Episcleritis and Monthlt cylce

I have been Diagnosed with nodular Episcleritis by two Opthomologists.  The thing is like clockwork I have a breakout on the forst day of my period every month and it lasts for a few days.  I have also been checked for Sjogrens-negative-Lupus neg and Rhematoid Athritis-neg.  I was diagnosed as having Hashimotos or what looks like Hashomotos and I have an underactive Thyroid for which I take medication.  What could be causing this?  I have also had two or three nasal lesions right nostril and now I have a problem in the right eye-I actually have a picture I could send of the nasal lesion if you want to see it?  I have been tracking this and I have it pinpointed.

[Michael J Kutryb, MD]

The good news is that you said it just lasts for a few days.  That is great because episcleritis can sometimes be quite persistant and troublesome.  THe key for you is to reduce the occurance of flare-ups by making the eye as happy as possible with frequent lubricant drops and ointment, possibly oral omega 3 fish oil and flax oil supplement to decrease inflammation and increase quality of tears, possibly using a very mild steroid drop on occasion under direction of your ophthalmologist, consider punctal plugs to keep eye more lubricated.  Make sure thyroid levels are monitered, take good care of yourself with excellent nutrition, plenty of water, vitamin supplements.  Nose lesions could be many things - not really my area of interest.  Not sure how they relate - if really concerned a doctor could always take a biopsy.  Herpes zoster and herpes simplex come to mind here - make sure doctor is able to rule them out.  In the end you may never know why you get this problem but you can just do everthing in your power to reduce incidence and severity of problem.

MJK MD

[mick777]

Thanks so much I did an internet search on episcleritis and Menstruation and what came up?
Hansens disease (Leprosy) I got very freaked out considering that there were two cases in Phoenix last year and I thought what did I touch a door handle and then my eye or something?  The lesion I had was yellow and crusted up near the nostril of my nose-I have been exposed to Herpes so I don't know if I have Ocular herpes or if I touched my eye somehow?  I just thought it strange that it broke out the same exact time every month on the first day and worst day of my period like clockwork?  Thanks for your comment and sorry for the typo's above.
Mick

[MLWTR]

Just a thought, but has anybody suggested the possibility of Crohn's disease? It does raise the risk of episcleritis, and can cause lesions in unusual places. Typically they are in the intestinal tract, including sometimes in the oral mucosa, but nasal lesions are also a possibility, although an exceptionally rare one. They can present there before any other GI symptoms of Crohn's appear.  

Lesions can characterize some forms of vasculitis as well, but since you've clearly see a rheumatologist, I suspect those possibilities have been ruled out already.

Good luck to you.