EGPA x Skin nodules

[Beaniebabe]

Hello, I am new to this forum and my husband has EGPA, diagnosed in 2019.He's currently prescribed mycophenolate, pred 15mg x has nucala injections once a month.

As many who are diagnosed with the same condition will be aware thete is little known of this disease x at times it feels specialist's don't know much either.

Since diagnosis we have gone through many ups x downs with his health, the worst being when his mobility was affected x he struggled to walk up the stairs. After 9 months on nucala this significantly improved x although he still sufferers with joint x muscle pain his mobility has improved. One issue we have noticed since diagnosis, that specialists do not feel is connected to EGPA is that he has developed numerous skin nodules on his body, mainly on his head, back, legs. They are mainly flat wart type nodules that seem quite dry. I am convinced these are related to his condition so I would be interested to know if there is anyone else with EGPA or on similar meds that suffer from the same x if there is anything that could reduce these. Thankyou

[AtopicGuy]

This article includes nodule-like skin lesions within a list of EGPA symptoms:

dermnetnz.org/topics/eosino...

Under the "vasculitic phase" of EGPA, it says:

"Skin involvement occurs in about half of patients: Blisters, petechiae, purpura and nodules, often with central necrosis due to tissue breakdown. Affects backs of arms or fronts of legs, especially elbows and knees. Scalp or trunk may be involved. Crops of new lesions may appear over months."

[Beaniebabe in reply to AtopicGuy]

Thanks for this information, it's very helpful x explains a lot why he has these nodules. I initially thought the vasculitis phase would cause further deterioration, however he's probably the best he's been health wise since diagnosis, can medication such as pred mask symptoms as his blood tests always seem to come back OK.

[AtopicGuy in reply to Beaniebabe]

Yes. As the steroids reduce the levels of inflammation (and/or the production of autoantibodies) one or more of the markers in the blood will usually reduce too. Sometimes doctors forget that the blood markers are fallible, however, and that patients can still have symptoms when the markers are within normal bounds.