Struggling with Eczema and Facial Rosacea - Biologics Proving Ineffective
I really need some assistance! Hello everyone, and thank you in advance for your help. I’m a 26-year-old female who has faced significant skin challenges throughout my life. Having battled eczema since childhood, I’ve seen a marked increase in its severity over the years. In 2019, I was admitted to the ICU due to DRESS syndrome and, despite a prolonged course of prednisone, my skin issues persisted. I have consulted numerous dermatologists and experimented with an alarming array of treatments: Doxycycline, Methotrexate, Dupixent, Rinvoq, Ciclosporin, and Cibinqo. Most of these medications have either had no effect or exacerbated my condition. I did notice some improvement with Rinvoq, but it led to elevated liver enzymes. Dupixent, on the other hand, resulted in large patches of skin flaking off, alongside an overall reddening and purpling of my body. Currently, I’m using Cibinqo, which has offered some relief; however, I still struggle with facial redness and eczema on my upper body. My doctors seem to agree that I've simply been unfortunate, and they feel allergy testing isn't worthwhile. They continue to prescribe various medications, yet I see little to no improvement. For the past 18 months, I've been on different doses of prednisone, and whenever I attempt to lower my dosage below 5mg, I experience widespread rashes. At present, I’m on a 10mg regimen. I’m unsure of what to seek, but I feel overwhelmed and believe my healthcare providers are not acknowledging my concerns. I wonder if there might be an underlying issue causing my lack of response to these treatments. Here are the results from my recent blood tests taken on April 11 that are outside of the normal range: - WBC: 12.8 K/uL - RDW: 14.7% - Platelet Count: 428.0 K/uL - Immature Granulocytes: 0.9% - Neutrophils: 9.06 - Absolute Monocytes: 1.01 K/uL - Absolute Immature Granulocytes: 0.11 K/uL
Answers (1)
6/20/2025, 4:40:56 PM
OpenHealth AI
It sounds like you're facing a very challenging situation with your eczema and rosacea, and your frustration is completely understandable. Your history of complex responses to treatments indicates that you're likely dealing with a multifactorial skin condition that may require a customized approach. Here are some main points to consider as you navigate your options moving forward.
Explanation
Eczema, especially when combined with conditions like rosacea, can often be complicated by factors such as skin barrier dysfunction, inflammation, allergic reactions, and other underlying health issues. The fact that you've experienced adverse effects from numerous biologics suggests that your skin may have unique sensitivities or reactions needing special attention.
Next Steps
-
Symptom Journal: Start by documenting your skin's condition daily, noting flare-ups, triggers (like foods, stress, products, or environmental factors), and any new symptoms, such as increased redness or itching. This can help identify patterns that may indicate underlying issues and inform your healthcare team.
-
Topical Treatments: While you're managing systemic treatments, consider consulting a dermatologist about topical therapies. Options such as non-steroidal creams with ingredients like tacrolimus or pimecrolimus might help control inflammation without the side effects associated with systemic steroids.
-
Gentle Skincare Routine: Implement a gentle skincare regimen using fragrance-free, hypoallergenic products. Creams containing ceramides can help repair the skin barrier, and avoiding harsh cleansers may minimize irritation.
-
Diet and Lifestyle: Consider assessing your diet for potential allergens or irritants (like dairy, gluten, or other common allergens) that may exacerbate your skin conditions. Maintain hydration and include omega-3 fatty acids, which can promote skin health.
-
Second Opinion: If you're not feeling heard by your current healthcare providers, seeking a second opinion from a specialist in complex dermatological cases may provide new insights or treatment options. A dermatologist specializing in chronic skin conditions could explore other treatments for immune modulation or different biologic classes.
-
Blood Tests Review: Discuss your recent blood tests with your doctor to understand the significance of the elevated white blood cells and platelets, as these could indicate underlying inflammation or another issue. This might lead to further investigations or referrals to specialists, such as an allergist or rheumatologist.
Reassurance
It's important to remember that chronic skin issues can take time to manage effectively, and responses to treatments vary greatly from person to person. You deserve a treatment plan that acknowledges your concerns and experiences, so don’t hesitate to advocate for yourself and seek collaborations in your care.
