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Crohn's Disease Forum » General IBD Discussion » Rash from Remicade? (With Picture)


08-20-2017, 02:33 PM   #1
whoawhoawhoa
 
Join Date: Aug 2017
Rash from Remicade? (With Picture)

For the last 4-5 years I've been dealing with a rash mostly on the sides of my stomach, and few spots here and there on my legs (it gets much worse than what the picture shows). The first dermatologist said it was psoriasis, then the second dermatologist said it was eczema (I had a biopsy taken both times).

From what I've heard, remicade can cause these rashes. I've been taking remicade ever since 2007/2008, and its still been working great. I talked to my gastroenterologist about the rash, although he punted it over to a dermatologist.

I haven't had much luck with the topical creams, and I'm in search of finding the root cause. Could this be from anxiety? I'm wondering what the next step could be to get rid of this .. Has anyone had a similar experience? I do have an appointment with an allergist, in case that might be the solution.

Would switching from remicade to humira be an option? If something went wrong, can I switch back to remicade?

I apologize for so many questions, but I'm a bit lost (and frustrated). Any input would be greatly appreciate!
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Last edited by whoawhoawhoa; 08-20-2017 at 03:27 PM.
08-20-2017, 05:51 PM   #2
aypues
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get the Anser IFX prometheus test done maybe to see if you've built up antibodies to Remicade.
08-20-2017, 06:41 PM   #3
Ladybug12
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For the last 4-5 years I've been dealing with a rash mostly on the sides of my stomach, and few spots here and there on my legs (it gets much worse than what the picture shows). The first dermatologist said it was psoriasis, then the second dermatologist said it was eczema (I had a biopsy taken both times).

From what I've heard, remicade can cause these rashes. I've been taking remicade ever since 2007/2008, and its still been working great. I talked to my gastroenterologist about the rash, although he punted it over to a dermatologist.

I haven't had much luck with the topical creams, and I'm in search of finding the root cause. Could this be from anxiety? I'm wondering what the next step could be to get rid of this .. Has anyone had a similar experience? I do have an appointment with an allergist, in case that might be the solution.

Would switching from remicade to humira be an option? If something went wrong, can I switch back to remicade?

I apologize for so many questions, but I'm a bit lost (and frustrated). Any input would be greatly appreciate!
My daughter had a similar experience a couple of months ago. I changed her bath soap to Dove sensitive and purchased an over the counter cream called TriDerma. It healed in a couple of days. The affected area was air dried before applying the cream.
08-20-2017, 11:56 PM   #4
Maya142
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Remicade can induce psoriasis. Generally, if it isn't too bad, it is treated with topical treatments. Adding Methotrexate also might help. Checking for Remicade antibodies is also a good idea.

If it gets unbearable, then usually Remicade is stopped and you would be put on another biologic - it could be Humira or it may be a biologic with a different mechanism (Stelara, for example, is approved for both psoriasis and Crohn's and is a good choice).

I would get a third opinion - preferably from a dermatologist who has a lot of experience with psoriasis. The treatment would depend on if it's psoriasis vs. eczema.

There are a lot of studies on Infliximab or anti-TNF induced psoriasis if you search. Here are some:
https://www.ncbi.nlm.nih.gov/pubmed/21752492
https://www.ncbi.nlm.nih.gov/pubmed/18092839
https://www.ncbi.nlm.nih.gov/pubmed/28300922
https://www.ncbi.nlm.nih.gov/pubmed/20580412
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08-21-2017, 01:13 PM   #5
Caitlyn336
 
Join Date: Jul 2017
Location: Reno, NV
The TNF alphas can cause new or worsening psoriasis. Right now I work in dermatology, my boss is the one who did biopsies for me to decide if mine was eczema or psoriasis. The tests can be tough because sometimes it just comes back as inflammation.

You could talk to Derm about adding methotrexate, it is safe to use with remicade. If that knocks the rash out then clinically you would know it was psoriasis. Getting off the remicade may or may not improve the condition.

If methotrexate did not clear then clinically it could look like eczema. There are some systemic treatments for eczema but I am unsure if they could be coupled with remicade.
08-21-2017, 08:26 PM   #6
whoawhoawhoa
 
Join Date: Aug 2017
I appreciate everyone's input. i'm going to the doctor this next week. The only reason I'm leaning towards eczema is because the cream seemed to subdue the area better than the cream prescribed when it was called psoriasis.

Another question --- I seem to feel bloated each time the rash comes around. Is there a chance these are linked? Could this be from small intestine bacterial overgrowth (SIBO)?
08-21-2017, 08:28 PM   #7
Caitlyn336
 
Join Date: Jul 2017
Location: Reno, NV
I appreciate everyone's input. i'm going to the doctor this next week. The only reason I'm leaning towards eczema is because the cream seemed to subdue the area better than the cream prescribed when it was called psoriasis.

Another question --- I seem to feel bloated each time the rash comes around. Is there a chance these are linked? Could this be from small intestine bacterial overgrowth (SIBO)?
I have no input on if it's SIBO, but would you mind telling me which cream worked and which didn't. If you don't want to that's fine I'm really just curious.
08-21-2017, 08:36 PM   #8
whoawhoawhoa
 
Join Date: Aug 2017
I have no input on if it's SIBO, but would you mind telling me which cream worked and which didn't. If you don't want to that's fine I'm really just curious.

