Eczema and staph

[TT08]

Hi! I have chronic eczema and it is getting worse. so I ended up going to a new doc this last week who decided finally to run some test. I have already had a RAST test, patch test, and skin *****. But they decided to do some medical test such as thyroid levels, h pylori and they even cultured my leg where I had eczema and a few pustules. Well my labs came back with a potassium of 3.1 and white bollod cell count of 11.2, eosinophil count of 0 and 2+ staph in my leg. What should I do for now, unitl I hear back from the docs? They didn't give me a follow up, so I am waiting to here? It might be good to know that I am cyclopsorine, zantac, xyzal, accoluate, and now prednisone for 1 month? Anyone have any ideas or thought?? please help?

[BhumikaMD]

Hi,

What does your doctor suggest would be the bettr option in your case?

Like i have been saying in my posts, the constraints of this type of information is that we sometimes feel bound as nothing can replace a clinical evaluation and looking at the reports yourself.

I suggest your doctor would be the best person to consult and discuss about the further line of management.

Let us know what he/she advises and also if you have any doubts.

Keep us posted.

Regards.

[TT08]

Thanks for the comment. Well  the patch test resulted with nickel allergy, potassium, and one other one that is used in vaccines started with a T. Anyways, they don't think that this is where all my eczema symptoms are coming from. The yeast culture was negative. So they gave me two options one to start imuran for 12-18 months or to have a infusion of medication called rituxan. There is a new study out about Rituxan and eczema patients. The only thing with Rituxan is that the study just came out and only 6 patients were in the study????? So I don't know what to do? I am thinking the imuran is a safer option due to it being used more? ANy thoughts?

[BhumikaMD]

Hi,

Glad to knw about the steady though gradual improvement in your symptoms.

You should try to ask for a copy of all the investigations being done, and keep one with you.

Do post us the culture and sensitivity and allergy testing reports.

Let us know what your doctor advises and if you have any other doubts.

Keep us posted.

Regards.

[TT08]

Well, they decided to do a patch test. I am still in the process of going throught that right now. I went to the doc on mon to have them put on, wed to take them off, and then last fri to have them checked. I am for sure allergic to nickel and they want me to come back this monday for another check. I forgot to ask about the sensitivity report but I will on monday. I ended  up having to do another stool test for yeast because they did it for salmonella as a mistake. When I went back on friday they talked about putting me on immurane and taking me off the cycloporine but they think this is not the best idea due to me being of child bearing age. There is a new study out on eczema and the use of rituxan which is usually for lymphoma but they mentioned maybe trying this. I am not sure what else I should do. Are there any other tests that I should mention before they decide to try an IV medication. Any thoughts?  Oh yeah I am still broken out in places but I must say that my itching has decreased to a 4-5 out of 10 compared to a 8-9 out of 10 when I first started looking into all of this.

[BhumikaMD]

Hi,

What about the sensitivity reports? Ask your doctor about them and let us know.

Have you stopped taking the steroid medications? Could that be a cause of your exacerbations?

Let us know if you have any doubts.

Keep us posted.

Regards.

[TT08]

Well, I went back to the doctors office and they decided to do a stool for yeast. They said that if this came back positive that this could be causing my continous break outs. I ended up changing the way I take my cyclsopronine.Now once in the am and once in the pm. I have not heard anything yet and it has been over 3 weeks. I have started to break out again, so I called today to get an appointment instad of waiting until april . I have a few pustles on my legs likeI did before when they said I had MRSA. So I am not sure if this is what I have again. Also they wanted me to start with bleach baths, which were awful. They really stung and I ended up breaking out more from this. Any ideas on what I could do to keep the MRSA away. I have no idea what has caused my eczema to reappear. I haven't chenged anything. Please let me know your thoughts.

Thanks

[BhumikaMD]

Hi,

Well talk to your doctor again - once the culture comes out to be positive for some organism like MRSA in your case - the lab generally also does a sensitivity - the antibiotics to which the organism is sensitive are also reported - which helps in deciding the choice of antibiotics. Was this done in your case?

You could wait and see if your lesions respond. If not you could see an infectious disease specialist.

Do let us know what the doctor advises.

Hope this helps.

Good luck.

