Skin problems: medication-related, or ??

[Goddess]

Hi, all,

Any help that you can give me would be very...helpful.

I finished a fairly high-dose course of Prednisone at the end of December. Finally tapered down to 10 mg., then off.

Since then I have been on Pentasa, 4 mg/ day.

I am not sure what to call it, but I have developed a skin condition on my face that presents as follows:

-skin swelling, like deep cystic acne, except can be isolated or in groups...never spread all over, though.
-swells, but more like widens beneath the skin, then eventually bursts and weeps large quantities of clear fluid...seems to be coming from between layers of the skin.
-after it has drained and is flat, the skin dries and peels off, leaving a raw red section that takes forever (current one has been 3 days) to crust over at all...just raw red skin, very painful and looks scalded.

The weird part is that it doesn't ever look at all bad to start with, just a small swelling...now the current one has become 1 inch x 1 inch, and bright red, and hurts way more than it seems something like this should!

I have been to 2 dermatologists. One said it's staph, gave me some ointment (Mupirocin) that does not help. The other said it's acne, gave me a 1-month course of antibiotics which I just finished, plus topical antibiotic solution, plus antibacterial wash and skin lotion. That doesn't help either. Neither doctor seemed all that concerned, but they don't have to live with it.

I have been using the antibiotic skin lotion and a coat of Mupirocen, and bandaging it at night. Kinda hard to keep a giant bandage on your face in the daytime. I tried tea tree oil, but it stung like hell, so I gave up. Same with alcohol-based antibiotic solution.

I am kind of hoping that it's just a lingering effect of the Prednisone...but I've always had problem skin, just nothing like this.

What do I even call this? Is it a boil? Anyone had anything similar? Any advice

Thanks!

 

[Jennifer]

How long have you been taking the Pentasa? About 2 months (maximum I believe) after starting some new medications I started having similar symptoms although not as severe as you described. It was only on my face. I looked up the side effects of my newest medications which were Pentasa and Allopurinol and the "rash" as I called it, on my face began the day after I finally finished my last dose of Entocort. So that's 3 medications that could have been the cause. I found that both Pentasa and Allopurinol can cause rashes on the skin. I waited it out to see if maybe it had something to do with the steroid since I had been on it for 6 months and when I take it long term it presents side effects similar to Prednisone. It didn't go away, in fact I started having another symptom that was more concerning. My urine turned pink/rose colored. I contacted my GI and he called me back that same day and told me to stop taking the Pentasa. I stopped and the following day my face had started to clear a lot and my urine was a normal color.

If you haven't done this already, take a picture of your face (in case it clears up) and contact your GI and let them know what's going on (if you see them in person and it's cleared up you'll at least have the image to show them). Ask them if this could be a side effect from the Pentasa. My GI didn't ask me to come in. All I had to do was describe the symptoms but I did take a photo just in case.

This is a terrible picture but my face is not this red and there were a lot of little bumps that the image doesn't show very well. The bumpy areas would hurt (it was red, hot and felt burned) and sometimes even itch. I didn't notice a lot of weeping like you described but it was very minor and it would crust over a bit but more like dead dried skin in large patches.

Edit: My chin felt like it had really deep acne or something (felt like it just filled up with fluid). It would itch a bit and there were a lot of them close together but then disappear and would simply crust over.

I stopped the Pentasa about a month ago I believe and it completely cleared up within a week at most.

 

[Goddess]

I've been on Pentasa for 3-1/2 months.

Your picture and what you're describing sounds like my skin a month ago, except in smaller patches. It's just gotten worse...deeper, weepier, rawer, takes longer to crust over.

My friend's daughter had "scalded skin syndrome" (as an adult, it's more common in little kids), and said that this looks exactly like that...except SSS was all over her whole body. Oh, my, I can't imagine! Anyway, that is caused by staph, so I guess that's also a possibility.

I'll do as you suggest and email the photo to my GI and hope he's got a handy Plan B in mind, because this is a bit beyond "suck it up and deal" territory.

Thanks!

 

[Jennifer]

Ask them if you could switch to Asacol or something similar if that's the type of treatment you plan on sticking with for now. I've taken Asacol in the past and didn't have the same reaction even though they are both made from Mesalamine. Mesalamine medications are not the best for Crohn's however so at some point you might want to talk about something stronger like 6MP, Imuran etc. http://www.crohnsforum.com/showthread.php?t=50253