Can this skin condition be a side effect?

[sister1234]

My husband who is 66 years of age has emphysema for 5 years now. He is prescribed 16 hrs oxygen daily (we have machine)but only uses this when he feels he needs it (some days as little as 3 hours).  He daily takes spiriva, symbicort and sabutamol inhalers and calcichew tablets also mucodyne capsules occassionally. These are prescribed by his doctor. He also takes Nytol (over the counter) herbal sleep tablets quite often. For the past 18months he has suffered from a tingling, burning feeling in his skin.  This started around the ankles and has now progressed up to the legs,arms, face and neck.  It feels a bit like a sting from a nettle and the skin just looks dark red and feels hot - no rash. It flares up quite regularly and it is making him very worried. The doctor has tried antihistamines and emollient creams but nothing gives any relief. He was tested for a shortage of zinc and magnesium - negative. We have paid privately to see a dermatologist who diagnosed eczema, but none of his prescribed creams are helping either.  We have tried stopping the steroid inhaler and trying  Bricanyl instead of Sabutamol, but no difference. When it flares up it makes him really agitated which in turn affects his breathing and heart rate.  His oxygen levels can drop to as low as 84% & pulse fluctuating between 65 - 115 beats per minute. He then has to get on the oxygen continuously. He feels no one can help him and is really low and panicking.  His recent report from the respiratory clinic was that his overall condition was down to 69%.  Please have you got any ideas? Could it be a side effect from the emphysema - we are thinking lack of oxygen to the skin? Or could it be the drugs? Do you know of anyone else who is suffering from the same? We would be most grateful for your opinion. Please help us.

[National Jewish Health]

What you describe indicates that your husband is experiencing a “tingling, burning sensation” of his skin.  That the skin appears dark red and feels hot but that there is, “no rash”.  I will assume that the dermatologist concurs that the dark red appearance is not a rash.  In that case, what your husband has may not be a skin condition but more a sensation, the medical term for which is paresthesias, that originate in the peripheral nerves, at or near the surface of the skin. (see next paragraph re peripheral neuropathy)  Such sensations have been described by roughly 3-4% of persons using either Spiriva or Formoterol (in the Symbicort).  That may be the cause and the information I found on this suggested that while a nuisance, this is not considered a serious reaction and not a reason to discontinue the medication.

Another possibility would be that this peripheral neuropathy is secondary to a disease other than emphysema and the most common of these would be Diabetes Mellitus (DM).  This can be  both annoying and anxiety-provoking and obviously has you and your husband quite worried.  For this reason, I recommend that he be tested for Diabetes and, if he does not have DM, that you request consultation with a neurologist, who will probably be able to identify the cause of the tingling and burning.   What you describe is almost certainly not serious of itself or as a sign of more serious disease but it would be comforting to know that for sure, so you should get a neurologist’s opinion.

Good luck

[sister1234]

Thank you very much for your reply Dr Tinkelman.  We are very relieved that finally someone seems to have an idea of what could be wrong. My husband will contact his doctor for the DM test and referral to a neurologist as you suggest.

Many thanks once again.

[boomer658]

I am 65 years old, I too have the burning, tiny poking sensation in my ankles, accompanied by the redness and either dry flaky skin or a slight rash.   I have had this for several years. I was recently diagnosed with COPD. While researching COPD I found these symptoms listed in the COPD symptoms.by inputting key words COPD symptoms into Google..........J.R