Keith’s GoutPal Story 2020 › Forums › Please Help My Gout! › Gout Treatment › Rash after 14 months of Allopurinol
Tagged: Gout Skin Rash and Itching Forum
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October 17, 2010 at 11:50 am #3434cjeezyParticipant
Hey all,
I’m a bit nervous right about now. Because I have a rash that’s developed on the tops of both my legs, forearms and a little on my back. The rash is just real small tiny red bumps but cover a good 6-8 inches in each spot. I feel fine, but I’m praying right about now it’s not from my 300 mg of Allopurinol.
I don’t have health insurance right now either. So I’m hoping that since I’ve been on this drug for about 14 months with no problems that the rash is unrelated. I do have a slight cat allergy and was laying on my girlfriend’s floor for a couple of hours the other night too. So maybe it’s from that. Also, I just started using a sea sponge in the shower. Not sure if either of these could have caused the rash.
Should I go to the Dr tomorrow or just keep an eye on the rash? Do rashes from Allopurinol look a certain way? Any help is really appreciated
October 18, 2010 at 12:00 am #10363trevParticipantBad news CJ- I can see why you're worried- but if it's any help my reaction actually caused localized pain at a lesion breaking the surface [on AP].
Lowering your med or stopping temporarily would flush out any connection- it's not a drug to take lightly when reactions occur.
I don't think my replacement med [Sulfinpyrazone] is available in the US. [Not sure why not].
October 18, 2010 at 8:08 am #10365cjeezyParticipantThanks Trev,
I?m trying to get in to see my Dr today. I put some calamine lotion on areas yesterday and it seemed to dry it up a bit, but when I woke up today there are still new areas it has spread to 🙁 The rash is just lotes of real tiny red bumps?some itch. My gout has been completely under control for the past 14 months. This totally sucks!!! Does this mean I definitely need to stop AP? What are mt options? Uloric at $200/mo?!?!
October 18, 2010 at 8:11 am #10366zip2playParticipantBuy a tube of 1% Hydrocortisone…usually $2.99 at a discount pharmacy or supermarket. Apply a little twice a day.
Without health insurance doctors' visits are getting prohibitively expensive.
Remember, we take allopurinol all our lives and people who don't take it have a 99.9% chance of getting a rash from something unless they die in the cradle.
I don't know what an allopurinol rash looks like but it usually occurs, when it rarely does, after many years of treatment. If you see any hives, or lip or eyelid swelling, then stop the treatment ad consult a doctor, although all can be casued by the common cat allergy. Does the rash itch?
Allopurinol may cause rash with both raised bumps and flat discolored areas (“maculopapular rash”) in 1% to 3% of people.
Not so serious but it could presage other developments, diferent kinds of rashes.
October 18, 2010 at 8:17 am #10367cjeezyParticipantThanks for the input Zip,
The rash is spread out all over my forearms and upper thighs and a little on my back. It?s not in clumps but little red raised bumps that itch. I was going to attach a pic but could not figure out how to. It just figures that I’m one of the few that develop a rash from it…and 3 days after I’m unemployed 🙁
October 18, 2010 at 8:33 am #10368zip2playParticipanthttp://www.medicine.ox.ac.uk/b…..hyper.html
cjeezy,
You will find that interesting. Of the 100's of million doses of allopurinol prescribed through 1990, 127 cases of hypersensitivity syndrome resulting in 27 deaths were reported. This is from the literature of the entire world.
Note also, that the rash f alllopurinol hypersensitivity is almost ALWAYS (95%) associated with fever.
(It's the pussy cat.)
The rash of alopurinol is usually described as maculopapular and here's a sample, a slightly raised red patch with a bump in the middle:
October 18, 2010 at 8:48 am #10369cjeezyParticipantHow did you post that pic. I don?t see an ?attach button.? My rash looks similar to this?although many of the bumps do not have a middle raised bump (some do though). I do not have a fever either. I?m f***ed!
