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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Allergy On Neck, Back, Forearms. History Of Arthritis. Symptom Of Toxic Epidermal Necrosis?

My mother is 47 years old. She is under the treatment of arthritis . She had folitrax 15 on last two consecutive sundays. And she is having some kind of allergy on her neck ,back and forearms. They are itching a lot. They seem to appear like ringworms but. They aren t ringworms. They are increasing im size and are round in shape.. Is it a symptom of TEN ( toxic epidermal necrosis )
Fri, 14 Dec 2012
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Allergist and Immunologist 's  Response
Hello,
TEN is a very serious adverse drug reaction and the patient is usually quite unwell. The rash covers a wide portion of the body with skin peeling off about 10-30% of body surface area. There is associated fever, a very toxic look and hence quite an unwell patient.
If there is any feature (or features as above), please consult a doctor as soon as possible or take to the nearest emergency. Folitrax or methotrexate is one of the drugs that can cause this, but is quite rare.

The more likely possibility (if none of the above features are present) is an urticarial eruption that responds to high-dose antihistamines. If she is on steroids, a slightly higher dose may be required if the lesions are quite bad. You can apply calamine lotion to some areas that are very itchy for a local cooling effect.

I hope that answers your query.
Best Wishes.

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Allergy On Neck, Back, Forearms. History Of Arthritis. Symptom Of Toxic Epidermal Necrosis?

Hello, TEN is a very serious adverse drug reaction and the patient is usually quite unwell. The rash covers a wide portion of the body with skin peeling off about 10-30% of body surface area. There is associated fever, a very toxic look and hence quite an unwell patient. If there is any feature (or features as above), please consult a doctor as soon as possible or take to the nearest emergency. Folitrax or methotrexate is one of the drugs that can cause this, but is quite rare. The more likely possibility (if none of the above features are present) is an urticarial eruption that responds to high-dose antihistamines. If she is on steroids, a slightly higher dose may be required if the lesions are quite bad. You can apply calamine lotion to some areas that are very itchy for a local cooling effect. I hope that answers your query. Best Wishes.