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My wife has been AP for >2yrs and responded quite well given the extreme nature of her RA. She also takes Humira 3yrs. AP is clearly what caused her great turnaround so we are big time advocates of AP.
She had a rough spell this spring but started doing fabulous about the beginning of May. Started getting her strength back and able to get out of the house some although limited. Bless her heart she even pulled a couple of weeds. Unfortunately it appears at least one of them was poison ivy or something similar. (She has always been very allergic to it so we know what is “normal” for the rash, itch, process).
What started off to be relative minor exposure quickly started growing (not uncommon) to finally settle in on both sides of neck and one shoulder with a few very small spots here and there on the legs. As of Friday we thought the spread had essentially stopped. The discomfort from the itch motivated her to go to Urgent Care yesterday to get some relief. Doc perscribed a dose pack of steroids which we planned on starting today.
THE CHANGE – this morning it looks like the rash has spread significantly. It is not the bubbly, weaping type of rash that she normally gets from poison ivy. This is blotchy pink and red that is now covering fully the neck and showing up on stomach and legs. There was not change in diet or routine that we know of. We are also confident we have cleansed the house of potential residue that might cause repeat exposure.
Questions – Does RA make you react more intensely to things like poison ivy? Maybe the immune suppression of Humira makes more suseptable? Can ivy kick in psoriatic arthritis or similar? Any risks other than the normal risks associated with taking the dose pack of prednisone?
We're trying to track down dr and pharmacist as well. Thanks to all for input. And prayers to all that are dealing with these crazy diseases.
Best regards,
W
[user=141]W[/user] wrote:
Questions – Does RA make you react more intensely to things like poison ivy? Maybe the immune suppression of Humira makes more suseptable? Can ivy kick in psoriatic arthritis or similar? Any risks other than the normal risks associated with taking the dose pack of prednisone?
W…what a kind, caring husband you are. So sorry to hear about your dear wife's troubles with poison ivy and this nasty reaction. I've seen how horrible it can be for people who get it really bad…a neighbor has struggled with this, too.
Your questions are really good ones and they're just what I'd be asking, as well. Having severe RA, myself, I know I am more hypersensitive than I ever was to many things now. As Dr Brown described it, it's a hyperallergenic state and poison ivy creates an allergic response that only seems to increase in intensity with each exposure. So, there is probably an over-amplification of allergic responses with which rheumatoid patients have to deal that your average healthy person wouldn't have to face, making recovery swifter.
It's hard to say what could be causing this new type of rash you're describing and you're wise to seek out your pharmacist's and doctor's advice. The picture might be a bit more complex, as you've got two conflicting treatments going on….one being more immunosuppressive (humira) and one that is trying to work with the immune system (minocycline) to retrain it to function again. Are you working with an experienced AP physician? If not, it might be a good idea to seek one out and see if you can get some informed answers this way. Although I'm not very clear on this, I think Dr S takes non-patient phone consults, so you might try that avenue on Monday, if you don't have any answers by then. You can get his number from apdoctors@roadback.org Hope this works for you – someone did have a bit of trouble getting past his receptionist the other day, but not sure if that's a common occurance or if there is a way around that. Someone who has called Dr S before may be able to offer some tips.
It's not out of the realm's of possibility that a heightened hypersensitivity reaction has been triggered by the poison ivy and some otherwise sub-clinical manifestation of psoriasis has resulted, as you've suggested, but it may take some time to figure this out and see if the psoriasis remains to be a problem or is just how the poison ivy is drying up and presenting as it's healing this time. It doesn't look like shingles, does it? That popped into my head, but you said the blisters were now gone, so probably not.
Hopefully someone here will come up with a similar experience to share with you or some other helpful insights to pursue. Please stay in touch and let us know what you discover.
Peace, Maz
Dr S is going to retire but he hopes to keep contact & treatment consults with his RA patients. Because of this, he is preferring NOT to have new phone consults.
I found this out about a week ago.
Devie
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