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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Would Actemra And Leflunomide Cause Lesions On Neck And Head?

I have rheumatoid arthritis, and have been treated for the past 6 years. After continually going thru new r/a meds, my Dr. suggested trying Actemra. I ll try and keep this short. I had been taking Arava (lufleunomide) for several years as well. 5 weeks after starting the Actemra, I started getting leasion type wounds on the back of my neck, and head. The docs at the major teaching establishment just couldnt/can t figure what caused this condition. Question Would Actemra and lefleunomide cause such a radical condition? It s taken almost 9 months to heal my neck. The visual tissue is deep tissue wounds. Thanks for any insight you may have.
Wed, 26 Apr 2017
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Addiction Medicine Specialist 's  Response
dermatologic conditions are hard to discuss without seeing them. But if I were going to look into any skin condition, personally, I try to figure the type of reaction (immunological and type) or infection or direct trauma. Oddly enough, you wouldn't think direct trauma was the one I was going to pick, but that is the most likely along with metal allergy. Why the back of the neck?
So, something the neck is exposed to is a trigger: abrasion, something you put there.

You wear necklaces or other things that rub there. Chemotherapy makes wound abrasions more likely. It MIGHT also change immune reactivity to metal producing more a reaction to metal necklaces.
Type of skin reaction... a wound in either case
location...where there is wear and tear.
It will NOT be everywhere.
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Would Actemra And Leflunomide Cause Lesions On Neck And Head?

dermatologic conditions are hard to discuss without seeing them. But if I were going to look into any skin condition, personally, I try to figure the type of reaction (immunological and type) or infection or direct trauma. Oddly enough, you wouldn t think direct trauma was the one I was going to pick, but that is the most likely along with metal allergy. Why the back of the neck? So, something the neck is exposed to is a trigger: abrasion, something you put there. You wear necklaces or other things that rub there. Chemotherapy makes wound abrasions more likely. It MIGHT also change immune reactivity to metal producing more a reaction to metal necklaces. Type of skin reaction... a wound in either case location...where there is wear and tear. It will NOT be everywhere.