Eczema and RA? | Arthritis Information

Hi Everyone,

I'm 35, have RA, and am on Enbrel. I recently developed eczema. I've read that you usually develop that as a kid or young adult. So I'm curious if RA, or enbrel, or even my diet has anything to do with it.

Does anyone have any advice?

Nori

Is it Eczema or Psoriatic?

Psoriatic Arthritis is very similar to RA and you can have both. From what I know Psoriatic Arthritis has some extra issues on top of all the similar RA symptoms, tendon issues and, of course, when someone with PA flares they experience all the RA flare symptoms with the added extra of an outbreak of Psoriasis on their skin also.

If I was you I would be doing some research on Psoriatic Arthritis and Eczema.

As far as I know there are dietry things that can help Exzema, I think but I don't know very much about it I'm afraid so I can't be much help with answering that specific question. Again, I would do some Google research and see what you find. Thank you for your response. The dermatologist said it was eczema. She gave me a steroid cream. However, I saw on a website that a steroid cream can weaken the immune system and make the eczema worse in the long run.

Nori

[QUOTE=nori king]Thank you for your response. The dermatologist said it was eczema. She gave me a steroid cream. However, I saw on a website that a steroid cream can weaken the immune system and make the eczema worse in the long run.

well... I just began with eczema too.. at least that is what my research is indicating.

I do notice that when I have to stop my enbrel..... i have a major outbreak of the eczema... ad..all over the bottom of my feet.

If you dont' mind.. can you describe YOUR eczema? *TMI warning* I have blisters that mke me crazy with the itching.. then they pop with fluid.. which then turns into VERY dry skin ???

Blisters? When stopping Enbrel? Sounds like psoriasis (sp?). Enbrel is used to treat that, which makes me suspicious about you stopping the enbrel and having worsening of symptoms.

Mine is dry itchy pinkish/reddish patches all over. No blisters. It is responding to thick aquafor lotion/ointment in a jar over the counter. I haven't used the steroid yet. But I have to apply it twice a day, and it is very inconvenient. My dermatololgist said mine is not psoriasis.

I wonder if gluten and caesin have anything to do w/ my problems.

PS - it's good to see you too, Babs10!

Nori

[QUOTE=nori king]Blisters? When stopping Enbrel? Sounds like psoriasis (sp?). Enbrel is used to treat that, which makes me suspicious about you stopping the enbrel and having worsening of symptoms.

I wonder if gluten and caesin have anything to do w/ my problems.

[/QUOTE]

well.. I have to say I share your fears about the psoriasis....

What about the gluten and caesin,, what would that have to do with this issue?

Is this a rheumatologist who is diagnosing? In any case, even dermatologists sometimes have a problem distinguishing between eczema and psoriasis.

PsA shares many of the same features as RA. Most people with PsA show signs of skin involvement first before the arthritic component kicks in, though very few people with PsA never have skin involvement. [Or the meds we take manage to do a good job of hiding any skin problems.]

Psoriasis takes many different forms. Some are blisters, some are just dry skin, some are red raised welts.....and the list goes on.

Methotrexate does a good job of dealing with the skin problems and many people who take Enbrel also take MTX concurrently.

I have done a lot of research [and so should you] and have never found any credible source that connects food or diet with either disease. There are a lot of snake oil salesmen out there though.

Sam12342009-11-15 17:31:48It was a dermatologist. It's dry patches. My stomach, forearms, shins, chest, lots of places. I'm very confused about this PsA thing. I would definitely want the correct diagnosis.

Nori

Then go to a university with a medical school and make an appointment with the dermatologist there. These people see it all.

Personally, I think too many dermatologists are building their practices around cosmetic stuff, so it's important to have a dermatologist who treats inflammtory skin diseases.

What does your rheumatologist say?

In the end, it's the rheumatologist who is going to be masterminding your treatment, not a dermatologist.

Sam12342009-11-15 18:39:48 [QUOTE=Sam1234]Is this a rheumatologist who is diagnosing? In any case, even dermatologists sometimes have a problem distinguishing between eczema and psoriasis.[/QUOTE]

I so agree. I think it can be very difficult to diagnose between them and if you dermatologist isn't factoring the RA issue alongside the skin issue then they could be missing a connection here.

I would think too that it would be wise having a rheumatologist diagnose the skin condition not just a dermatologist alone.

I'm with you, Cordelia, about being tired of well-meaning people who believe that taking certain vitamins or supplements or some "magical cure-all" are the answers to my problem.

Don't they have enough common sense to know that if these things really worked that our doctors would have prescribed them long ago? Duh!

Babs, look up palmoplantar pustulosis. Do you smoke, or have you ever? What you describe sounds like PPP. I have it and when I have an outbreak, my joints hurt. When my hands and feet are clear, little to no joint pain. My RD insists that I have RA because I have a very low anti-CCP and low RF, even though I seem to have a very mild, controllable form of this disease.

Gluten is a no-no for me - when I stay away from it, my hands and feet do not break out and I am free of pain for awhile. Just came back from vacation, where I ate bread and pasta and cake, and my hands and feet are terrible - and my shoulder is aching!

hmm.. one article I read stated that MTX is beneficial.... but i"ve been taking MTX for more than two years.. and suddenly I'm breaking out in these pustules.... ( http://www.aocd.org/skin/dermatologic_diseases/palmoplantar_pustu.html )

the one description that may not match is yellow "pus" ....which I do not have.. It's merely watery .....

Good stuff. Thank you for the posts. OTC heavy cream is helping, but I have to use it. It's thick and gooey. If I still have any spots at my december appt w/ the rheumy I will bring it up. I did talk about the RA to the dermatologist, but I know they aren't an expert.

