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    Default Newly diagnosed and now getting eczema

    Hello everyone,
    I got a butterfly rash since May 2013. I did a lot of hiking last year and I was healthy. This May, I got a red patch next to my nose, I thought it was a bug bite. Until 2 months later, it's still there and spreading. It took a lot of troubles to see a specialist and get the blood test results due to irresponsible clinics and labs. So I know I'm diagnosed with lupus. The doctor gave me 5mg Prednisone and Hydrocortisone. I've been taking them for 2-3 months. My butterfly rash is gone now, and I had the doctor to reduce the prednisone to 1 tablet a day. I'm reluctant to take it because I heard about its bad side effects too. But 'm still taking it now cuz I'm afraid my sickness will get back to square 1.

    The side effects I'm seeing are trembling hands, feeling so tired everyday, trouble sleeping and would wake easily, cannot focus, super bad memories, and very afraid of the cold.

    And hair loss. I'm so scared hair loss is permanent. The medication is not curing my hair loss.

    Before I got the butterfly rash months ago, I was going to acupuncture, and my right knee was feeling stiff. I thought maybe I sat too long? But I had been hiking....right now my right knee still feel stiff. I asked the doctor, and she didn't say this is related to lupus.

    Now I'm having eczema on my fingers and palms. It started with itchy blisters, then peeling. All my fingers are gone now, and the 2nd layer of my skin is starting to peel. My hand would get very very dry, and i've been trying to avoid soap and any skin product with alcohol. My doctor referred me to a demintologist, she doesn't thinking its related to lupus. But I read somewhere that if you taking prednisone for a long time, your skin will get very thin. I think this is making me having a lot more hair flakes, and body skin flakes.

    It took me a long time to accept that's I have lupus because I love the outdoor. Now I can't be in the sun anymore.

    Joyce

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    Hi Joyce

    I'm responding because I'm having some weird rashes not typical with lupus. First, I should share some of my experience with SLE.

    My lupus dx was 1 1/2 years ago, after 1 1/2 years of symptoms developing. My primary symptom was swelling and joint stiffness in my hands, with weird bony overgrowths at the joints. Then Raynauds, hair thinning, and tiredness. My ANA was sky-high (1:1280), and my anti DNA only slightly elevated (in the 5-9 range.) I developed increasing photosensitivity, but no butterfly rash. Treated with plaquenil, the hand swelling is resolved about 95%. Also taking Naproxen. Didn't need prednisone. The Raynauds responded to Nifedipine, so it has been less severe this winter. Most recent ANA was 1:680 and anti DNA 3. So treatment success.) I'm 65, and have read that SLE onset after age 60 is a less severe disease.
    My new sx this winter has been extremely itchy skin on my back, thighs, ankles, buttocks, which develops a raised, but not red rash, when I scratch. Hydrocortisone cream manages it, but my rheumy is not particularly interested, and officially, it isn't related to SLE.

    However, I have found some articles saying Atopic dermatitis is often associated with elevated ANA, and there may be a connection to SLE, Sjogrens, and Scleroderma, which also have elevated ANA as a hallmark. It is an auto-immune condition. When I was first dxed, my rheumy left open the idea that additional sx could develop.

    I am annoyed by the photosensitivity issue, since we like to camp, hike, and kayak. So my wardrobe is increasingly UV protective, and using high SPF sunscreens. I work hard at avoiding sun exposure and make sure to get adequate rest (8+ hours nighttime sleep, and a 1+ hour nap) to prevent a flare. During my immediate pre-dx phase, my work hours and schedule changed, and the inability to get adequate rest really flared my sx. After dx, I was able to get my hours and schedule returned to my previous, and that has worked for me.

    I've had osteoarthritis for 20 years, and have had good experience with fish oil and glucosamine for those joint pains, which were primarily knee, ankle, and shoulder. Osteoarthritis ofter overlaps SLE.

