Generalized rash since starting Fludara...

[swee2000]

My husband began Fludara chemo treatments on 2/4/08. Since then, he's developed a generalized, constant, & extremely itchy rash all over his body. Initially, the rash started on his back, spread to his front torso around the time of the 2nd treatment, and, just today, began appearing on both sides of his neck & upper-half of his legs. The itchiness is so bad it leaves my husband scratching all day & all night, sometimes to the point of breaking skin &/or waking me up from a sound sleep due to how loud or vigorously he's scratching. Adding to the fact that my husband has CLL, thus the Fludara treatments, he's also a Type II diabetic, which adds to his body being more immune-compromised right now.

The oncologist & his nurse practitioner are very aware of the rash, as both my husband & I have mentioned it to them. Yet, neither one has done anything to figure out what's causing it. They've both stated that it's not related to/caused by the shingles virus, mainly because the rash is so widespread & does not follow the typical nerve-root pathways. They've both suggested applying an OTC topical cream/ointment(like Hydrocortisone or topical Benadryl) to the rash &/or taking oral Benadryl, as well as making an appointment with a dermatologist. Well, my husband's done all of those, even tried the home-remedy of applying corn starch to his entire body. Yet, the rash continues to spread, the itchiness & scratching keep getting worse & more constant, the OTC treatments have not been effective, and my husband can't get an appt with the dermatologist for anytime in the next week(due to scheduling conflicts). Again, the oncologist is well aware of all of this, but still acts the least bit concerned about the rash, how long it's been going on, the fact that it's spreading, &/or that it's causing my husband so much discomfort(due to his never-ending need to scratch so much/bad).

Has anyone ever heard of Fludara causing an outbreak like this? Or could this be an allergic reaction to the drug? What else can my husband do if the doctor doesn't think the rash is med-related &/or something to be concerned about?

[gra767]

My dad has finished his sessions, and now he was diagnosed with herpes, he has it on the front of his chest and on his uppder back.  He was on antibiotics calles ACEVIR, but i have notices that he has started to be inchorent.  He also takes medicine for Parkinsons', please tell me if this confusion, incoherence, will dissapear after he stops taking the antibiotics for the herpes or what should I do.  Thank you, G

[Dennis MD]

Hi.
Thanks for the update.
It’s good to know that your husband’s rashes have gone down by 50%.
Allergic drug reaction is a common cause of generalized rashes.  When there are multiple drugs being taken at the same time, it is hard to pinpoint exactly to where the reaction is coming from.  What is usually done is withhold all the drugs and reintroduce them one by one, and check to which drug/s there will be a reaction.  In your husband’s case, it is the allopurinol he was taking that caused the generalized rashes.  Discontinuation of the drug intake is needed to relieve the drug reaction.  Supportive measures like antihistamines and corticosteroids, and hypoallergenic diet can help.

[swee2000]

I think we solved 50% of the mystery regarding my husband's severe skin rash: Allopurinol. I completely forgot that he was on this med and started it at the same time as the chemo treatments w/Fludara. What upsets me more is that the oncologist never said a word about Allopurinol being a possible source/cause of the rash or that its most common side effects are skin rashes/irritations(including serious, possibly life-threatening ones like Steven-Johnson syndrome). On the other hand, he did tell my husband 2 weeks ago that he doesn't have to take the Allopurinol anymore. Since then, the rash seems to have decreased about 50%, although the itchiness is just as bad.

And on a side note, my husband also saw a dermatologist this past Friday regarding the same rash & itchiness. Unfortunately, this doctor was no more help to us than the oncologist and basically gave us the feeling like we were wasting his time. To show you how well this doctor listened to us, he wrote 2 prescriptions for the same meds that my husband just finished telling him he had already tried & only got minimal results with.

[Dennis MD]

Hi.
How often is your husband being treated with fludarabine (fludara)?
The generalized itchiness with appearance of rashes could be a side effect of fludara.  There are times when an existing skin problem or a latent skin problem would flare with fludara injection.  Treatment would range from giving antihistamines and corticosteroids.  If there is severe reaction to the drug, there may be a need to discontinue giving it.  You can discuss this with his oncologist.
Good luck.