Nori

Because I was diagnosed with PsA by xrays of my fingers and no skin psoriasis I was misdiagnosed by 2 dermatologists, my internist and my RD!!! They all told me I had skin psoriasis (even though I kept telling them that I had never had any psoriasis plaques) and I faithfully used every cream and medication known to man to help the skin eruptions. It spread from my ankle to my knee and 1/2 way around my calf. I finally got fed up and went to an elderly doctor who was chief of the psoriasis clinic at the Univ. of Wa. He examined me, took a complete history and a scraping and informed me that I had a fungal infection.

I was appalled that I had spent 8 months and thousands of my insurance's dollars on a misdiagnosis. My leg was ugly and kept getting uglier and nothing was helping. I was given an antifungal cream and within a week the area on my leg was 60% better and is now completely gone.

Sometimes a second and a third opinion are needed. Fungal infections are often one of the side effects of the immune suppressing drugs that we take. Only a scraping or a biopsy will give you a definitive diagnosis. If the cream is helping then it's probably as diagnosed.

Babs, get to the doctor about the bottom of your feet. It could be a fungal infection. Mine started with bumps that itched badly, broke, became very red, spread and then would dry out and start all over again. Lindy

[QUOTE=LinB]

[/QUOTE]

oh that sounds JUST Like it.

should i see a dermatologist/?

Babs, I'd start with a dermtologist. I used an over the counter fungal medication. Because of the toxicity of the antifungal drugs they didn't want to prescribe the oral meds. They're infamous for causing liver damage. LindyAnd I would insist on a skin scraping!!!Yes, be sure to get a skin scraping. I did, and it came back negative for fungus.[QUOTE=Nancy R.]Yes, be sure to get a skin scraping. I did, and it came back negative for fungus.[/QUOTE]

But was it positive for any other skin disease or did they only look for fungus? Many scrapings are negative for some diseases but positive also. Lindy

Hey Guys,

So the spots I posted about are clearing up nicely with over the counter heavy moisturizer. It's great, but I have a feeling I'm only fixing the symptom....

Nori

[QUOTE=nori king]Hey Guys, [QUOTE=LinB]Babs, I'd start with a dermtologist. I used an over the counter fungal medication. Because of the toxicity of the antifungal drugs they didn't want to prescribe the oral meds. They're infamous for causing liver damage. Lindy[/QUOTE]

amazingly....... or not

question..... what about my shoes? can it hang out in there and wait for me to come back and reinfect????????

Nori King!! I am so thrilled that you are finding relief!! that's great.... hope it continues.

My youngest has eczema and the doc gave us some ointment that looks like vaseline. Well, vaseline is cheaper than getting a refill of the rx ointment so we've been using that to lube him up instead (tub of lard & unscented moisturizer). Seems to work well. I really enjoy the vaseline lotion myself... if you pile it on at night, you end up with super supple skin in the morning.Nori, I'm so happy that the eczema is cleared up. Like I said if the cream worked it was eczema.

Babs, glad to help you out and glad that your doing better. I use an antifungal powder in my shoes. Because of our immune system the fungal infection can spread to other parts of our body easier than if we had superwoman immune systems. Lindy

I live in a colder climate, so I think it's also due to the weather. I was also a bit itchy on my forearms today. I'm stressed, and I think that is impacting me as well. Yuck!

Nori

Well this has been an interesting post. Glad you are all getting to the bottom of your skin problems.

LinB I had no idea a person could have psoriasis without skin issues.

I usually treat eczema by finding the cause. Very important to take your skin rashes to your RD. He may wish to consider if the Enbrel is causing it.

What? Enbrel could be causing my skin rash/eczema? Yikes. Please let me know if this is possible. Would I have to stop Enbrel?

Nori

[QUOTE=milly]

LinB I had no idea a person could have psoriasis without skin issues.

[/QUOTE]

Yes, very true. I have PsA and have never had any skin lesions, not even to "herald" the disease.

Only 15% of all people with psoriasis will have psoriatic arthritis. I don't know offhand what the percentage is of those people with PsA who never had skin involvement, but it's relatively low. That's not to say the the pain and inflammation are low in contrast to those with skin involvement.

Sam12342009-11-19 19:00:21Sam, I think it's about 5% without lesions but with PsA.

Milly, yes, it's possible like Sam said. Diagnosis was made by xrays of my hands. There's a particular bone deformity of the long bones of the fingers that's only found with active PsA.

Lindy

LinB2009-11-19 20:45:40Hi Nori.

Be VERY careful about using the RX steroid creams. I went through this for a couple of years, and ended up with a steroid-induced rosacea that almost blinded me, AND with MRSA. Took 2 years to recover once the doctors figured it out. Glad to be alive. Am still fighting the eczema outbreaks, but am now wondering: my 21-year-old daughter just got diagnosed with psoriasis on her hands (she's a string musician). One of my brothers was diagnosed as a teen with juvenile RA. Father had gout and so have I. Obviously an immune problem that is genetic.... As to my eczema on my hands, arms and legs, the only thing that has worked for me when it cracks and bleeds is vicks vaporub. Nothing (prescription or otherwise) really eliminates the blistery rash that comes up on my face, but bactroban or neosporin keeps it from turning into staph. Also have to take massive Vitamin D boost, which helps keep it under control -- have your levels checked.
LT,

Thank you for the post. It reinforces exactly what I suspect. Which is that I should avoid steroids. Dr. weil's website www.drweil.com also advises this. the spots are gone, but now it is an all over itch. I am also getting a face flush very often like right now. I am soooooo stressed right now.

nori