Question: I have an 87yo aunt suffering since May 2013 with A-fib and a persistent skin rash (mostly on torso) that has been determined by biopsy (14 months after onset, August 2014) to be caused by one or more of her meds...May 2013-Her initial drug profile included Atenolol, Pradaxa and one course of antibiotic,Keflex. After 2 months of persistent rash, PA in her doctor's office initially prescribed Prednisone which ended up with her being hospitalized for several weeks to get her A-fib and meds under control. Her Atenolol was changed to Metoprolol and Cardizem, her Pradaxa was changed to Coumadin, and Amiodarone was added. She underwent a successful cardioversion in November of 2013. Her rash continued without relief and her Afib returned within months. After 5 months, her Amiodarone was discontinued because of intolerable side effects. As a side point, her appetite has not returned since she began taking Amiodarone. She has been hospitalized several times with CHF and has been on Lasix, potassium, and magnesium during these episodes, rash persisting. In December, 2014 she underwent ablation and had pacemaker implanted at XXXXXXX due to her failure to tolerate her drug regimen. She was put back on Atenolol, Coumadin was changed to Eliquis, Aldactone was added to her Lasix regimen and Thyroid meds were added. Her rash has never abated. In fact, it is getting so bad that she is developing open lesions on her torso and head that she describes as both itchy and painful. She has had no relief from this persistent rash since XXXXXXX of 2013 and is tormented day and night as a result. Her PCP has diagnosed her with malnutrition (due to her inability to eat since Amiodarone tx), hypothyroid (has just doubled her initial dose), low vitamin D3 (put her on 35,000 IU per week), extremely low albumin; has ordered Trazodone at bedtime for insomnia and a GI consult. She is without relief of this body rash/itch that has now started to extend to her upper legs. Topical steroids, Cereve skin cream recommended by dermatologist, topical benadryl give no relief...How do we resolve this intolerable situation? In May of 2013 she was completely independent, caring for a husband with Parkinson's disease, a capable woman one would estimate to be in her early 70's. Please help.

1. Please find attached the dermatologist biopsy report.

2. She has not nor is she presently on any oral antihistamine....she cannot take anything that is sedating as she lives alone and is at risk for falling.

3. I am sending digital photos via my iPhone momentarily.

4. I will have the name and/or ingredients of her steroid cream within a couple of hours...we have been advised not to use the steroid cream to a vast area of her body on a regular basis as there are concerns that her entire torso is involved and her immune system may become involved if this is the tx of choice for a prolonged period of time.
She has used hydrocortisone 1% ointment

I am resending the images to the attachment address stated in your directions; they are being sent from my iPhone Attn: Dr. Kakkar Ref. ID 583876 from phone number 0000 (Deb Stott).

Also, before receiving your response I had asked a pharmacist about Loratadine and was told that OTC Allegra was a little stronger than OTC Claritin. Do you have a preference, and are you saying that she can have 10mg Loratadine every 12 hours?

Thanks!
I have just resent the six images.
I am resending the images again from my iphone to the attachment address contained in your directions. The message for you will be from Deb Stott at 0000 with an attention to Dr. Kakkar and the Ref. ID hcmg 583876.

A pharmacist suggested I might try OTC Allegra rather than the OTC Claritin...Also, if I do use the loratadine, are you saying that she can have 10mg every 12 hours?

I will try to download images onto my home computer and attach them to an email from there. I will not be able to do that for several hours but will start her on the loratadine prior to going home. I will attach images to both email addresses. Thank you very much!