Permanent discolouration at injection sites

[Trish77]

I have clearly discoloured skin patches where my injection sites were.  I thought they might go away eventually but approx 18 months post treatment, it's clearly not going to happen.  They haven't faded whatsoever.  Looks like they are here to stay.  The left side is about 1-1/2 " in a ragged circular patch and the right side is blotchier and larger but same thing.  Not going to look pretty if I ever get myself back into a bikini (hey, a girl can dream) but I'll live.  I tended to keep with alternating right and left side and sort of used 4 different injection sites but not really far apart from each other.  Was anyone else left with this?  I think if I had known my skin would discolour to this degree from the injections I would have approached it differently.  Minor deal in general and compared to other gifts I was left with, just wondered if others also had likewise.

Trish

[merryBe]

trish--well, if your body mounted a little bit of an immune response to the time release agent, it might have been just enough to then also attack the melanin in the area.
I know some people do react to the releasing, there was info on the black box sheet on that.

GD--if it's not heavily chlorinated it shouldn't be a problems, but a solution heavy enough to bleach the skin is a lot more concentrated. It's definitely not good for any of us even in good health, the liver has to deal with those toxins. To a sick or previously sick liver, it would just be an extra risk.  I know quite a bit about chlorine poisonings, I've watched a couple of people almost die from too much chlorine exposure...so the idea is scary to me, naturally.

[Trish77]

It's not fungus and it's not bruising.  As mentioned above a number of times, it's loss of pigmentation and only at the injection sites.  It's stayed like this for 18 months now since SVR.  It appears to be permanent.  

[GoofyDad]

MB: So what's the scoup on clorinated pools?

NY: So what happens to the carpeting when you soak it in the bleach?

[merryBe]

you are forgetting though that bleach goes through the skin and into the liver where it HIGHLY oxidative....meaning bad news to livers...sometimes we need to think health before beauty maybe??

[merryBe]

couple of things come to mind,
one is vitilago is not going to just appear at injection sites...
2 if it was that, then like me you might have pituitary involvement, my symptoms, that les me to look into pituitary dysfunction research, was a whole host of minor issues, vitilago being amongst them.
3. it's also possible to get skin fungus at injection sites, you need a dermatologist to confirm this one, but I wouldn't take the meds to get rid of fungus, they are liver killers.
4. you might still have iron deposited at the sites...this should't happen, but it could if you iron count was already too high, I'd get that checked as high iron ain'y good for us.
5.do just your injection sites have this bruising...or do other bumps and bruised respond the same...if so, many blood disorders, some serious have bruising as their first red flag...if not, it could be you had an immune response to the time released agent in the peg...sometimes the body forms little cysts to surrond and protect the body from an agent it does not like, and the matter in the cyst stays isolated and that would include the iron from the blood in the area of the injection.
just a few possibilities : )
mb

[Diane12855]

Oh! Oh!

[Trish77]

Be careful what you wish for, you just might get it.

[Trish77]

You're kinda cheeky, aren't you.  

[can-do-man]

"Before and After.  Sheesh.  That's what Bill asked for.  I almost told him no T&A pictures either but erased that."

So does that mean there will be T&A pictures?

I'll be  ‹(•¿•)›  for those.

[GoofyDad]

" Cheeks?"

I understand the temptation, but I think somewhere below the shoulders might be best.

[Trish77]

Before and After.  Sheesh.  That's what Bill asked for.  I almost told him no T&A pictures either but erased that.  

Tattoos on the right and left what??  Cheeks?  Hmmmm... a whole new set of punchlines runnin' through my head......

[GoofyDad]

"no B&A pictures. :)"

What the heck? "Blotch 'n @ss?"

What about a tatoo of the Goof-man? One for the right and one for the left?  

[Trish77]

Mike:  "The bottom line is........................ I am really lucky. "  

I would agree, despite how much you have been through in transplant, treatment and motorcycle accident and lord knows what else.  I understand your assessment of your situation.  Not always good to blame everything and anything on treatment.  I try not to.  Definitely my thyroid is treatment-related. I tend to think my arthritis is as well, when I was running 10K the first weekend I started treatment and now I have these joint issues post treatment.  

Thank you for posting the articles on vitiligo and the relation to treatment, I don't think I've ever seen that before and I had no idea it was an auto-immune situation either.  I'm paying close attention to those things lately as I'm displaying various auto-immune issues and I'll have to be cognizant of those things.  That information will be useful to others who may run into the same thing.

Portann...thanks for starting the vitiligo discussion.

I would not have thought a simple question asking if anyone else has lost pigmentation at their injection sites would have led to this sort of information.  Interesting how often that happens on this forum.

Nygirl:  Your idea is brilliant to use the tanning cream on only those spots.  It won't be an even match but the spots will be less startlingly white than they are now and I think I'll do just that.

