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What Causes An Acute Discoid Rash On The Arm While Suffering From Lupus?

Posted on Mon, 17 Apr 2017

Question: I have lupus and i have a severe discoid rash on both my arms. I was prescribed clobetasol propionate foam .05% however my arms HURT really bad and this foam burns really bad. i still use it however. Im hoping there is something that can ease the pain? I have tried EVERYTHING o.c. i did an oatmeal bath as well that didn't help. The rash is progressively getting worse generally I would go see my dr. but she's on vacation and i can't see my rheumatologist or dermatologist for a few weeks.

Answered by Dr. Naval Mendiratta (2 hours later)

Brief Answer:
Discoid lupus

Detailed Answer:
good evening

thank you for writing on HealthcareMagic,

Well firstly I would say if the drug is harming you too much you should stop it. we never continue drugs if they arengiving side effects.. Clobestol is not going to be very useful in discoid lupus as it is...Since it is an internal problem we will need drugs to suppress it internally

I would like to ask you a few more questions for the disease

1. do you have any oral ulcers

2. do you experience any joint pains

3. The location of rashes?

4. How about ANA and ENA profile..

5. Any other systemic therapy like hydroxychloroquine or steroids have been tried

Do let me know these queries..will guide you further from here

regards
Dr naval

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Naval Mendiratta (15 hours later)

1. I do not have any oral ulcers. I do however get them frequently. 2. yes I have MCTD as well and arthritis in many joints. 3. It's on my arms all over them. 4. My ANA has always been negative I tested positive through a skin biopsy. 5. I have used steriods am currently taking prednisone

Answered by Dr. Naval Mendiratta (21 hours later)

Brief Answer:
Discoid lupus

Detailed Answer:
good evening

Sorry for the late reply.. Had a long day at work

Well, firstly I would suggest we add Hydroxychloroquine to your regime as well( Plaquenil) as it is very useful for skin lesions due to lupus...Even if ANA negative, it is known to work well....

As of the pics I saw, the rash doesnt seem too bad or it wasnt really clear, but we can temporarily increase the dose of prednisone if the new lesions are coming up. I am not sure about the dose you are taking...But it will definately help as steroids act the quickest...

For topical application, you can discuss with your rheumatologist and prefer switching to tacrolimus ointment.. It is better than Clobestol and may not even burn

Hope the information was useful...I feel a little bit treatment modification is needed, cause if the rashes are flaring on tapering the steroids we need to add another steroid sparing drug with lesser side effects

Do let me know for more queries

REgards
Dr Naval

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar