Rashes: Caution for Stevens-Johnson Syndrome

Diseases & Conditions Rheumatoid Arthritis
1
Hey ya'll,
I wanted to write something about this due to some posts about rashes.  An opportune time to bring it up and I think it is very useful not only for us here at arthritis but other forums as well.
Many of us are on a LAUNDRY LIST of medications.
Common medications that can cause skin rashes are:
Aspirin
Relafen
Ketoprofen
Morphine
Imuran
These rashes are typically benign and go away on there own.
 
Anticonvulsive treatments for pain like Depakote, Lamictal...have an increased risk for a systemic rash called Stevens-Johnson Syndrome.
 
For anyone who notices a rash on their body that is to them, a bit abnormal!!!...report it to your doc immediately. 
Warning signs that tell you a rash is a serious one that needs attention STAT:
 
  • the rash develops within a short time after taking a new medication.
  • 2-8 weeks into therapy of a new drug.
  • the rash is widespread and has a bright red blotchy color.
  • swelling.
  • fever.
  • difficulty breathing.
  • lesions that spread in your mouth and eyes.

When in doubt check it out.  Read medication bottles carefully.  When we are heavy into a medication regime it's tough to keep up with what may interact with what...and sometimes pharmacies don't catch EVERYTHING.

Out of all the side effects, rashes should be taken into careful consideration.

Steven-Johnson Syndrome is very distinct looking, I'm sure if you google it one can find lots of photos.  It's just a very good thing to be aware of.

Again, most times small little itchy rashes are normal and go away...but do be mindful of them!

Be well & take care. 

 
 

Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.

2
Very cool... thanks Erin! :)

Diagnosed January 2005 - Psoriatic Arthritis/Spondylitis
-Currently taking 50mg shot weekly of Enbrel
Diagnosed May 1998 - Graves Disease
-Complete Thyroidectomy September 1998 - While 11 weeks pregnant
Other Complications - GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes
Current Meds -  Enbrel/Prevacid/Synthroid
Past Meds - Inderal/PTU/Prednisone/Voltaren/Feldene/Mobic/Cortisone and Steroid Shots

3

Thanks for that information Erin.  That validates my theories about what happened when I was taking sulfasalazine.  I did have an overall body rash, red and splotchy, and it went into my mouth.  It was disgusting.  Consequently, that same week I also had a high fever (102 F)that kept spiking, blood in my urine, and increased joint and muscular pain (above and beyond what is normal).  My dh is the only one who saw the c omplete rash, and he freaked out.  It was a Friday night, and he begged me to go to the ER.  But I had been to ER the previous night due to massive joint pain, so I wasn't about to go again.  I started a regimen of prednisone Saturday morning.  By Monday, my primary saw the tail end of the rash on my stomach and that was it.  When I described the rash to my rheumatologist all he told me was that it was a severe allergic reaction to the sulfa in the sulfasalazine and that I should never touch a sulfa drug again.  When I got on the internet, and saw all the literature on stevens-johnson syndrome I got a bit creeped out.  I think that's what compelled me to start taking the prednisone, which I wasn't real thrilled about taking.  I'm 100% positive I had a mild steven-johnson reaction and if I hadn't started taking the prednisone, it would have been much much worse.  If I had gone to the ER, they would have hospitalized me.

Steven-Johnson syndrome is real, and not all that uncommon.

Elcamino

4

good move!  that could have saved your life!  it is very serious and could be lethal. the prednisone was the right move!

i think it's really important to never underestimate the seriousness of any rash. ya never know.

Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.

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by the way, provigil can cause this rash also. it was being tested for use with kids who had adhd and aa few kids came down with the ras taht can affect your mouth lips and urinary tract sytem. i developed some bad blisters that i thought looked very suscipious and stopped the provigil. my skin literally rubbed off after using a clipper for 2 min to prune a small bush. not normal at all for me.

9-02 crash w/ C-5-6-7 anterior/posterior fusion in neck w/11 screws and 4 metal plates. multilevel HNP at T & L section. FMS, PA in dec 05. on SSDI after 2.5 yr wait. sezuires, CTS, IBS ( C & D). norco, xanax, predisone shots. i dont know what else is wrong with me and neither does anyone else!!!

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I've read that there are certain drugs that are more predisposed to causing the stevens-johnson reaction, but I understand, or perhaps have misunderstood, that any drug has the potential to cause it.  It just depends on the individual and their sensitivity to it?  By the way, what is the difference between an allergic reaction and a hypersensitive reaction?  Are they the same thing?

Elcamino

7
very true, very true elcamino.
one thing i am sure of is that it WILL BE POSTED ON THE BACK OF THE MEDICATION BOX & IN DIRECTIONS of meds that cause SJS.  just look at a bottle of aspirin and it's packaging...it should be there.  most times it'll say something like..."do not take this medication if you have a fever or a virus because Stevens Johnson Syndrome can arise...etc..."
 
but yeah, there are a number of drugs that are more apt to cause this. and they are listed and do have warnings.  skull   BIG WARNINGS. skull   but this is for safety.  it shouldn't scare people away from anything.  it is a wonderful thing to be aware of this.
 
ooh, OK now ya got me on my toes. tongue LOL. here we go:
an allergic reaction: COULD RANGE FROM ANNOYING TO LIFE THREATENING.  pretty broad.  it still is an immune response. usually from a foreign antigen. this is what people are going through now with pollen and dust and trees and all. 2 other allergic reactions are CONTACT=poison ivy and INJECTION=bee stings.
LATEX although is very serious. beestings can be as well.
 
hypersensitivity: are subgrouped into types. Types I through IV i think? (now i'm boiling my brain!) type I is hypersensitivity to drugs and foods; Type IV is from following direct contactwith an allergen. SO BASICALLY: hypersensitivity is an ABNORMALLY or EXCESSIVELY suscebtibility to a given agent.
 
alright, i'm exhausted. LOL. you better not be one of my old nursing instructors! LOL. testing me! tongue hah!

Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.

8

Erin, you're too funny!  I am a professor, but of psychology, not nursing/medicine.  You pass!  So, if a hypersensitivy reaction is when you're particularly susceptible to the effects of a drug, I probably have lots of those.  When I was in fertility tx, my body responded to the drugs too well.  I ended up taking only 1/4 of what a normal female would take.  I've had this reaction to lots of other drugs as well.  Currently, the tramadol I'm taking--I only take 2/day.  Rheumatologist told me average is 4-6/day, but I really don't need to take all that.  The only allergic reaction I know about is my reaction to sulfasalazine. 

Elcamino

9
oh how cool! a professor of psychology!
my favorite professor in college was Dr. Donald Patrick Thornly Williams!!! he was GREAT. and HARD! but what an innovative thinker. he was in Marymount Manhattan College. you know those off the wall types? but too genius for his own good! i realy enjoyed his classes. if ya got a C you were really lucky! that's how difficult the courses were. we had a final, open book, and nearly everyone failed! hah...i got a C! liked him so much i took 2 of his courses, didn't care if iwould fail...you just learned so much that grades didn't even matter.
psych professors ROCK!

Active, Severe RA. Crohns Disease. Chiari Malformation & Right Brain venous anomoly. AS. Emphysema. Rheumatic Lung. MVP and Tricuspid prolapse. Had Lymes disease for 10 years.
Meds: Humira 40mg every 4 days; pred; Pentasa; Imuran; dilaudid; diazepam; Avinza 30mg; MiraLax & too many others.