October 18, 2010 at 9:31 am #10371cjeezyParticipantJust left my Dr. He said the patches on my back look like poison ivy. He said the other areas on my upper thighs and arms do not look like poison ivy (his exact words were woah, that?s funky looking). He said it was most likely an ?id reaction? to the poison ivy. He called me in some Prednisone. He said he?s never seen an AP rash in his 20 yrs of medicine but he?s 99.9% sure this isn?t from my AP. I?m still not sure what to think. Aside from the rash, I feel fine and don?t have a fever. He said to keep taking my AP and I should be much better in 2 days. The odd thing is this rash came on like a bat out of hell. I mean this spread across my whole body in literally a day to a day and a half.
Thanks for the link Zip btw. Yes it would appear that my chances of being hypersensitive would be rare. “IF” they are from AP what are my options? Can I try Probenecid if I’m allergic to Penecillin? I can say that I just had my liver and kidney functions tested a week ago and result were normal. Would they have detected abnormalities in my liver function if I was about to have a reaction? I don?t think they tested blood counts though. In addition, I don?t have kidney or renal failure, nor do I have hypertension. This is the most depressing feeling I’ve had since feeling helpless when I was first diagnosed.
October 18, 2010 at 7:28 pm #10375hansinnmParticipantcjeezy said:
Post edited 11:16 pm – October 18, 2010 by cjeezy
1)…. He said he’s never seen an AP rash in his 20 yrs of medicine but he’s 99.9% sure this isn’t from my AP. I’m still not sure what to think. Aside from the rash, I feel fine and don’t have a fever. He said to keep taking my AP and I should be much better in 2 days. The odd thing is this rash came on like a bat out of hell. I mean this spread across my whole body in literally a day to a day and a half.
2)…Can I try Probenecid …
1) An Eskimo who has never left his igloo probably has never seen a black person from Africa. My rash came out of the clear blue sky and it lasted close to 6 weeks. When it started I was covered from head to toe and I scratched my entire body bloody. I saw the dermatologist 3-4 times a week and almost killed him. He did his damnedest to get it under control. The last ointment (TRIAMCINOLONE ACETONIDE, USP,0.1%) did the job, however, I don't have the proof. After 6 weeks, the rash could have run its course.
2) Yes, you can take Probeneci, if your liver and kidneys are OK.
October 18, 2010 at 9:53 pm #10377cjeezyParticipantHi Hansinnm,
How long were you on AP before the rash started? Also, are u still taking AP now that the rash has cleared up? Also, I?m allergic to Penicillin. I thought I once read that I might have q problem with Probenecid because of that.
October 19, 2010 at 8:11 am #10378cjeezyParticipantWell, I prayed last night and then took my 4th, 5th and 6th Prednisone pill before bed. I woke up this morning and this is the first time the rash looks like its gotten a little better (still itches in areas though)! Another thing I thought of was that I just got my comforter back from the dry cleaners, maybe they used a chemical or something on it. Who knows, but I’m just so thankful right now!
October 19, 2010 at 5:54 pm #10382hansinnmParticipanthansinnm said:
cjeezy said:
Post edited 1:46 pm – October 19, 2010 by cjeezy
Hi Hansinnm,
How long were you on AP before the rash started?
~3 weeks
Also, are u still taking AP now that the rash has cleared up?
NO. I am now on Uloric 40mg.
Also, I’m allergic to Penicillin. I thought I once read that I might have q problem with Probenecid because of that.
I wouldn't know about that. Either google Probenecid or ask Dr. Zip.
While you are at it, meaning reducing your LSD, google Penicillin, and draw your own conclusion.
October 19, 2010 at 8:16 pm #10386cjeezyParticipantWhat does reducing your LSD mean?
October 19, 2010 at 11:11 pm #10391trevParticipantCJ- As you're lurking -and I'm up way too early, I'll put you out of yr miz-
Hans is fond of the term Lazy,Stubborn amd Dumb! Don't blame me- He's one of yours,
October 20, 2010 at 12:47 am #10392cjeezyParticipantHmm. Interesting. Im always humored with name calling on a forum lol.
Anyways, while you’re up too early, I’m up too late. On a good note, I feel great and my full body rash is subsiding rather quickly with the Prednisone! This thing was wicked!
October 20, 2010 at 6:48 am #10393trevParticipantCj- On protocol others can speak for themselves- but i appreciate clear heads when worried or in pain are not alwways top of the list!
