Rash on soles of feet on Remicade

[xmdmom]

So of course on Friday afternoon, my son (22) says he has a new rash on the soles of his feet. It is slightly pink and seems to have some vesicles. It doesn't hurt and it's not itchy. No fever So far he says nothing is oozing. He's been on Remicade for 1.5 years. He is under stress with the end of the semester. Any thoughts? Would you wait till Monday?

How do I post a photo?

 

[ronroush7]

I would probably call the doctor on Monday.

 

[my little penguin]

Ds had vasculitis on his feet
Once was classic entire toes turn red and spread up his foot and leg
Later just red spots similar to a red crayola marker tip touching the bottom of his foot
Could be vasculitis or just a simple rash

If it is spreading I would at least call the on call Gi or ER
Hugs

 

[Grumbletum]

I got psoriasis on my feet and legs while on Infliximab (Remicade) but if his rash is not itching, it's probably not that.

 

[Tesscorm]

Any change from yesterday?

He's away at school, right? Makes it tougher when you can't see it yourself but I would ask him to keep an eye on it and, as MLP said, if it changes (spreading, starts to itch, etc.), I would get it checked.

 

[xmdmom]

Actually he's home this weekend and he reports no change this morning. He called GI who told him that Derm office would call him to make an apt. I'm not very good with rashes - I know how to recognize some deadly ones but not the more common ones.

Rash photos here:
https://drive.google.com/open?id=0BxcxWmrvUyqaV3hEYlJBenA4d00

 

[my little penguin]

My non Doctor mommy opinion
Dyshirotic ezcema
Ds has it
His isn't itchy sometimes
Other times it is ( weird )
Hope dermo has an idea and he gets seen quickly

 

[xmdmom]

That was first on my differential diagnosis. The other possibilities I've thought about are atypical athlete's foot (vesicular type) or beginning palmoplantar pustulosis (rare and bad - so far palms are clear).

What do you do for the ezcema and how bad does it get?

 

[my little penguin]

https://nationaleczema.org/eczema/types-of-eczema/dyshidrotic-eczema/

http://www.healthline.com/health/dyshidrotic-eczema#ReadThisNext8

 

[Eridon2002]

I'd have to second my little penguins opinion that it is dyshidrotic eczema. I've gotten it a few times in between my fingers. Sometimes it's itchy but other times is just tender. Doc's can prescribe a steroid cream for it. I notice it has happened when i touch something my body reacts to. The weird thing is the contact isn't between my fingers but it always appears here. Once it was from brushing up against a bleeding heart plant(this plant has alkaloids that some people-like me-react to)

 

[my little penguin]

He has silver sulfanazine for the deep blisters
His is on his toes and deep under the skin not the surface
He can get four or more blisters on top of each other under the skin
His also bleeds under the skin

High dose Kenalog cream is put in it
No shoes or socks as much as possible
Sweating makes it worse and all cotton no plastic on shoes to let the feet breathe

Really minor
Only infection risk is the big issue

 

[Tesscorm]

Hope it's improving by now... (or, that you've got a derm apptmt coming up soon!). :ghug:

 

[Lisa]

Looks like what I have had on and off too! For me, goes away on its' own eventually, and yes, I'm bad about popping the little blisters....I've also had it on my hands in the past.

 

[xmdmom]

And the diagnosis is...

 

[xmdmom]

The diagnosis is unknown since the rash has mainly faded now and my son decided it wouldn't be worth going to the derm apt. I think it was probably dishydrotic eczcema.

 

[Tesscorm]

Glad it's going away and hope it was just a one time thing...

Over the years, I've gotten better at remembering that people without crohns or it's meds get random pains, rashes, off-days, etc.... It's always hard to sit still and watch though because, reality is..., they are on these meds. (I think our kids are better at the waiting and watching part...! )

 

[xmdmom]

Actually when he first saw it, he called me and said he wanted to go to the ER.

 

[David]

Out of curiosity, would the bumps pop and ooze a liquid?

 

[Tesscorm]

I think it's really good that he's on top of his own health! It's especially comforting when they're out of town and you don't see the everyday things.

S flip-flops... at times, I'll be worried about something and ask him to go to clinic and he'll say no, that he'll just wait a bit... other times, he's the one worried and wanting to go get it checked and I'm the one wanting to wait a bit (which always puts me on edge!... Actually, to be honest, I end up on edge either way! :ywow. But, I much prefer it when he's cautious...

Although, this brings me to another small worry that saddens me a bit... there have been times when it's seemed he's overly aware of 'symptoms' and I'm afraid that it's because I've given him warnings about side effects, things to watch for, etc. that it's made him too aware or worried about his health, especially for someone his age. As your son is about the same age, have you ever noticed or worried about this? Although, given the meds they are on, perhaps that extra awareness/worry is, unfortunately, necessary in their circumstances???

 

[xmdmom]

Yes my son flip flops too from being unconcerned or oblivious about weight loss or other symptoms to being extremely worried about something small that seems insignificant to me.

Yes, knowing side effects and possible complications can cause one to be alert to very minor body changes and perhaps hypochondriacal at times. But I think it's important to know these things because you'd want to catch these problems early before they could become really serious.

 

[Clash]

Count C in on the flip flopping as well. Also, count him in with being unconcerned about weight loss or now ferritin levels but ready to go to ER to things that seem small or insignificant.

I, too, wonder if part of it is I make him aware of certain symptoms, side effects etc so they seem familiar and inside the CD box where as if something doesn't fit the CD mold he worries that he lost the CD lottery so he thinks he could lose other health lotteries as well.

Lastly, I totally agree that chronic illness can make you hyper aware of body changes. I recent was looking of my med files. And it seems my resting hr has always be relatively high. Often it was been slightly tachy, like 105-110 and I never really knew beyond the GP asking if I may have doctor anxiety or am I staying hydrated. But once I had a couple of episodes where my hr would take off to 180, for no reason, that led to my IST diagnosis I've become hyper aware when it raises to even 95 when resting. I think I'm always waiting for it to take off. It's so weird because it's obviously gone up with exercise in my past and I didn't think twice about but now I'm hyper aware even when it raises while exercises. I'm better about it now but not so much for awhile after dx.

 

[Tesscorm]

I suppose it's the more obvious things that draw their attention, like rashes, coughs, etc. And, the reality is, as common as those types of symptoms are, they are also things we've told them to watch for. It's bad enough that we, as parents, have to find that balance between vigilance without paranoia, I wish they didn't need to find that balance too. I know this weighed on S over the past year - between his rash last year, chest pain, cardiac questions, back to rheumi related, colds/bronchitis and his shoulder issues in between, a number of times S mentioned that he was feeling down and upset that he always had health worries weighing on him.

Hopefully, this is just part of the transition in becoming an adult. In years past, these worries were just ours and we eventually learned what could wait but now, while they're more aware of the symptoms, they just haven't enough experience yet in balancing what can wait or what needs to be seen right away.