Eczema: allergy or Remicade induced?

[FrozenGirl]

So in the last couple months I have been having issues with my hands. They get super dry and then they crack and occasionally bleed. They are also itchy sometimes after washing.

At my last appointment my GI noticed and stated it was Eczema probably from an allergy but there was also a possibility it was from Remicade. He put me on a steroid cream,Diprolene (betamethasone diproponate). I used it for 2 weeks and my hands cleared up. I then stopped using it when they were completely clear however 2 weeks after stopping they are back to bad again.

I saw my family doc for a physical who noticed it. I explained all of the above and she just said "that makes sense". Also I haven't started using any new soaps/cleaning chemicals since before it started.

My question is what should I do about this and is there any way to tell if it is an allergy vs Remi induced?

 

[Charlotte.]

I have quite similar issues from time to time. I was convinced it was from gluten, as it came back when I accidentally ate gluten (went gluten free for a while without being celiac), steroid creams always help with any eczema. My nutritionist made me eat spelt again, as well as oats, and it did not come back yet, as I finally (and it took ages, everything burned) found a good hand balm that prevents me from that eczema coming back. And it was really really bad, everyone asked me about my hands and people kind of "threw" the change coins in my hand as they probably had no idea what that was. It was itching 24/7, super red, super dry, sometimes cracked and started bleeding.
I still don't know where it comes from. No biological is the cause in my case, it just comes a few times a year, at least once a year and disappears or comes back again. Eventually disappears before it comes back in the next year. Weird but “normal“, nothing to worry about for me though. I make sure I use my hand balm still twice a day, that helped me so much when everything burned, even though I now do tolerate other hand creams as well. Just to make sure it won't come back soon.

On the other hand, that reaction could also be related to any biological. I developed an allergy to Humira, my face started getting red, was itching all over, then it spread to my whole body that my skin was itching. I would get very red when I sit in the sun behind the window, just for two minutes, e.g. on the bus, so that people think I have some serious health problem (becoming super red in the face without any reason). It got worse the more often I injected, it got better the days when it wore off.

If it's not super clear what the reason is or if Remicade is the reason, maybe it's worth just waiting and seeing what happens, especially when you respond to Remicade Crohn's-wise.

 

[ronroush7]

Maybe you should see a dermatologist. I developed folliculitis on my scalp from Remicade. My dermatologist diagnosed it.

 

[Bunty]

I have been tentatively diagnosed with remicade induced psoriasis, I say tentatively because my GP who has an interest in skin conditions has said that's what she thinks it is. I've been referred to a dermo consultant for a definitive diagnosis though, and until he's confirmed it, my remicade infusions have been suspended.
My IBD nurse has suggested that depending on what the dermo says there are a number of options, restarting remicade being one of them.
I tend to agree with what I think Charlotte is saying, in that as I'm having a good response to remicade I'm prepared to put up with psoriasis and treat that (assuming it is manageable which it is at the moment with two types of topical treatment) rather than discontinue remicade for good.
Once I've seen the dermo there will be a discussion, including me, as to which way to go.
I find it really interesting that so many Crohn's treatment drugs can bring on skin problems as well as control them, like psoriasis and remicade.
Bunty x

 

[ronroush7]

Agree

 

[Lisa]

I have had different skin issues over the years....as a child I would get very cracked/dry hands.....other miscellaneous minor issues - all pre-biologic treatment.

Since being on Remicade, I have had numerous issues including pseudo-psoriasis (or Gutatte psoriasis ) which came about after strep - twice...which took a loooooong time to clear. I have also had bouts of pustular psoriasis pop up here and there which cleared on their own.....

All in all, my success with Remicade far outweighs any skin issues I have had...right now I'm actually clear of any issues - the Gutatte P finally cleared up entirely a few months ago, don't think I have any patches of that left....

 

[ronroush7]

I had folliculitis.

 

[FrozenGirl]

Thanks everyone.

My thought train is pretty similar IF it is from the Remi (which my GI said was unlikely given it usually shows up other places on the body but is possible) then I would lean toward just treating symptoms because it's not worth going off Remi for it.

If it's an allergy i would assume treatment would be avoidance but i have no clue what it is so that is proving tricky.

The downside to that is that current treatment is steroid cream and long term that does not do good stuff to your skin. However I figure not treating it leaves me open to infections with all the cracked open wounds.

Issue is I'm not sure who should deal with that. Family doc didn't really seem to want to do anything about it, but I'm not sure if that is because she didn't know or because she assumed since GI prescribed meds he was dealing with it. Ugh.