Trish

[susan400]

I'm not sure that what I have is vitiligo.  I clearly remember getting a sore like area (like an abscess actually) on my abdomen, right around the areas where I eventually ended up with the scars.  It's actually worse on my lower left side than my right.  And it only happened in like my first 1-3 TX's time frame because I never got any new scarred areas in my later treatments and never got any on my legs or thighs or anywhere else except the injection areas where the sores developed.  

As far as the bleach bath thing goes, I actually did that years ago for another skin condition unrelated to psoriasis, or Hep C, or any of the TX's.  It solved the problem but, MAN did it leave an unpleasant sensation in my nose, lungs and itchy skin!  I don't want to go into the personal details of why I needed the bleach bath thing at that time, it's too private/personal to share on a public forum.

Susan400

[nygirl7]

Sorry for hijacking the thread but it seems a good thread to put this info in.

If properly diluted and used as directed, a bleach bath is safe for both children and adults. For best results:

Add 1/2 cup (118 milliliters) of bleach to a 40-gallon (151-liter) bathtub filled with warm water.
Soak the affected areas of skin for at least five to 10 minutes.
Dry your skin thoroughly and apply a thick layer of moisturizer.
Take a bleach bath no more than twice a week.
Though some people experience positive results, a bleach bath can cause skin dryness if the bleach concentration is too high or if the bath is done too often. If your skin is cracked or extremely dry, any bath — including a bleach bath — may be painful. Talk to your doctor before trying an eczema bleach bath

[nygirl7]

OK I'm not crazy and hallucinating at least!

Bleach baths may help kids with eczemaApr 27, 2009 ... Soaking in a bath with diluted bleach may help treat children with eczema, a study shows.
www.webmd.com/.../eczema/.../bleach-baths-may-help-kids-with-ezcema - Cached - Similar
Eczema bleach bath: Can it improve my symptoms? - MayoClinic.comAug 18, 2009 ... Eczema bleach bath — A diluted bleach bath may help treat chronic eczema.
www.mayoclinic.com/health/eczema-bleach-bath/AN02003 - Cached - Similar

[nygirl7]

Abstract: Well-known cutaneous side effects of interferon (IFN)-alfa therapy include dry skin, pruritus, hair loss, and psoriasis. Presumably because of its potent immunomodulatory activity, the use of IFN-alfa has also led to the development of autoimmune diseases in susceptible individuals."

Well I ended up with this wierd eczema rash that I cannot get rid of.  I had read recently to put a tablespoon of bleach (clorox) in the bathtub because it will help to kill some germ of some sort that is in the eczema. Well last night my leg was itching so much I took my bathroom mildew cleaner and sprayed it on my leg in desperation. I have to say........whatever it did the itching completely stopped.  I'm not suggesting that anybody else do this (I am a bit insane) - but I will see if I can find whatever it was I read (or hallucinated) in case it helps someone else.

[mikesimon]

See: http://www.hepatitis-central.com/hcv/ifn/vitiligo.html

"Dermatology 1996;193(1):65-66

Interferon-induced vitiligo in a patient with chronic viral hepatitis C infection.

Simsek H, Savas C, Akkiz H, Telatar H Hacettepe University Medical School, Department of Internal Medicine, Ankara, Turkey.

Vitiligo is an autoimmune disease characterized by depigmentation of the skin due to destruction of melanocytes. Interferons have been used for the treatment of chronic hepatitis C and some malignancies. We report interferon alpha-2a-induced vitiligo in a male patient with chronic active hepatitis C. All skin lesions disappeared completely without requiring therapy after discontinuation of interferon. This case suggests that vitiligo may be developed during interferon therapy as a side effect."


Krzysztof Tomasiewicz1 Contact Information, Romana Modrzewska1 and Grażyna Semczuk1
(1)   Department of Infectious Diseases, Medical University of Lublin, ul. Biernackiego 9, 20-041 Lublin, Poland



See:http://www.springerlink.com/content/e2t4649714h3221v/

Abstract  The use of pegylated interferon (PEG-IFN) and ribavirin is considered standard therapy for patients with chronic hepatitis C. Many adverse effects of IFN appear to be of autoimmune origin. Vitiligo is a hypomelanotic disease, whose cause, despite many investigations, remains unknown, although some evidence points to an autoimmune pathogenesis. This report describes a case of vitiligo that occurred during the third month of treatment with PEG-IFN and ribavirin. The sustained virologic response was the result of a 52-week regimen; however, hypomelanotic cutaneous patches persisted. Autoimmune adverse effects of IFN therapy, which may include vitiligo, should be carefully monitored. The decision about whether to discontinue treatment should be discussed with the patient, who must be informed that the lesions may persist.