On the allergy bit I can see why you were worried- even Zip admits to 27 deaths worldwide- which is worrying if one of them esp. !
I looked into this earlier when I got worried by AP use. I figured 16 [or was it 16%?] known deaths from a one in 3000 reaction was worth considering, really! [ Note to acedemic leaners: From memory- I'm not basically lazy 😉 ]
My lesion started soon after AP use and persisted through it. Local 'call in' clinic said it didn't look 'normal' and offered to dress it.They wouldn't advise on what was causing it.
My normal health care was not available right then. I persisted for a week and then stopped AP- within a day or two the lesion settled and now has left a red lump.
I think it was at a typical urate gathering site as I've had pain on the other hand in exactly the same point with the same burning feeling- just no breaking of the surface that side- or topical pain either.
I suspected from the start that yours was an allergy to something external [or maybe just hoped like you].
Some reactions occur on the way in using the med and others after a while, and some get ignored- depending on users withstand and life habits.
This site is where you can get some non specialist re-assurance when medics are wanting- as they were in my recent case.
October 20, 2010 at 11:12 am #10396hansinnmParticipanttrev said:
CJ- As you're lurking -and I'm up way too early, I'll put you out of yr miz-
Hans is fond of the term Lazy,Stubborn and Dumb! Don't blame me- He's one of yours,
Gee, Trev, if you keep this up, I may never die and, you sure as hell don't do “humanity” any favors. Several people got tired, waiting for Mother Nature to shorten my stay on this beautiful planet, and instead have kicked the bucket before I do. You added a second day to my life. However, at the same time you also gave me a LSD booster. I didn't have to explain. (I am not complaining.)
October 21, 2010 at 7:30 am #10401zip2playParticipantBetween the cat and the poison ivy, your girlfriend seems a danger to your naked body, cjeezy.
To post a picture, use that TREE symbol in your reply taskbar.
Don' worry too much about penicilln sensitivity and the uricosurics. More concerning would be a sulfa allergy, but even then the risk of hypersensitivity reaction is small.
As for the 27 deaths in all the world for the half century of allopurinol, it is probably lower than the deaths from a reaction to M&M's.
To put it in perspective:
October 21, 2010 at 7:47 am #10402cjeezyParticipantHi Zip,
Even though i started with a larger patch on my back (which is still somewhat there), i dont know if it was poison ivy because i cant think of anywhere i could have gotten it from (my gf cat is an inside only cat). Fortunately the rash is about 75% gone now! My question to you is, in your opinion ?if? it was from the AP would the Prednisone have worked this well or would it have still gotten worse? Also, Would my liver tests from 2 weeks ago have detected an abnormality?
October 21, 2010 at 11:20 am #10403trevParticipantConcluding phrase from article ref'd by Zip…
“Effective interventions for the underlying emotional and spiritual wounding behind most chronic disease is critical for the reinvention of our medical paradigm. These numbers suggest that reinvention of our medical paradigm is called for”.
Something we Gouties are always getting back to on here- in our more reflective/narky moments!
October 21, 2010 at 12:43 pm #10381zip2playParticipantPrednisone works for almost ALL rashes regardless of cause. It is the ultimate “symptomatic treatment.”
October 21, 2010 at 1:01 pm #10404cjeezyParticipantWell that sucks I was starting to get my hopes up. So I guess the true test will be to see if the rash comes back AFTER I finish the Prednisone? Or do you think I?m most liekly in the clear? I hate to sound like a worrier, but as I mentioned, I dont have any insurance anymore and can’t afford the alternative 🙁
October 22, 2010 at 7:39 am #10406zip2playParticipantDo what I said in my first post: buy a tube of 1% hydrocortisone cream and apply it to your rash daily now, and a couple times a week afterwards. If it recurs, use it some more.
The cost is $3 bucks or so, and it is FAR less dangerous to use a corticosteroid locally than to fill your body with it orally or parenterally (by injection.)