    Ruth

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    When they say a long term use of prednisone, they are talking about a year or more. Three months is not really considered long term use. Also, you are on a very low dose of Prednisone. I am not a doctor and cannot say what is causing your skin issues, but at this point, I would guess that it is not the Prednisone. It sounds a bit like you are suffering from Lupus lesions/uclers. This may also be the issue with your hair loss.
    I know that the hair loss can be devastating. Perhaps you can speak to your doctor about Plaquenil. This is usually the first line of treatment for skin and mouth issues with Lupus. Plaquenil is a cumulative drug and can take several months before you see real results. However, since you are already on a low dose of Prednisone, you may see results a bit faster.
    There is a lot of information about Plaquenil here on our site. You can do a search for it and all posts related to that subject will appear. It might be worth it to discuss this with your doctor. In the meantime, I am providing you with some information about Lupus lesions/ulcers and some websites so that you can get a general idea about what they are and what treatment modalities are used:


    Skin disorders are very common in Lupus

    • Cutaneous manifestation of lupus are as follow:
      • Discoid lupus: lesions present as urticarial patch, scaly patch (follicular plugging), scarred patch, with pigmentary changes.
      • The palms can be involved with atrophy, erosion or hyperkeratosis.
      • During acute flare up of systemic lupus erythematous, patient often develops transient maculopapular butterfly rash affecting both cheeks.(commonly known as the malar rash or mask)
      • In subacute lupus (SCLE), the eruption can be urticarial (annular), papulosquamous (psoriasiform).
      • Mucosal involvement is also commonly seen and these include ulceration or nosebleed.
      • Scalp involvement is not uncommon and both diffuse or scarring alopecia can be seen.
      • Vascular lesions seen in lupus include: Raynaud's phenomenon, nail fold telangiectasia and infarct, splinter haemorrhages, chilblain LE, acquired C1 esterase deficiency, vasculitis, urticarial vasculitis, purpura, thrombophlebitis, livedo reticularis, antiphospholipid syndrome, Degos syndrome and calcinosis.
      • Others less common cutaneous manifestations are Bullous LE, LE profundus, erythema multiform.




    • This type of specific lupus lesion was most recently described by Sontheimer and Gilliam during the late 1970's.
    • This lesion is characterized as a non-scarring, erythematosus, or red, coin-shaped lesion which is very photosensitive, meaning it gets worse when exposed to UV light.
    • This type of lesion, which is characteristic of subacute cutaneous lupus, occurs in lupus patients who, approximately half of the time, demonstrate features of systemic lupus erythematosus.
    • Renal disease, however, is unusual in these patients.
    • These skin lesions also occur in people who only have clinical evidence of skin disease (discoid lupus), and do not show any symptoms of systemic lupus.
    • Approximately 70% of people with these lesions have anti-Ro antibodies.
    • The subacute cutaneous lupus lesion can sometimes mimic the lesions of psoriasis or they can appear as non-scarring, coin-shaped lesions much like hives.
    • These lesions can occur on the face in a butterfly distribution, or can cover large areas of the body.
    • Unlike the discoid lupus lesions, these lesions do not produce permanent scarring, but can be of major cosmetic significance.


    Non-Specific Lupus Lesions - ALOPECIA

    • The non-specific lupus lesions include several forms of alopecia, or hair loss, which are not related to the presence of discoid lupus lesions in the scalp.
    • Systemic lupus patients who have been severely ill with their disease may over a period of time, develop a transient hair loss in which large amounts of hair evolve into a resting phase and fall out, being quickly replaced by new hair.
    • In addition, a severe flare of systemic lupus erythematosus can result in defective hair growth which causes the hair to be fragile and to break easily.
    • The hair is broken off above the surface of the scalp, especially at the edge of the scalp, giving the characteristic appearance termed "lupus hair"
    lupus
    .org/answers/entry/how-
    lupus
    -affects-skin
    dermnetnz.org/immune/cutaneous-lupus.html
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    Please let us know if you need anything further. We are here to help you in any way that we can. I wish you the very best.

    Peace and Blessings
    Namaste
    Saysusie
    Look For The Good and Praise It!

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