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Dermatology (Expert Forum)
Rash/Blisters on Hands § Feet. Side Effect of Fertility Drug?
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
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Rash/Blisters on Hands § Feet. Side Effect of Fertility Drug?
by SusanaC, Jan 27, 2002 12:00AM
Seven days ago I finished a course of fertility drugs: Repronex & HcG, and then had Intrauterine Insemination. I continue w/ Progesterone (vaginal supp). I developed hyperstimulation of the ovaries immediately after the IUI and have been confined to bed for the last 6 days.
Three days ago I noticed slight itching at the tops of my toes. Two days ago I woke up with a bright red rash bilaterally on the tops of my toes and on my thumbs and across the knuckles of my hands. There are tiny, fluid filled blisters and it is very itchy. The rash has spread to my palms and tops of my fingers, and on the inner sides of my feet. There are some tiny bumps at my facial hairline also, but those are not itchy.
I called the doctor at reproductive medicine and they told me they'd "never heard" of such a reaction to the drugs I was given and said it must not be related to that. (note: I have no vaginal/genital itching or redness, so it seems unlikely the prog. supps are causing this). i took some Benadryl pills which gives me relief from the itching,but I'm nervous about continuing them just in case I am actually pregnant (which I can't confirm for another week or so).
My skin is not unusually dry. The rash is mainly in the areas of my knuckles (at the base of my fingers) with the tiny blisters going up to the base of my fingernails. It goes down the webbed area between thumb and forefinger (bilaterally), and continues to my palms and faintly on the wrists. It has crept up slightly toward my ankles but is mainly at the base of my toes (top of feet). It is itchy. The skin at the rash seems thick and tough.
I do not have a fever or coughing, although I have had a headache most of today with some sinus pressure. No other symptoms.
Can you offer any ideas of what this could be? I'm going to see a doctor at the Urgent Care center soon (and will go back to my repro med doc), but could use some expert suggestions as to what things the nurse practitioner might look for or test for. I feel miserable and am worried about my (potential) baby's health!
By the way, I do have a cat, although since the IUI I have had someone else change the litterbox. Also, I've no known food allergies and have eaten nothing out of the ordinary...
Three days ago I noticed slight itching at the tops of my toes. Two days ago I woke up with a bright red rash bilaterally on the tops of my toes and on my thumbs and across the knuckles of my hands. There are tiny, fluid filled blisters and it is very itchy. The rash has spread to my palms and tops of my fingers, and on the inner sides of my feet. There are some tiny bumps at my facial hairline also, but those are not itchy.
I called the doctor at reproductive medicine and they told me they'd "never heard" of such a reaction to the drugs I was given and said it must not be related to that. (note: I have no vaginal/genital itching or redness, so it seems unlikely the prog. supps are causing this). i took some Benadryl pills which gives me relief from the itching,but I'm nervous about continuing them just in case I am actually pregnant (which I can't confirm for another week or so).
My skin is not unusually dry. The rash is mainly in the areas of my knuckles (at the base of my fingers) with the tiny blisters going up to the base of my fingernails. It goes down the webbed area between thumb and forefinger (bilaterally), and continues to my palms and faintly on the wrists. It has crept up slightly toward my ankles but is mainly at the base of my toes (top of feet). It is itchy. The skin at the rash seems thick and tough.
I do not have a fever or coughing, although I have had a headache most of today with some sinus pressure. No other symptoms.
Can you offer any ideas of what this could be? I'm going to see a doctor at the Urgent Care center soon (and will go back to my repro med doc), but could use some expert suggestions as to what things the nurse practitioner might look for or test for. I feel miserable and am worried about my (potential) baby's health!
By the way, I do have a cat, although since the IUI I have had someone else change the litterbox. Also, I've no known food allergies and have eaten nothing out of the ordinary...
Doctor's Answer
by Alan Rockoff, MD, Jan 27, 2002 12:00AM
, Jan 27, 2002 12:00AM
Thanks for your careful description of symptoms.
Symmetrical rashes of the kind you describe are often either allergic or viral in nature. The fact that your rash is localized (not all over the body) makes allergy quite unlikely, as does your reproductive doctor's unfamiliarity with it. (Generally, specialists get to know the likely side-effects of their particualr corner of medicine quite well, because they get calls about them.)
In many cases, funny little red rashes with bumps and blisters come, last a few days, and go away as mysteriously as they came, leaving no trace or consequence.