[mikesimon]

"Abstract: Well-known cutaneous side effects of interferon (IFN)-alfa therapy include dry skin, pruritus, hair loss, and psoriasis. Presumably because of its potent immunomodulatory activity, the use of IFN-alfa has also led to the development of autoimmune diseases in susceptible individuals. Vitiligo, an autoimmune cutaneous disease, has been reported to occur during IFN-alfa therapy. We report a 10-year-old girl with chronic hepatitis B infection in whom IFN-alfa treatment induced de novo development of vitiligo and psoriasis. Neither skin condition improved after withdrawal of interferon treatment. Concomitant occurrence of vitiligo and psoriasis due to IFN-alfa has not been reported previously."

http://www3.interscience.wiley.com/journal/118781872/abstract?CRETRY=1&SRETRY=0

".....Depending on the number, size and location of the white patches, you may decide to seek medical treatment. Medical treatments for vitiligo aim to even out skin tone, either by restoring color (pigment) or by destroying the remaining color.

Treatment for vitiligo may take as long as six to 18 months, and you may have to try more than one treatment before you find the one that works best for you.

Medical therapies

    * Topical corticosteroid therapy. Corticosteroids may help return color to your skin (repigmentation), particularly if the medication is started early in the disease. Milder topical corticosteroid cream or ointment may be prescribed for children and for people who have large areas of depigmented skin. It may take as long as three months of treatment before you begin to see any changes in your skin's color. This treatment is easy and effective, but your doctor needs to monitor you closely for side effects, such as thinning of the skin (atrophy) and streaks or lines on your skin (skin striae). Calcipotriene (Dovonex), a vitamin D derivative, also may be used topically and is sometimes used with corticosteroids or ultraviolet light.
    * Topical immunomodulators. Topical ointments containing tacrolimus or pimecrolimus are effective for people with small areas of depigmentations, especially on the face and neck. This treatment may have fewer side effects than corticosteroids and can be used in combination with UVB treatments. However, studies conducted on these treatments have been small, and there is concern that they may be associated with an increased risk of lymphoma and skin cancer.
    *

      Topical psoralen plus ultraviolet A (PUVA). This option, which is also called photochemotherapy, may be effective for you if less than 20 percent of your body has depigmented patches. You'll have to visit the doctor once or twice a week for treatment. The topical psoralen is applied in a thin coating by your doctor or nurse about 30 minutes before the light exposure. Psoralen makes your skin more sensitive to ultraviolet light. Your skin is then exposed to UVA light, which turns the treated areas pink. As the skin heals, a more normal skin color appears.

      Possible side effects include severe sunburn and blistering, though you can minimize your risk of complications by avoiding direct sunlight after each treatment. Hyperpigmentation — over darkening of the skin — is usually temporary and eventually lightens when treatment stops......"

http://www.mayoclinic.com/health/vitiligo/DS00586/DSECTION=treatments-and-drugs

[portann]

I found this link but can't open it right now to see if it's relevant to what you describe:

Vitiligo occurring at site of interferon-alpha 2b injection in a patient with chronic viral hepatitis C: a case report.

Anbar TS, Abdel-Rahman AT, Ahmad HM.

PMID: 18498412 [PubMed - indexed for MEDLINE]

TTYL -  maybe someone can access it to see if it's on-topic.

Best,
Susan




http://www.ncbi.nlm.nih.gov/pubmed/18498412


Clin Exp Dermatol. 2008 Jul;33(4):503. Epub 2008 May 21.

[nygirl7]

I think tanning would simply make everything different shades of brown. :)  "

Why don't you try using a self tanner, just a light dab on the affected area and see if that helps cover it up? Self tanners are more like well they sort of carmelize your skin.....not tan it directly.  I'd start with a light dab of jergens express.  That should 'tan' you in a few hours.  If it works on the affected area you at least could feel as if you didn't really have them any longer.

Just an idea for a temporary solution for summertime and bikini's!!!!!!!

[can-do-man]

Count me as one who never had a reaction, as for women in  bikinis i wouldn't worry to much. I don't think i would notice that area anyway:)

Now if any of you need a judge just let me know, i'm more then willing to go the extra mile girls........... Except for you bill, i don't do Mankinis so your on your own.

Trish i really tried to stay away from this but i just couldn't hep myself.

Cando can and will

[susan400]

My marks are exactly as you describe them.  They are white as well and look about like the size of a cigarette burn, which I can tell you for sure that they are not!  I've had them for years and they have not gone away.

Susan400

[Trish77]

I had Roche's Pegasys and used syringes and vials, not the pre-filled ones.  Makes me wonder if the others got the interferon a little further into the "subcutaneous than my syringes would have.  And not marks....loss of pigmentation.   The skin there is white white.  I think tanning would simply make everything different shades of brown. :)   Not really an overly big deal....more a curiosity than anything and if I'd known it was going to happen, maybe I would have spaced it out more and made better use of my .. "subcutaneous" areas.  I'm SVR and I'll take discoloured skin blotches and SVR any day than the alternative.