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Suggest Treatment For Rashes On Leg, Elbow And Buttocks After A Boniva Injection
Question: I had a Boniva iv treatment on November 9, 2015. I have developed a rash that started on my left leg, elbow, left buttock, behind my left ear and my chest. I have not changed my diet, my care and products. Went to dr to make sure it wasn't shingles. I have multiple myeloma-remission(insert cheer here!!), post stem cell transplant. . First dr told me folliculitis- change my razor blade, round of keflex and a topical acne. Condition worsened and developed deep tissue pain and rash turned into huge hives all same locations. Went to urgent care- told dermatitis, go to dermatologist, round prednisone multi pack and take Benadryl. Went to dermatologist- biopsie 2 areas- it is not fungal, bacterial or viral. It was allergic reaction or bug bites? My home is under pest control contract and no other family members have bites? Was taking Benadryl around the clock, if I went past 4 hours hives grew larger and spread further. Had allergy testing-allergic to gold, black rubber and formeldahyde. I have have checked everything for black rubber and formeldahyde-none. I have worn gold for years++++ (I am 52 years old) and never, never any rash from my jewelry. Dermatologist placed me on really high dose of prednisone ( 4 days 60 mg, 4 days 40 mg...) My oncologist called and prescribed hydroxyzine- helps stop itching but knocks me out. Prednisone did reduce the hives from blisters, raised skin the size of nickels to flat but still really red. Well, then I got the stomach bug Christmas night for 24 hours. Unable to take prednisone one day, hold any food or even water down for 12 hours. Was able to only hold down infant pedialyte. Rash now started on right leg for first time and small welts back on chest. Started back on Prednisone next day( I only missed one day of a 1 pill- 20 mg dose). None of the Drs think it is allergic reaction to Boniva? I think it is.....??? Thank you! XXXXXXX
Brief Answer:
Boniva is less likely to be the cause
Detailed Answer:
My Dear Madam
Welcome to this portal!
I am Dr V XXXXXXX a Sr Dermatologist.
I have reviewed your description and will help you in dealing with the problem as best as possible.
I feel that your problem is unrelated to an external cause and it would be quite improbable to ascribe it with the use of Boniva. Though skin rash and hives are mentioned as side effects of this therapy, but then the rash should have been bilateral and symmetrical. However, as at present I do not have your pics, I think it would be good to share few pics of the rash from both close up as well as from distance to depict its distribution.
Use of steroids will help clearing any rash almost but is always associated with the lurking risk of recurrence when their dose is tapered or they are withdrawn, apart from side effects that are associated.
For the time being, I would advise any patient with this profile to undertake following measures till The doctor has seen the pics and other reports of blood etc, if available.
1 Keep the affected areas clean, dry , without deodorants or volatile chemicals
2 Consider Levocetrizine 5 mg a day or comparable antiallergic
3 To taper steroids with the help of treating physician unless there is acute need for their use.
4 maintain a diary of your activities, food etc and attempt to relate the rash with any particular event.
This is quite possible that the rash may be idiopathic or one that cannot be attributed to any cause that is known.
I will be awaiting your reports and pics to help you further.
Thanks for writing in. Best wishes.
Boniva is less likely to be the cause
Detailed Answer:
My Dear Madam
Welcome to this portal!
I am Dr V XXXXXXX a Sr Dermatologist.
I have reviewed your description and will help you in dealing with the problem as best as possible.
I feel that your problem is unrelated to an external cause and it would be quite improbable to ascribe it with the use of Boniva. Though skin rash and hives are mentioned as side effects of this therapy, but then the rash should have been bilateral and symmetrical. However, as at present I do not have your pics, I think it would be good to share few pics of the rash from both close up as well as from distance to depict its distribution.
Use of steroids will help clearing any rash almost but is always associated with the lurking risk of recurrence when their dose is tapered or they are withdrawn, apart from side effects that are associated.
For the time being, I would advise any patient with this profile to undertake following measures till The doctor has seen the pics and other reports of blood etc, if available.
1 Keep the affected areas clean, dry , without deodorants or volatile chemicals
2 Consider Levocetrizine 5 mg a day or comparable antiallergic
3 To taper steroids with the help of treating physician unless there is acute need for their use.
4 maintain a diary of your activities, food etc and attempt to relate the rash with any particular event.