October 22, 2010 at 9:20 am #10408cjeezyParticipantYes that’s what’s I’ve been doing this week. The problem was that the rash was all over my entire body so it was difficult to cover it all with the cream. I’d need an entire tube! My radh is now 90% gone. I’m starting to taper off my dosage of Prednisone too and should finish it off late next week. Even if it was from the AP is there a chance that I could still take the drug?
October 22, 2010 at 11:21 am #10409trevParticipant? Have you stopped the AlloP then , CJ ?
October 22, 2010 at 11:37 am #10411cjeezyParticipantHi Trev, per my Dr’s recommendation I’ve continued to take 300 mg of AP this whole time
October 22, 2010 at 11:58 am #10413zip2playParticipantEven if it was from the AP is there a chance that I could still take the drug
Thank god there is an IF in that sentence because without it you would have to discontinue allopurinol, there is no doubt about it. But I, like you doctor, think it is very unlikely to be an AP rash.
Basically, hypersensitivity is evident very quickly and intolerance usually develops after MANY years. So your being in-between points away from an AP problem. I am happy you continued taking your 300 mg./day. If the rash goes away and stays away I think you can dismiss it from your mind.
You MIGHT want to confront your cat allergy again and see what develops? Or ask your doctor to do a cat allergy scratch test on you?
And rolling around on a bed is SO much more comfortable than rolling on a rug…with or without pussy.
I wish I could be more helpful but the casues of RASH are SO omnipresent that even skilled dermatologists just go from one drug or another…try the antibacterial…try the antifungal…try the anti-yeast…try the anti-allergy…try eliminating, foods, soaps, drugs, people, pets…then start over with a NEW antifungal, etc.
But I gave myself an idea…try Benadry. It's OTC and try using divided doses totalling maybe 100 mg./day for several days. If it works, it helps prove a histaminic allergic reaction to something. It WILL make you sleepy, so dose accordingly. No high wire acts or driving a tank (the ultimate “heavy machinery!”) A 50 mg. dose before bedtime is a decent sleep aid.
October 22, 2010 at 1:01 pm #10414cjeezyParticipantYou?ve all been very helpful, and I really appreciate everyone’s feedback. Maybe I?m being a bit of a baby about this whole thing, but I?ve never had a full body rash before (or really any bad rash I can think of). I do know in the past I?ve gotten hives and very itchy eyes from being around certain peoples cats so there is some sort of allergy I have. I?ve never had a rash from a cat(s) before though.
I tried the Benadryl thing at first (liquid) when starting the Prednisone, however the Prednisone was working so well that I stopped it since it was making me too drowsy.
In terms of the delayed rash from my therapy, I was freaking out a bit at first because I read the following article from medscape.com and interpreted it as ?a person can still develop a rash WITHOUT hypersensitivity syndrome.? This is why I was wondering if I did not have hyper sensitivity syndrome and only a rash if I could possibly continue AP.
?Dermatologic and Local Effects
Skin reactions may be delayed and have been reported to occur as long as 2 years after initiating allopurinol therapy. Rarely, skin rash may be followed by severe hypersensitivity reactions which may sometimes be fatal. (See Cautions: Hypersensitivity Reactions.) Some patients who have developed severe dermatitis have also developed cataracts (including a case of toxic cataracts), but the exact relationship between allopurinol and cataracts has not been established. Pruritus, onycholysis, and lichen planus have also occurred rarely in patients receiving allopurinol. Facial edema, sweating, and skin edema have also occurred rarely, but a causal relationship to the drug has not been established.
I guess it?s just a waiting game at this point now 🙁
October 23, 2010 at 8:25 am #10418trevParticipantCJ: Have you considered using a uriscoric in place of AlloP? Probenecid is available in the US, I think.
This could be as a temporary measure to test your reactions cause – or maybe worth a try, in its own right.
Sulfinpyrazone seems OK with me so far, though it's supposed to be harder on the kidneys. My tests so far have been OK.
October 23, 2010 at 10:23 am #10422cjeezyParticipantHi Trev,
I don?t know whether I?m an over producer or under excreter. Will Probenecid work in both cases like AP?
I?m also on day 2 of a lower dose of Prednisone (80mg/day). So far rash is still 99% gone. I?m keeping the faith it will stay gone. Tomorrow I step down to only 40mg/day
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