image
Abdul

I've got exactly the same rashes on the same places as you described .. When my consultant saw them he told me they are one of the steroid side effect and they will disappear when I reduce steroids .

They are fading now after I reduce steroid to 5 mg a day ..

luggsey profile image
luggsey

I just checked the NHS site and found pred side effects listed which include red itchy skin, low blood pressure, fever, (her temperature is up a fraction from normal) mood swings,check,check,check. Hopefully that's all it will be? I'm going to let her consultant for Renal/vasculitus know as well just in case.

Andrew she feels ok but I have learned she always feels ok even when ill so I go on my gut instinct now. Her kidneys are monitored closely, she also had kidney failure and dialysis due to vasculitus but thankfully the damage was limited.

Nurse just told me she had a good night, they have been giving her extra fluids after I pointed out they are not giving her enough to drink! Dehydration in the mix wont help....

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