Stage 3 Incivek Rash

[DresdenO]

I've noticed its difficult to find good illustrations of a stage 3 - severe Incivek rash. I've developed one in the last two weeks and have posted a couple of photos to illustrate it on my personal journal as well as the one here. I go to the hospital in a couple of hours where I think they'll admit me, to monitor the rash more closely. I finished my twelfth week of Incivek on Monday. The question now is whether the rash can now be brought under control without suspending the interferon/riba for the next twelve weeks and I would welcome input from anyone who has had a similar experience. I understand the Incivek takes about 6 days to clear the body. I began treating aggressively with a heavy steroid cream last night and there has been noticeable improvement. I can provide more details of the dazzling array of medications I'm currently on if anyone is interested. I was UND at 4 weeks and waiting on the 12 week pcr.

[pooh55811]

Just wanted to let you know that the topicals will usually eventually work, but it takes a long time. I was first prescribed only the fluocinonide ointment. I used it everywhere that I had the rash. At that time, my arms were very bad, like your back, maybe even worse because the hives were piled on top of each other, a solid mass of red bumpy skin. It took at least a week and half before you could see any difference and it took a total of 3-4 weeks to clear it up. In the meantime, it just moved next door, where ever I was not putting the ointment, the rash appeared. If you are not on a strong oral antihistamine like Hydroxyzine, it would be advisable to ask your doctor for one. The 50 mg Hydroxyzine every 6 hours  in conjunction with the topical steroids is what finally got my rash under control.

The rash is a systemic reaction to the drugs and that is why the topical ointments and creams alone won't always work or won't work very fast.

Best of luck. I hope you can stay on treatment.

[Advocate1955]

Doesn't seem like a good time to fly or be away from your hepatologist right now.

[DresdenO]

Thank you for all the helpful input on this thread, and the links, which have also been useful, I won't thank each of you but I am so grateful for your trouble. Just to update, after visits with a dermatologist and a liver specialist this morning - Thursday - the decision is to monitor the success of the topical ointments to Monday at which point if progress is not significant, treatment is to be stopped so I can be treated with steroids intravenously. The dermatologist wanted to admit me and I had to sign a release form before they'd let me go. I'm supposed to fly to Paris for the weekend tomorrow, not sure what to do now.

[working dog]

i had that except worse was my lower back and legs....man was it bad....2 weeks after the incivek it got a little better but still was bad....sometimes worse then others.....good luck with the rest of tx....billy

[yodennis]

As all are: I'm sorry to "see" your dermatologic distress! I had less of a rash and was taken off Incivek at around 10 weeks....I definitely continued with the interferon/riba (the latter was reduced secondary to anemia which has no relevence to your post)....Since the rash was unambiguously caused by the Incivek it went away over a week or two post Incivek. I have never given direct advice on this forum but this one time I really recommend you get a second opinion before suspending the Interferon/Ribo if the hospital default is to "stop everything"....It just seems so futile and sad to discontinue the necessary secondary medications to achieve SVR when all you might have to do is discontinue the primary causal medication! You've earned an optimal chance at SVR. d

[Advocate1955]

I'm sorry you're struggling with the Incivek rash.  It can be a very challenging side effect.  My husband had the Incivek rash from about week 2 all the way through and shortly after week 12.  It didn't look quite as bad as yours, but pretty close.  He used Hydroxyzine, Triamcinolone ointment, and we put tea tree oil on the the blisters.  I think you will see steady improvement in the rash now that you're treating it and also now that you're finished with Incivek.  
Advocate1955