Triamcinolone Acetonide Cream USP .1% (eczema). I believe this is considered a moderate strength cream.

I do not have the other name, since its been so long and I threw it out.
08-21-2017, 08:43 PM   #9
Caitlyn336
 
Join Date: Jul 2017
Location: Reno, NV
Triamcinolone Acetonide Cream USP .1% (eczema). I believe this is considered a moderate strength cream.

I do not have the other name, since its been so long and I threw it out.
Thank you
I try not to be nosy but I get very curious about derm things. That one is a mild steroid cream, one of the most common. Glad it helps with the rash. Hopefully you'll find some answers soon and have more relief.
08-21-2017, 08:53 PM   #10
Maya142
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That's a steroid cream - I believe that would work if it was psoriasis or eczema...
08-22-2017, 12:47 PM   #11
Caitlyn336
 
Join Date: Jul 2017
Location: Reno, NV
Maya it does, but eczema tends to respond much better to steroid creams than psoriasis does. Not a definitive answer but something to think about. Most cases of psoriasis respond well to steroids but a potent one works far better than triamcinolone for it.

whoa-does the bloating come first? Or the rash? I know that when my Crohn's flares one of my first signs is my psoriasis flares. My skin goes nuts, and then my stomach quickly follows.
08-22-2017, 12:52 PM   #12
Maya142
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That makes sense, Caitlyn. My daughter was prescribed a similar (weak) steroid cream for her eczema.

A third opinion might be the way to go, if you're not getting good answers.
08-22-2017, 01:37 PM   #13
whoawhoawhoa
 
Join Date: Aug 2017
Maya it does, but eczema tends to respond much better to steroid creams than psoriasis does. Not a definitive answer but something to think about. Most cases of psoriasis respond well to steroids but a potent one works far better than triamcinolone for it.

whoa-does the bloating come first? Or the rash? I know that when my Crohn's flares one of my first signs is my psoriasis flares. My skin goes nuts, and then my stomach quickly follows.

It's hard to say. I believe the rash might begin to appear first, then the bloating. Both occur within a day or 2.

Is there anything to take to combat the bloating? I use probiotics occasionally but I haven't seen much improvement.
08-22-2017, 01:42 PM   #14
Tuff
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I had a rash like that on my leg while on Remicade. I was prescribed Betaderm. Since switching to Stelara, the rash hasn't come back.
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Previously: 5-Asa, Cipro, Flagyl, Prednisone, Aza, Remicade.
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08-23-2017, 11:48 AM   #15
whoawhoawhoa
 
Join Date: Aug 2017
I had a rash like that on my leg while on Remicade. I was prescribed Betaderm. Since switching to Stelara, the rash hasn't come back.
I'll ask about betaderm. I have an older cousin who has crohns. She was on remicade and had a rash, which came and went. She also switched to humira, but I'm not sure if this was the same time the rash disappeared. At least this gives me some hope if it's as simple as this.

I'm nervous switch medication because I'll never forget what life was like before going on remicade.
08-23-2017, 11:50 AM   #16
whoawhoawhoa
 
Join Date: Aug 2017
I should mention one thing --- It's kind of weird but the sun seems to help the most. I know it's recommended to stay out of the sun if you're on remicade, although I'm not sure what the reason is?
08-23-2017, 12:16 PM   #17
Caitlyn336
 
Join Date: Jul 2017
Location: Reno, NV
I should mention one thing --- It's kind of weird but the sun seems to help the most. I know it's recommended to stay out of the sun if you're on remicade, although I'm not sure what the reason is?
Funny enough UVB is used to treat psoriasis. We tell patients to get 10-15 minutes a day of natural sunlight in the morning or evening. Afternoon light is the most harmful for skin cancers.
08-23-2017, 06:38 PM   #18
Lisa
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Just saw this thread- I have the SAME RASH right now, had it a few years ago after a bout with strep, this last bout started July 4th week after having a wicked sinus infection.....

I use Clobetasol cream, it is a steroid... It definitely helps with mine.....

Google Gutatte Psoriasis..... That is what I think it is.....I had a scrape test done the first time and it was negative for regular psoriasis. My antibodies were negative 8 weeks ago.... No blood work today before my infusion though.
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08-23-2017, 07:25 PM   #19
whoawhoawhoa
 
Join Date: Aug 2017
Just saw this thread- I have the SAME RASH right now, had it a few years ago after a bout with strep, this last bout started July 4th week after having a wicked sinus infection.....

I use Clobetasol cream, it is a steroid... It definitely helps with mine.....

Google Gutatte Psoriasis..... That is what I think it is.....I had a scrape test done the first time and it was negative for regular psoriasis. My antibodies were negative 8 weeks ago.... No blood work today before my infusion though.
Thanks for the reply! I'll have to look that up. When mine first came on I know I was having a lot of sinus issues (for more than a year). I'm not sure what is triggering it now.
08-23-2017, 08:30 PM   #20
Lisa
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I will tell you that the first bout I had did take a looooong time to finally clear up......but it did...... This round is starting to fade already....I use the Clobetasol cream sparingly, as I have seen a rebound effect in some spots where they get a little worse after I stop using the cream.

For me, as I haven't had other effects from the remicade to speak of, and I see a dermatologist, it hasn't made me think about switching medications. My GI is aware of this also.....
08-24-2017, 06:18 AM   #21
Tuff
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I didn't switch because of the rash, I also got peripheral neuropathy
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