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Remicade skin issues

Hello all. My 11 year old son has been on Remicade and Methotrexate for about a year now and has been feeling great GI wise, but over the last few months has developed what looks like acne all over his butt and groin, with some spots spreading up his back and also has persistent jock itch that doesn’t respond to Lotramin. I showed his GI doc who prescribed an oral antifungal. It seems to be clearing up his jock itch, but his bottom and groin look worse than ever, with large swollen white head looking spots. I’m sorry if this is graphic, but has anyone else had a child with anything like this?
 

my little penguin

Moderator
Staff member
Definitely see a dermo who is familiar with immunosuppressants/biologics and Crohns .
Ds has had different skin issues (not those )
But have a good dermo in the team really helps
Ds had to see three dermis before we found an adult dermo who also sees kids and knows Crohns /biologics

Good luck
 

Maya142

Moderator
Staff member
I would definitely see a dermatologist - perhaps your GI can recommend one that knows Crohn's? We didn't have those skin issues but my daughter does see a dermatologist yearly. They actually made her see a dermatologist in the transplant clinic because he was familiar with immunosuppressants.

Your poor kiddo. I hope they can figure out what's going on soon.
 
Hi. I'm new to forum, but I saw your post and wanted to reply. My son,14,has been on Remicade every 6-8 weeks now for 4 years. Two years ago he developed 'what we thought' nasty bad athletes foot on both feet, up to ankle. Saw an adult derm who gave him oral anti fungal, but I was reluctant to give him more med. So we continued self treating until last week when he was in hospital overnight 4 days for MRSA on his ankle. In hospital he saw a pediatric derm who is familiar with Crohns kids and said it was Remicade induced psoriasis. And that he probably got the MRSA bc he scratched his ankle so much, it was easy for bacteria to enter.
My advice is same as above seek out a pediatric derm familiar with IBD/meds, and be mindful of open scratches and sores so that bacteria doesn't enter. I hope your child finds relief soon!
 

Maya142

Moderator
Staff member
I'm going to tag crohnsinct because she has a lot of experience with psoriasis. Mutti has a good point - if they are open sores, he needs to be very careful when cleaning himself, particularly if he has diarrhea.

I have to admit, I also thought of MRSA when you said he had large swollen pimple like spots. My older daughter had a MRSA infection when she was younger (and was on a biologic and MTX) and that's kind of what it looked like.

Symptoms
Photos of two staph infections: one minor, and one serious
Staph infection
Staph skin infections, including MRSA, generally start as swollen, painful red bumps that might resemble pimples or spider bites. The affected area might be:

Warm to the touch
Full of pus or other drainage
Accompanied by a fever
These can quickly turn into deep, painful abscesses that require surgical draining. Sometimes the bacteria remain confined to the skin. But they can also burrow deep into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.
Honestly, I would see his pediatrician or ask his GI specifically about MRSA. He may need IV antibiotics if it is MRSA.
 

crohnsinct

Well-known member
My oldest Crohnie has Remicade induced psoriasis. She has it in her scalp, ears, neck, chest, back and genitals.

She mostly has plaque psoriasis but in the genitals it is usually inverse psoriasis.

What you are describing could be pustular psoriasis. Not usually in the genitals but it certainly could be. O has gotten it on her back, stomach and chest before.

She is a swimmer and with all her broken skin from the plaques the term did tell her to shower as soon as she got out of the germ infested pool. The reason being the broken skin combined with the immunosuppressants and the higher likelihood of infection. She has actually never heeded the advice or gotten an infection...just lucky I guess but I wish she would shower right after practice.

Here is a link to the NPF. I think you could find pictures there and see if what he has looks like pustular psoriasis.

https://www.psoriasis.org/about-psoriasis

Either way you will need to see a derm as the term will help you treat the psoriasis.

There isn't much you could do about it. We have added methotrexate to treat the psoriasis and it lessened it a bit but not enough to justify the side effects or added drug burden. She just uses steroid creams. Two weeks on, two weeks off. We have also tried decreasing her Remicade dose a bit to see if that helped but the only thing that did was send her into a Crohn's flare. So she just lives with it. She would rather be an itchy, scaley mess than deal with Crohn's.
 
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