This is quite possible that the rash may be idiopathic or one that cannot be attributed to any cause that is known.
I will be awaiting your reports and pics to help you further.
Thanks for writing in. Best wishes.
Above answer was peer-reviewed by :
Dr. Sonia Raina
The rash initially was only in the left side. After the flu, it started in the right leg. I submitted four pictures. One of right leg, one of left leg(large dark scab is the biopsy). Then two of my chest rash. I had a diet log and no new foods,seasonings.. were introduced during that time.
Brief Answer:
Steroid side effects
Detailed Answer:
My Dear Madam,
Thanks for submitting the pics and more details.
It has helped but the pictures that you submitted are all from the chest area.
However, under the circumstances I will do my best to relieve your problem.
The rash on the chest is most likely a side effect of oral steroids having been given to you. I could see small bumps and redness in an area which is known to show such changes due to steroids. I would advise any such patient to consider tapering steroids with the help of her doctor so that you side by side monitoring is feasible.
Coming to the genesis of problem, I think it started as an allergic response to some irritant or substance that was not well tolerated by your skin ( which seems to be sensitive(and then it got suppressed due to medication but the original allergen could not be traced. It started from left side is a proof that it is something external in origin.The cycle went on and in the present, it has encroached upon the other side of the body as well.
Anti allergics are a better option like Levocetrizine/Cetrizine that I mentioned. If needed, one can combine them with class of agents called H2 antagonists. They also are antihistamines and potentiate the affect of antiallergics that are conventionally used and of which Levocetrizine is just one example. Cimetidine and ranitidine are two such compounds (H2 antagonists)
You please have a relook at at your activities and objects of use to see what are the activities in which left side is predominantly used because ultimately the best outcome would be pinpointing a substance that can be removed from the routine activities for durable improvement.
I think once steroids are taken off and you are well controlled on antiallergics, it would be good to slowly reduce the antiallergics and get normal as you used to be.
Please do post if you feel any help from me is required.I will be glad to do the needful
Best wishes
Steroid side effects
Detailed Answer:
My Dear Madam,
Thanks for submitting the pics and more details.
It has helped but the pictures that you submitted are all from the chest area.
However, under the circumstances I will do my best to relieve your problem.
The rash on the chest is most likely a side effect of oral steroids having been given to you. I could see small bumps and redness in an area which is known to show such changes due to steroids. I would advise any such patient to consider tapering steroids with the help of her doctor so that you side by side monitoring is feasible.
Coming to the genesis of problem, I think it started as an allergic response to some irritant or substance that was not well tolerated by your skin ( which seems to be sensitive(and then it got suppressed due to medication but the original allergen could not be traced. It started from left side is a proof that it is something external in origin.The cycle went on and in the present, it has encroached upon the other side of the body as well.
Anti allergics are a better option like Levocetrizine/Cetrizine that I mentioned. If needed, one can combine them with class of agents called H2 antagonists. They also are antihistamines and potentiate the affect of antiallergics that are conventionally used and of which Levocetrizine is just one example. Cimetidine and ranitidine are two such compounds (H2 antagonists)
You please have a relook at at your activities and objects of use to see what are the activities in which left side is predominantly used because ultimately the best outcome would be pinpointing a substance that can be removed from the routine activities for durable improvement.
I think once steroids are taken off and you are well controlled on antiallergics, it would be good to slowly reduce the antiallergics and get normal as you used to be.
Please do post if you feel any help from me is required.I will be glad to do the needful
Best wishes
Above answer was peer-reviewed by :
Dr. Sonia Raina
Thank you for your input. I will finish the steroid tapering and continue to monitor exposures.
Brief Answer:
Bright chances of recovery, though might be slow
Detailed Answer:
Dear Madam,
I hope that you will get well soon. Please count me in if you need help.
Best wishes
Dr XXXXXXX XXXXXXX
Bright chances of recovery, though might be slow
Detailed Answer:
Dear Madam,
I hope that you will get well soon. Please count me in if you need help.
Best wishes
Dr XXXXXXX XXXXXXX
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. Prasad
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