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I've been on allopurinol just over a year now. After starting I had the expected twinges and tingling, but no full on attack thankfully.
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At the end of last year though I developed a nasty throat infection, which laid me low for a few days. My wife thought it could be a quinsy and I was advised to seek medical attention. The Doctor felt a few days on antibiotics should sort it, which it indeed did. Strangely, at just the same time I awoke with a mild gout attack. Nothing full on, but enough to make me limp for a couple of days. Seemed a bit of a coincidence with the infection happening at the same time. Can fighting infection (or indeed any other illness) raise uric acid levels and cause a flare ? I've noticed in the past that being stressed, or very tired can worsen symptoms. Any views ?
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At the same time as all this going on I devleoped a rash. The rash was mainly at the top front of my legs. The Doc (same guy as the one above – same appointment) felt it was sportmans rash, which seemed a bit….well, rash. He gave me some cream which I applied. Its been reducing slowly over the last few weeks, though I've also had small outbreaks on my shins and arms. I'm sure this has nothing to do with allop, as I've been taking for a year with no side effects. However, how do we know when a rash may be due to an allop reaction ? Do they look a certain way, or appear in certain places or what ? Anyone any knowledge of this ?
nokka,
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Rashes are rashes are rashes. If you get them on your groin you assume fungal and treat with one after another of the 100 antifungals that treat jock rash. If you have them on your foot, the same. If you wife has it on her vagina it's judgeed yeast and nystatin is used. On the face the catchall diagnosis is usually sebborheic dermatitis and more trial and error.
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And then there are the thousand other rashes that neither doctor nor patient can identify so a mix of antifungals, antibiotics, anti yeast and cortisone is tried (cortisone stops the inflammation of all rashes, but? does not cure them.)
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All of this is to say it is very?hard to make anything out of a rash.
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The exceptions are sudden hives and facial swelling with?swollen eyelids and lips?this is a sign of allergic angioedema and means STOP THE DRUG, because your life may be in danger.
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But run-of-the mill rashes are illusive creatures.
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If anyone has a webshot of a proven “allopurinol rash,” please post it…I've never seen anything.
Thanks for the input, Zip. Rashes are common, of course, and diagnosing one is difficult. I usually let these type of things sort themselves out, which they usually do on their own. As I've had these ones about 6 weeks now decided to give them a helping hand. Bought some Hydrocortisoid cream from the pharmacy yesterday, plus some emollient cream to stop the skin drying out too much. Hopefully that'll do the trick.
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Having the rash just made me think about just what a allopurinol induced allergic rash looked like. From what you say, sounds like you'd know something was seriously wrong.
Sorry about the blurred image. I post it as there are so few pics of reactions possibly due to AP.
This shows the broad extent of a lesion on my middle left? finger , last knuckle joint.
There is still? now 6 months later,a raised red area there -with no pain or infection.
I think it was an unspecific reaction to AP.
The main issue at onset was the?pain [like a joint burn from urate] and the lack of healing to red area shown.
I stuck it?for about a week or so, before stopping AP. The soggy bit/red spot?was unusual in not healing over.
Once AP was stopped this cleared up- to a degree similar- but now to a knuckle just?'fixed with'?urate, .
When shown to Docs they just looked interested?but non-committal, not acknowledging?the patients ?worry of extreme reactions once AP started?-now they have? maybe shifted from refusing to prescribe, for probably that very reason. Side effects are regularly discounted in all meds use, in my experience. One said it wasn't normal.
Also,?the Doc who prescribed the AP sometime earlier, had left the practice.
[Also a gout sufferer and AP user]
I've since used Sulfinpyrazone daily [100 to 200mg] with good success, keeping under 5 mg/dl SUA..
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Picture August 2010 [Edited to show less red]
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