[TT08]

I have been on the doxycycline for a week and half no rash. The senistivity report? Are you talking about the culture? If so it came back MRSA that is all that they told me. I have been on cyclosporine since Nov last year, I didn't think that it was helping until I started to taper off  it and that is when I started to get worse with the really bad rash all over my body so they taold me to restart it at 200mg at night and the prednisone. I now have an appointment with another doc on Feb 11th. Should I be worried about the MRSA  or consider seeing someone else for the MRSA like a Infectious disease doc???

[BhumikaMD]

Hi,

Why were you taking the cyclosporine? Sorry but i dint get taht part i guess.

Well, if it is done by a certified doctor and one who knows your case hsitory then you should go ahead with it.

Dont worry about the prednisone, it would be gradually tapered and withdrawn once you are better so that the symptoms do not come back again.

Doxycycline is known to help for staph but doxycycline is itself known to cause a skin rash and photosensitivity, so ask your doctor for some other antibiotic.

Havent the sensitivity reports come in as yet?

Do let us know what the other doctor advises you.

Regards.

[TT08]

Hi, I wanted to let you know that I ended up going to the dermatologist and they gave me doxycyline( for the MRSA that was on my legs) , potassium supplement, and for me to stay on the prednisone until next week.  I have improved greatly, not sure from the doxyycyline or just from the prednisone. I have no rash right now. I am a little itchy but not bad, just feels like dry skin. I am really nervous about coming of the prednisone though because I don't feel like they resolved my issue. I am suppose to see another doc within the group who is the "itchy doc" sometime within the month. Do you think that the staph could have been causing the rash???  If so is the doxyxline enough? They are still talking about changing me to Imuran  instead of the cyclsporine. What are your thoughts on this??

[BhumikaMD]

Hi,

You would need to consult a dermatologist and have a clinical examination done.

You need to maintain adequate hydration and apply a soothing moisturising lotion.

A peel will not be done if the eczema is active that is itching or a rash is there - this might cause skin hypersensitivity and other side effects.

A look at the lesions is important before deciding anything.

Do consult your dermatologist and let us know what he advises.

Hope this helps.

Good luck.

[BhumikaMD]

Hi,

You would need to consult a dermatologist and have a clinical examination done.

You need to maintain adequate hydration and apply a soothing moisturising lotion.

A peel will not be done if the eczema is active that is itching or a rash is there - this might cause skin hypersensitivity and other side effects.

A look at the lesions is important before deciding anything.

Do consult your dermatologist and let us know what he advises.

Hope this helps.

Good luck.

[shapey]

My Cheeks gets real dark and dry and am told by the doc that its eczema. I was given a moisturizers and Triamcinolone/Ketoconazole however my face is still dry and the dark area is still there. My question is will a medical peel help me to get  rid of the black cheeks.

ThanksTTT

[BhumikaMD]

Hi,

I am glad the psots were of some help to you.

Do keep us posted about your reports and how you are doing.

Regards.

Good luck and best wishes.

[TT08]

Thanks so much! I will keep you posted!

[BhumikaMD]

Hi,

You should wait for the sensitivity reports to come in. they would help to decide the antibiotics which would be best in your case.

Also doxycycline is itself known to cause a skin rash and photosensitivity, so ask your doctor for some other antibiotic.

You will need to take antibiotics for a lomger time if the culture reports have come out positive.

Do keep us posted and let us know if you know have any more doubts.

Good luck.

[TT08]

Thanks for the comment! I have not heard yet so I will give them a call. If this is the case of the non-resolving eczema would I have to take the antibiotics for a longer period of time. Back in 2007 I went to a dermatoloigst due to my finger being swollen and red from a break in my eczema and they swabbed my nose. It came back as MRSA, but I am a nurse so they assumed that all of us in the heatlhcare world have been exposed. I did recieve doxycycline and a antibiotic that I put in my nose. So just wondering if I have taken that medication before should I get something different or possibly the same thing??

[BhumikaMD]

Hi,

You would need a course of antibiotics for the staphylococcus that was positive from the leg pustules. This might be the reason of the non-resolving eczema.

You did not hear back from the doctor as yet, because, most probably he/she must be waiting for the sensitivity reports to come in. This would help in deciding what antibiotics you need to be started on for the infection.

You can call up your doctor and confirm this and schedule a follow up appointment.

Hope this helps.

Good luck.