I think your nurse practitioner should evaluate you for any other evidence of a viral infection (other symptoms, white blood cell count.) If no other evidence is found, it may be hard or impossible to tell what this was by the time it goes away. This is certainly not the rash of rubella (German measles), to which you were presumably immunized anyway. That's the virus, as you may know, with potential risk for babies.
If it turns out you are pregnant, I suggest that you have an obstetrician, dermatologist, or experrt in infectious diseases look at you. Good-quality photos while the rash is fresh may be useful as well.
In other words, I doubt that you yourself are at any risk; the risk to your pregnancy, if any, is also probably very low, but needs the evaluation you are in the process of seeking.
Best.
Dr. Rockoff
Symmetrical rashes of the kind you describe are often either allergic or viral in nature. The fact that your rash is localized (not all over the body) makes allergy quite unlikely, as does your reproductive doctor's unfamiliarity with it. (Generally, specialists get to know the likely side-effects of their particualr corner of medicine quite well, because they get calls about them.)
In many cases, funny little red rashes with bumps and blisters come, last a few days, and go away as mysteriously as they came, leaving no trace or consequence.
I think your nurse practitioner should evaluate you for any other evidence of a viral infection (other symptoms, white blood cell count.) If no other evidence is found, it may be hard or impossible to tell what this was by the time it goes away. This is certainly not the rash of rubella (German measles), to which you were presumably immunized anyway. That's the virus, as you may know, with potential risk for babies.
If it turns out you are pregnant, I suggest that you have an obstetrician, dermatologist, or experrt in infectious diseases look at you. Good-quality photos while the rash is fresh may be useful as well.
In other words, I doubt that you yourself are at any risk; the risk to your pregnancy, if any, is also probably very low, but needs the evaluation you are in the process of seeking.
Best.
Dr. Rockoff
**The reason I wrote all of this is because I took Clomid(sp) Dec. 22nd for 5 days then got a hormone shot Dec. 31. Since taking the Clomid I have experienced the worst episode yet of the dishydrotic excema..read the letter from other fertility patient..maybe from nerves of anxiety.
She has a very strange thing going on with her feet. Two weeks ago i noticed her limping on one foot and then trying to walk on the outside of her feet. A swollen pink rash popped up on her right heel (the rash appeared to be under the skin, cottage cheese bumpy in appearance). I took her to a naturopath and an MD and neither knew what it was but said it looked like a viral infection and it would soon pass. Well 2 days later her fingertips blistered and popped and the skin peeled away. Then the rash spread to her other heel and she has some blistering on her left toes.
What has me so concerned is the itchiness it is causing. She was up from 11:45PM to 4AM digging at her heels and writhing around in the bed. I have tried several topical ointments from Hydrocortisone cream, to Calendula Gel to Calamine lotion, to witch hazel and NOTHING seems to bring relief which makes me think it's internal.
She was just prescibed Prednisolone and we are going to start treatment tonight. Reading your stories has got me worried. i would hate to see this get any worse!! Please check in if you find help or relief! Thanks!
Blue
She has a very strange thing going on with her feet. Two weeks ago i noticed her limping on one foot and then trying to walk on the outside of her feet. A swollen pink rash popped up on her right heel (the rash appeared to be under the skin, cottage cheese bumpy in appearance). I took her to a naturopath and an MD and neither knew what it was but said it looked like a viral infection and it would soon pass. Well 2 days later her fingertips blistered and popped and the skin peeled away. Then the rash spread to her other heel and she has some blistering on her left toes.
What has me so concerned is the itchiness it is causing. She was up from 11:45PM to 4AM digging at her heels and writhing around in the bed. I have tried several topical ointments from Hydrocortisone cream, to Calendula Gel to Calamine lotion, to witch hazel and NOTHING seems to bring relief which makes me think it's internal.
She was just prescibed Prednisolone and we are going to start treatment tonight. Reading your stories has got me worried. i would hate to see this get any worse!! Please check in if you find help or relief! Thanks!
Blue
I try to keep my hands well moisturized with lotion as I realised that they become more itchy if my skin is dry. I would really wish for a more permanent cure though.
It started about 3 years ago when I saw them FIRST on my palms 1-2 no more. Then it was worse, they started to itch so I ran to the doctor. He sent the skin piece to the test and it came back with 0 result. Nothing grew. The doc said the palms' blisters is a reaction to what's going on with my feet. It was going on almost nothing that time but what I have now is horrible.
Biopsy from my foot showed clearly Dyshidrotic Eczema. Check out Google for this diagnosis and you'll see it looks alike.
I have only 2 creams to stop itch and one is steroids that can be used not more than 5 days in a row..No cure doc said. Sounds optimistic, right?