Red spots/Rash on leg with 6 MP

[Ands]

Last night in the shower ds noticed a rash/bruise on his upper inner thigh. To start with we thought it might just be dry skin but it is as smooth as anything and only sore and itchy if touched. It is about the size of the base of a milk bottle and made up of lots of red spots.

He's been on 6 MP for about 5 weeks and I know this can cause skin problems but some places (sorry I did google) say not to worry and others say contact someone. I'm not sure what to do, last blood test was 1 1/2 weeks ago, and assuming all these have been ok as I've not heard back from anyone. He seems fine in himself (with the exception to the tiredness, which I can't see ever changing) and actually his tummy pain seems to has disappeared so I don't really want to change everything again.

Any views or ideas appreciated.

Thanks, as always.

Xxxxxx

 

[David]

Hi Ands,

The blood tests he's been having. Have any of the results been trending down? I realize you don't have the results back from the most recent one.

I see he stopped azathioprine after 2 weeks. What was the reaction he had?

I, personally, would bring it to the attention of my doctor (today) if I was in your situation. It sounds like it MAY be some form of vasculitis but could of course be a number of things.

 

[DustyKat]

I agree with what David has said Ands. :hug:

Is your son still having any symptoms of a flare?

If so another thing he may be experiencing one of the skin manifestations of Crohn's. The one that springs to mind from your description is Erythema Nodosum. Either way it is best to have it checked out.

Dusty. xxx

 

[Ands]

Thanks David. His reaction to aza was nausea, itchy skin and slight rash (although more blotchy, dr noticed it not me!).

He's gone into school so I think I'll check him out when he gets home and then give someone a call.

Interesting you mentioned Vasculitis, my Mum was diagnosed with that a year ago!

Thanks again.

Ands

 

[Ands]

Sorry Dusty, our messages crossed!!!!

December MRI showed no active disease. His consultant feels that he has been left with ibs symptoms, which would put a reason to the irregular bm's (he tends to do very little for 2/3 days and then mass clear out!!!!!). Tummy pain has become next to nothing over last few weeks :ybiggrin: so only other problem is tiredness. Oh, and now rash of course!

Thanks.

 

[David]

Azathioprine and 6-MP are both, "thiopurine" drugs. Azathioprine basically turns into 6-MP in the body. Sometimes when someone has a reaction to one, they won't the other, but it sounds like that might not be the case for your son

If your son is tired a lot, I would request a vitamin B12 and vitamin D test for him. Deficiencies in either can lead to fatigue and both are VERY common in people with Crohn's disease. If he's normal with them, at least you know but if he's not, it's an easy fix and can really improve his quality of life and health.

Please let us know what the doctor says.

 

[Patricia56]

I contact my sons pediatrician/gp or his specialist about any new rash or bruising the same day or next day if it is evening. With the exception of a rash accompanied by fever or symptoms that might be SJS (see below). I haven't had to do either of those things in 7 years but I am one of those who like to have some idea of when to act quickly rather than wait and see.

One rash you want to be aware of (this does NOT sound like the one your son has) usually presents with mouth ulcers and then a rash over some or all of the body, usually starting on the extremities. The rash looks a bit like a bulls eye on a target (they call it a target rash) and typically develops into large blisters.

The rash is often preceeded by a flu-like illness several days to a week before the appearance of the rash.

This could be SJS which is a very serious infection that spreads very quickly, sometimes in a matter of hours, and requires treatment at the hospital ASAP.

With this type of rash, do not hesitate to go to your peds, GP or ER immediately as, if left untreated, can become life-threatening.

 

[Crohn's Mom]

I agree with David, and it sounds like it may be the same reaction he had to the Aza ~

I would definitely contact the GI and at least make them aware.

Best of luck!
:hug:

 

[crohnsinct]

Late to the game here but what I thought (and two derms btw) was eczema was actually Remicade induced psoriasis...still not serious but now we know what we are dealing with and can stop giving her antibiotics for "infected eczema".

It never hurts to call.

 

[Johnnysmom]

My son had the very same thing when he started 6mp. And oddly enough it always appeared after he got out of the shower.

I called the GI and they sent us in to our Pediatrician for her to take a look. She said it looked like Petechiae and sent us to the lab for blood work. They checked his blood clotting factors and some other blood counts. Everything came up normal. It happened one other time a few weeks later but has not happened since. He had just started 6mp and was on a pretty high dose. It took us a while to figure out that the dose was too high for him and was bringing his White blood cell count too low. I don't know if that had something to do with it or his body need time to adjust to 6mp or it was some weird fluke. But I would have your Dr. take a look just in case. Try not to worry Hopefully it will go away as mysteriously as it appeared.

(((((hugs))))))

 

[my little penguin]

DS had the same rash on Mtx - his was vasculitis .
No one knew what it was but the Rheumotologist and allergist .

Fwiw our Gi thought DS extra symptoms ( 2/3 days no BM) stomach aches fatigue etc were just leftover Ibs since his mre was clean.
Turns out he just wasn't on the right med. remicade took it all away.

 

[Ands]

Well seen junior dr and although she doesn't know what the rash is, she took bloods and all came back normal.

Therefore just been told to keep an eye on it and see what happens.......

Hopefully nothing to worry about then.

Thanks for all support.

Xxxx

 

[Farmwife]

That's good to hear.
Thanks for the update!

HUGS

 

[Lewiss mum]

glad his blood works came back o.k . lewis has had the odd spot come up a couple came up in a cluster the oher day hes a scratcher and a picker so i was advised put some clfucidine on to reduce and swelling i asked if it was the aza they said it could ov exagerated as his body cant fight any infev and with beibg on infliximab aswell hopefully the rash will go away on its own . weve been using a soap substitute called dermol 500 i n the shower and bath aswell as a moisturiser maybe worh asking ur doc for i think oilatum has the same effect but my two have both had reactiins to this . xx

 

[Ands]

Well we saw Ped yesterday (scheduled appt) and she wasn't worried about an odd rash that comes and goes but her concern was over his alt levels. She showed us a chart and it has always been normal until he started and then failed on aza and now the last two results have been high. His last one was 96 and the one before a little higher. Took more blood yesterday and she said she would phone at the end of the week.

I know 6mp can cause this was just wondering what levels they let it go to before getting too concerned? Ds is making progress and just don't want to have to start all over with another medicine.....

Thanks as always.

Ands xx

 

[Johnnysmom]

They can cut the 6mp dose in half and add allopurinol if the numbers get too high. They did this for my son and several other kids on the forum. Works great.

 

[ALotToLearn]

My son is also on 6mp. However, it seems to be a pretty high dose, 75mg daily. He started on 50mg while he was taking pred. After the pred ended he started having more symptoms again so his GI increased the 6mp. That's been since the beginning of January. My question for those of you that have kids taking it, did it ever seem to cause any mental issues? I don't think that's a side effect, but this morning when I woke my son for school he was crying. Said he didn't know why? Just that his head felt weird, kind of scared, not voices or anything, just not right. I wonder if this medication is doing more harm than good for a 13 year old kid?

 

[Sascot]

I believe Andrew's level was around 90 when they became concerned and told us to stop giving the Aza to him. Hope this new blood test alt levels are not so high!

 

[my little penguin]

DS had his levels go high for ast and alt .
Gi pulled 6-mp for a week and cut his dose down to 1/4 what it was plus allopurinol.
Good luck