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Suggest Treatment For Peripheral Neuropathy

Posted on Wed, 7 Jun 2017

Question: I have been biopsied for granuloma annulare on my hands,The lesions have been there for approximately 2years. within the past 2 months they are now developing on my upper chest. I have peripheral neuropathy which is getting so bad I can't even sit with my legs down for more than 5 minutes because the nerve pain is so intense. Since the lesions have starts on my chest I feel like I have electrical shocks going through my body constantly,terrible joint pain,weakness and falling. I saw an episode of mysery dx on TV and it summed me up perfectly. I thought I would remember the initials but I did not as memory loss is another problem I have. The treatment was immunosuppresant therapy and IVIG. I was receiving IVIG before and felt much better but my insurance would not pain for it anymore and since then my symptoms just keep getting worse. All I remember is that it this dx is rare like 200 in the country and it was a long name that was condensd to 3 letters. Please help as my symptoms get worse by the day. Incidently I just received disability within the past 4 months.

Answered by Dr. Dr. Muhammad Sareer Khalil (2 hours later)

Brief Answer:
Granuloma annulare, IVIG, peripheral neuropathy

Detailed Answer:
Hello and Welcome

I appreciate your concern and am very sorry to hear about your distress

For generalized or extensive Granuloma annulare, phototherapy with oral psoralen and PUVA have been used with good success. Antibiotics like minocycline and anti acne meds like isotretinoin may also be advised.

If IVIG was used then it points to Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) or Multifocal Motor neuropathy. May be these were the terms you were looking for.

For the symptoms you are experiencing, Neurontin, Vicodin and lyrica are the appropriate medication which are needed in this condition to address such debilitating symptoms. Only dose adjustment would be needed. I would only advise addition of substance P depleting agents like capsaicin and vitamin B1,6, 12 supplementation with these to see for improvement.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

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Dr. M.S. Khalil

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

Follow up: Dr. Dr. Muhammad Sareer Khalil (2 hours later)

I was tested for cipd and the other one you mentioned. Tests were negative. Ivig was used because I've had several episodes of foot drop and times when I couldn't lift my arms and that heped. The disease I'm talking about is directly related to the annular granular with the other symptoms. Again it is very rare and was actually diagnosed by a dermatologist who listeNed to her other symptoms and put 2 and 2 together. Please try to find me an answer as I am becoming desperate. Thank you

Answered by Dr. Dr. Muhammad Sareer Khalil (9 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

Granuloma annulare presentation is usually as a localized disease. Its associations include diabetes, hyperlipidemia, thyroid disorders and HIV. Other than that there are no systemic diseases that are directly related to it.

It can also occur as a result of malignancies and medication induced forms.

I have gone through the literature and couldn't find the rare association you are looking for.

Thanks

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

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