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» LymeNet Flash » Questions and Discussion » Medical Questions » Help me brainstorm about this rash, please

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Author Topic: Help me brainstorm about this rash, please
cactus
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I need some help.

I have a bright red, burning rash that has spread for 4 days.

In most places it is solid red, like a bad sunburn (and feels like one, too). Other places it is splotchy, like it's trying to spread.

It extends from the top of my thighs all the way up my chest then under the arms and in splotches out my arms. One arm is solid red, the other just splotchy. It's also on my back, up my neck into my hair.

It started 36 hours after I started Nystatin and a low dose of Prednisone.

I know prednisone is a no no, but I have been out of active Lyme treatment for a year plus, and the pred was rx'd by my LLMD as a stress dose for Addison's Disease.

I had been on Vancomycin for 30 days prior to this, treating C Diff.

When the rash appeared 4 days ago, I stopped Nystatin, Vanco.

A day later I stopped the Pred as scheduled and resumed my
normal Addison's meds.

If this is an allergic rash, or hives, wouldn't it have subsided some by now? It's actually worse!

I've called the doc, but think it will be at least a day before I hear back.

Does this sound like an allergy? Or something else?

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�Did you ever stop to think, and forget to start again?� - A.A. Milne

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sixgoofykids
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Does Benadryl help?

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cactus
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I should have added that - no. It doesn't help! Although it knocks me out so I sleep through some of the pain.

It's a really painful rash. [Frown]

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�Did you ever stop to think, and forget to start again?� - A.A. Milne

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sickpuppy
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When you called your doc did you say it was urgent? Any trouble breathing, dizziness? Do you need to get to the ER?
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sutherngrl
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Kind of sounds allergy like to me! An allergic reaction to meds can last a good while.

My daughter had an allergic reaction to an antibiotic and had to be given steroids. It helped, but a week later she broke out again and had to have more steroids. Rash lasted about 2 weeks. She was also swollen though. If you have not had any swelling that is good. Swelling is serious and you would need to go to the ER.

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Jane2904
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Hi Cactus,

Sending healing thoughts to you. I am so sorry you are suffering with this rash.

Wish I knew something to help you. A family member once used Aveno oatmeal Bath for some relief of a red , itchy rash. Maybe this might bring some relief.

Hope you feel better, Jane

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Haley
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Cactus - I'm sure you must be frustrated. Six has a good question - if it is an allergy it should respond to Benadryl. Also if it itches, that is usually a sign of allergy.

The reason I asked about tinctures is I had a reaction to Lomatium ( I found out later). It was in a tincture I had. The rash was so bad (head to toe) I went to the ER. The rash did not itch and it didn't respond to benadryl or prednisone. It took one week to subside.

I found out later from an LLMD that it was a reaction but not an allergy. He told me that the substance can cause the measles to come out. I still to this day don't understand that as I have had the vaccine but that is exactly what it looked like.

My hunch is that your rash will subside. Mine did appear to get worse before it started getting better, even after I stopped all of my meds and tinctures.

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cactus
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No trouble breathing or dizziness - thanks for checking, sickpup.

It is helpful to hear that allergic reactions can last a long time - that makes me feel a bit better, sutherngrl... Did your daughter's rash burn, too?

Thanks for the healing wishes, Jane!

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�Did you ever stop to think, and forget to start again?� - A.A. Milne

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sickpuppy
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Does a bath help?
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cactus
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Haley... Thanks so much, I just saw your response.

Not responding to benadryl is a clue then...

I'm glad to know that yours got worse and then better though! The measles, oh my...

So it could be a reaction but not an allergy...

At least that gives me hope that it's not something completely new.

Thanks.

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�Did you ever stop to think, and forget to start again?� - A.A. Milne

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elizzza811
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Here's another possibility, according to a Swedish doctor...

Mystery in the Skin:
http://www.feb.se/ARTICLES/OlleJ.html

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sutherngrl
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cactus, don't really know if her rash burned, she was only 3 years old at the time. Hard to get a good description from a 3 yr old.

I just know it was an allergic reaction to medication and that it lasted 2 weeks.

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sixgoofykids
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If you started Nystatin, could it be related to yeast? I have gotten fungal rashes, so maybe it's a flare up, or the yeast trying to get away from the medication ... don't know if that CAN happen, but throwing ideas out there.

I would think it would have responded to Benadryl if it were an allergic reaction.

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TF
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What you are describing could be what is known as "red man syndrome." It can be caused by vancomycin, even oral vancomycin.

It is a hypersensitivity reaction.

Please do a google search and look at the pictures, etc.

The location of the rash is as you have described. Also the itching and burning.

They claim that antihistamines will help if this is what it is, but I am guessing that you will need a lot of antihistamines--like IV in the ER.

Or, you can try taking the max allowed at one time and keep it up.

Here is one website for you to read:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC270616/

Sometimes, people get this syndrome when other meds are added to the vanco--it pushes the person's body "over the top." So, that may explain your case. Or, it may be that you body just hit the limit of vanco and erupted.

I know you are miserable.

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Haley
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Cactus - can you give us an update on this. Have you seen the doctor?

TF - sounds like a reasonable theory. You should be an LLMD.

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cactus
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Here's the update: it spread a lot more overnight, so I got in with an NP at the LLMD's office.

TF, the NP I saw at the LLMD's office said the same thing, so you were onto something there.

The one odd part is that it hasn't decreased since stopping the vanco, and didn't respond to anti-histamines. But again, maybe I needed massive doses!

After seeing the NP, and getting checked out by my LLMD - they discussed and decided the best course is prednisone.

I am well aware of the risks but desperate. At this point, I can barely tolerate even loose clothing.

So - as I'm now more red than any other color... I'm doing a 10 day course of pred. Ugh.

Thanks for checking on me!

Itching but still kicking,
Red Cactus

[ 05-28-2010, 07:37 PM: Message edited by: cactus ]

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�Did you ever stop to think, and forget to start again?� - A.A. Milne

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mjbucuk
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when my son had allergic rxn to ceclor they gave him atarax I think, which was supposed to be stronger than benadryl.
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Paulette-2-Lively
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Hi Cactus,

I am a fellow addisonian...so sorry you and I are in the same "club". What is your normal steroid dose, how do you take it & how much Prednisone did they put you on & what schedule to take the Pred?

Do you have bartonella?

I have had a strange red rash from bart, but it looked more like stretch marks...only it spread rapidly following quitting the zithromax that was treating it.

Have you tried hydrocortisone cream?

With cortisol deficiency your body will not respond to the rash and fight the inflammation unless you are high enough on steroids...so my thoughts are that the pred is a good move.

Paulette

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Paulette

Staying positive - One Day at a Time!

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cactus
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Thanks, mjbucuk, I'll ask about that when I speak to the doc next!

Paulette, I take 15 mg hydrocortisone in the am and 5 with lunch. Also fludricortisone (can't remember the dose).

I am on 60 mg of pred for 2 days, then dropping down to 40 for 4 days, then 20 mg for 4 days. (Won't be taking the hydrocortisone or fludricortisone during that time)

Do you think that will help?

I have been treated for bart - whether I still have it is another story. But this doesn't look like a bart rash.

It looks exactly like the "red man syndrome" mentioned above though.

Despite the first 60 mg of pred yesterday - the rash spread overnight. It's down to my knees and onto my shins, as well as my hands now.

The rest of my body is almost entirely red, lobster red. The new sections are a brighter red than the older sections, insanely itchy and burning.

I am feeling very desperate at this point.

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�Did you ever stop to think, and forget to start again?� - A.A. Milne

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