Itchy red bumps…

[mj47]

So, about one week into AP my husband began developing small red bumps on his ankles which had been extremely swollen for a while.  We thought that perhaps it was detoxification coming through his skin as the swelling resolved.  Of course, there's no real reason that we thought that…it was pure speculation. 
Over time (that was in the end of Oct 09), the spots have gotten a little more in numbers and seem to stay focused around his ankles where they had been swollen.  The swelling is down now, but his ankles remain one of his bad spots where there is still pain.  It seems like perhaps some of the spots have developed into psoriasis (as oftentimes skin disruptions will for people with psoriasis).  Now he's complaining that his ankles are very itchy.
My question is, has anyone else ever had this happen?  Is there such a thing as detoxing through the skin for PsA as AP begins working?  Could this be a reaction to minocycline?

Anyone?  Anyone?  Bueller?  😉

Thanks guys.
MJ

[JeffN]

Mj – Soon after beginning generic mino for my SD I had a rash that sounds similar to the one you describe. Little red bumps that when you scratched them the top would come off and perhaps some clear fluid would come out and then they would heal. Mine began on my calves and as that area began to heal the rash would move up my body. After my lower legs it jumped to my torso and back. It moved all the way to my jaw line. I never did find out what it was but it did go away and while it was uncomfortable it was nothing compared to the rest of what I was going through due to SD. I chalked it up to detoxing. Like I say I don't know for sure though so get it checked. The rash took about six weeks to run its course. The funny thing was is that it came back exactly one year later a little less intense but still somewhat painful. It also repaeated itself last Jan. I think the second year I went to the doc as it was very uncomfortable on my upper chest. He gave me some steroid cream and that took care of it well, everything else I had tried did not. I am waiting for it to reappear this Jan but it has not as yet – perhaps there is not so much die off to detox anymore. Don't know if this helps or is even what you folks are experiencing but thats what happened to me. As I said get it checked.

[Maz]

Hi MJ,

I had a very similar thing going on as JeffN, which passed with time, too. I put it down to herxing and detoxing through my skin.

There are different kinds of psoriasis, which no doubt you're more fully versed in than me, but there is a type of psoriasis that can present as small, red spots that usually follows a strep infection, called, Guttate psoriasis:

http://www.emedicinehealth.com/guttate_psoriasis/article_em.htm

What's kind of interesting is that Brown felt that strep was a separate infection that needed to be addressed in people with rheumatic diseases who had elevated titers. I'm just wondering, therefore, if…connecting the dots here…your hubby may be experiencing a little overgrowth in strep? I don't know…it just came to mind as I was reading the link above. The article says guttate psoriasis appears a few weeks after strep throat, but as we all know here, strep can morph into L-forms which linger long in the body. So, when one infection is being addressed by the mino, I just wonder if any underlying strep might be seizing its day in the sun, too? Maybe worth having strep titers assessed?

These rashes are a bit of a mystery while on AP and, as long as tetracycline allergy is not a consideration, “exacerbations in cutaneous lesions” are pretty common with herxing, too. Some AP docs will prescribe benadryl when this is going on and, if it helps, then it's likely related to a hypersensitivity reaction.

There is a form of gluten rash, called dermatitis hepatiformis you can check out here:

http://adam.about.com/encyclopedia/Dermatitis-herpetiformis-close-up-of-lesion.htm

Just some ruminations that came to mind….

Peace, Maz

 

[mj47]

Jeff,
Thanks for giving your experience.  My husband's bumps don't seem to have any fluid coming out of them & they are not painful.  After reading Maz's reply, I am really feeling like they are a form of psoriasis.  But, it's always good to hear other people's stories.
Thanks again!
MJ

[mj47]

[user=27]Maz[/user] wrote:

What's kind of interesting is that Brown felt that strep was a separate infection that needed to be addressed in people with rheumatic diseases who had elevated titers. I'm just wondering, therefore, if…connecting the dots here…your hubby may be experiencing a little overgrowth in strep? I don't know…it just came to mind as I was reading the link above. The article says guttate psoriasis appears a few weeks after strep throat, but as we all know here, strep can morph into L-forms which linger long in the body. So, when one infection is being addressed by the mino, I just wonder if any underlying strep might be seizing its day in the sun, too? Maybe worth having strep titers assessed?

Maz,
I checked out the link you provided & a big HHHMMMM…..
Yes, we're familiar with psoriasis, but my guy has always had plaque psoriasis.  The pictures of the guttate look suspiciously like what he has on his ankles.  And the weird thing about the strep connection is that when he was much younger, there were a series of strep titers run on him.  Nobody remembers why they were done…I suspect that they were done after he had a bad case of the croup as a child as a sort of follow up.  None of the results seemed to show any results, they all came up 'inconclusive'.  Such an annoying result!   Could mean so many different things.  Since he hasn't been sick anytime recently, I do wonder if there is some tie in with the tests from his childhood & if he could in fact be harboring some l-form of strep.  Perhaps the mino has reactivated it or brought it to the surface.  Hmmm…very interesting.
I looked up what meds are used for strep & it seems eurythromycin is one.  But, mino seems to be an option too.  I'll have to double check the section in Dr. Brown's book regarding the strep connection & how he liked to treat it if he thought it needed to be addressed. 
Thanks for elucidating something that should've already been on my radar!  You're a gem.
I'm pretty sure that it's not gluten herpeteformis dermatitis because we are super strict when it comes to the gluten free diet & it's been over 2 years now.
Well, I know what I'll be reading tonight…..
Have a good one!!
🙂

[lynnie_sydney]

I looked up what meds are used for strep & it seems eurythromycin is one

Probably better than erythromycin is one of the newer generation mycins such as azithromycin (zithromax). Lynnie

Be well! Lynnie

Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
rotating abx protocol now. From Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg + LDN 3mg + Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, P5P 40mg, zinc picolinate 60mg, Lithium orotate 20mg, Magnesium Oil, Bio-identical hormones (DHEA + Prog + Estrog)

[Author]

Posts