Good morning,
I was diagnosed with PsA about 2-1/2 years ago. I had never had any psoriasis so the diagnosis was a surprise at the time.
About 2 years ago, I got a "rash" on the back of my thigh. The skin was red and painful. It then broke out in small blisters which then ran together and turned a yellowy color. The blisters eventually crusted over and I had a patch of scaly skin that lasted for a few months before going back to normal. When this first happened I went to my PCP. She said "I've never seen anything like this. It looks like it could be an infection but I don't want to open it up to do any testing and risk introducing bacteria." So she put me on antibiotics just to be safe and it eventually went away, like I said above.
Last summer it happened again. Sore skin, blisters, crusty, scaly. It took at least 6 months for the skin to go back to "normal." It was in the same general area on the back of my right thigh. This time I treated it with topical steroids myself (I was already on MTX) and eventually it went through the cycle and went away. I did some research and thought it might have been pustular psoriasis but I did not see the doctor.
About 5 days ago I started to feel unwell - nausea, headache, exhaustion - and the skin on the back of my thigh started to feel sore. Two days later the blisters started. Looking back I realize that both times before I also felt unwell leading up to the blisters. I also just finished a Medrol pack of steroids for inflammation in my salivary glands (a side effect of the radioactive iodine treatment I had recently for thyroid cancer). Looking back at my medical claims, I also had taken Prednisone last year before the break out.
I've read quite a bit about pustular psoriasis online but most of what I read refers to break outs on hands/feet/face/genitals or all over. Can you get a localized outbreak just on the back of your leg?
I'm not sure if I should call the doctor and if I do, should I call my rheumatologist or my dermatologist?
I am currently taking Otezla for the PsA. Given the cancer diagnosis this year, my doctor will no longer give me Methotrexate.
Has anyone had a similar experience? Any advice/input is greatly appreciated!
Thanks,
Heidi in CT
Hello Heidi, just reading your description of the 'rash' sounded very much like the blisters that I got when I developed shingles. Have you had chicken pox in the past? Shingles is reactivation of the latent herpes zoster the virus which causes chicken pox and typically it happens when your immune system is run down or compromised .... and can certainly make you feel unwell and also take some time for the skin to heal and return to normal. Whilst it can occur anywhere on the body it typically follows a nerve branch. And you can get it more than once. Might be worth looking up some info. on a reputable online site.
I also suffer from a sun/UV induced skin rash on my arms and chest made up of tiny blisters, I've only recently read of a form of psoriasis like this. I do, infrequently, get a bit of pustular psoriasis on my palms or soles of my feet which start as small discoloured spots/blisters before developing into more of a plaque. Neither of these seem like you describe.
Whenever I've had a mild skin problem I've always managed it without seeing a doc/derm but that is probably how I got to nearly 50 before I discovered that my 'rashes' were psoriasis!!!!!!!!
Would think (although I'm no medical expert and not giving medical advice!) that if you think it might be shingles you definitely need to see your doc. Hope you're feeling better soon.
Hi Jules,
Thanks for your reply.
I have actually had shingles 3 times. I got the vaccine after the 3rd time. Each time the shingles breakout followed the same nerve up my neck/ear to my face. This is quite different. Blisters may not be the right word as they are not filled with water but they are certainly pustules. The pustules are very small but end up running together to form larger pustules. That's usually about the time they turn yellowy. Then they dry up and the skin gets scaly and flakes off. I don't know what to think.
I am reluctant to take the time out of work to go to the doctor because I am leaving in a few days for vacation. I feel like i see so many doctors! Between the psoriatic arthritis and thyroid cancer - I take a lot of time off for medical reasons. It's very stressful.
Thanks again :). Be well!
Heidi
..... three times ........ that makes you a shingles expert :-)
You could always take a sequence of photos as the rash develops and changes to show and discuss with your doc the next time you go.
Feel better soon, I'm sure your vacation will help .... mine's not until October.
OK, so the more I thought about this the more I thought this might be shingles. While the rash is very different the sickness is the same. So I went to the doctor and SURE ENOUGH SHINGLES! That means that I’ve now had shingles 6 times! 3 times on my neck and 3 times on my leg! I give up!
Oh my goodness Heidi I have never heard of that. How awful for you. Now that you say it it makes sense that every time you take a medrol pack your shingles come back. The shingles are kept in check by your body. When you take the steroid it gets let loose. I am so sorry but I am glad you know what it is. Sometimes putting a name to it is half the battle. I hope you feel better soon.
Oh Heidi, I'm so sorry you're having to go through it again but at least you know what it is and can see there is a trigger in the steroids. I hope the docs can find a workaround treatment for you. Get as much rest as you can and enjoy that vacation. Be well again soon.
I’m glad you guys figured it out! After I read your post. Immediately thought of shingles too! Your doc might give you a prescription for one of the antivirals? If you are okay to take them, you can just start taking them any time you finish steroids. It will definitely save you a lot of pain.