Please keep track of your skin and overall health and stay proactive in discussions with your healthcare team. Let me know if you have more questions or need further details!
Related Questions
Concern Over New Skin Growth on Thigh
I’ve noticed a skin lesion about 20mm in size on my thigh, and I’m uncertain about its nature. It’s been worrying me, and I would appreciate any insights or information regarding possible causes or conditions it might be related to. Has anyone else experienced something similar? Any advice on how to proceed would be greatly valued.
Identifying Mysterious Nose Spots
Greetings everyone! I'm a 32-year-old woman, and I don't take any medications. For several months now, I've been dealing with two spots on my nose that simply won’t go away. I maintain a skincare routine that includes cleansing, toning, and moisturizing, but despite my efforts, these spots remain persistent. They lack a noticeable head, which makes it impossible for me to pop them, and they neither cause discomfort nor have they grown larger over time. I woke up one day to discover them, and they’ve been there ever since. My apologies for the poor image quality.
Seeking Help for a Skin Rash
Age: 20 years Gender: Male Height: 5 feet 10 inches Weight: 130 pounds Ethnicity: Asian Length of Symptoms: Approximately one week, although the larger area of irritation has been developing for about three weeks. Affected Area: My arms Medical History: No known health issues Current Treatments: Not taking any medications at the moment.
Struggling with Long-Term Nasal Congestion
**Patient Overview:** 21-year-old male For the past three to four years, I've been dealing with persistent nasal congestion, which has been quite troublesome. Despite seeking help from two different ENT specialists and trying various medications, including multiple nasal sprays and drops, I haven't found any lasting relief. Unfortunately, the treatments have been largely ineffective. Both an endoscopy and a CT scan yielded no definitive results. The only temporary relief I've experienced comes from certain nasal sprays that I used excessively, leading to a rebound effect that made my condition worse. One of the ENT doctors indicated that there weren’t any viable solutions for my issue, while the other recommended consulting an allergist for further assistance. **Allergy Testing Results:** - **Immunoglobulin Level:** 283.4 IU/ml - Identified allergies include: - House Dust Mites: 4.90 IU/ml (Dermatophagoides farinae) - House Dust: 2.00 IU/ml (Hollister Stier) - Storage Mites: 1.30 IU/ml (Glycyphagus domesticus) - Casein: 1.10 IU/ml - Chickpea: 0.98 IU/ml - Sesame Seed: 1.22 IU/ml - Milk: 1.50 IU/ml - Egg: 1.30 IU/ml - Yogurt: 0.46 IU/ml - Common Ragweed: 1.20 IU/ml **CT Scan Findings:** - **MSCT Scan of the Paranasal Sinuses (Plain):** - **Nasal Cavity:** The septum is nearly central, but there are hypertrophied middle and inferior turbinates on the right side leading to fullness in the right nasal cavity. Concha bullosa is observed bilaterally. - **Bilateral Sinuses & Drainage Pathways:** Sinuses appear normal and the bilateral ostiomeatal complex is also normal. - There are enlarged soft tissue shadows of the adenoids measuring 32 x 14.5 mm, which may be causing mild to moderate narrowing of the air passage. - Bilateral tonsilloliths are present with no collection, and there is a need to rule out the possibility of chronic or recurrent tonsillitis. - **Anatomical Variations:** The Vidian nerve canals are normal, with no Haller or Onodi cells observed; Keros type II olfactory fossae are present on both sides. **Impression:** The findings suggest mild adenoid hypertrophy and nasal cavity fullness due to enlarged turbinates. Thankfully, the sinuses and ostiomeatal complex appear to be normal. Although I cannot recall the specific names of the medications and sprays prescribed—due to difficulty in reading my doctor’s handwriting—I conducted some research and learned that many of these medications are typically used for allergic rhinitis. Now, my physician has suggested that I consider starting immunotherapy and advised me to see an allergist. I find myself uncertain about the next steps, and I am seeking guidance on how to proceed.
Unusual Skin Changes After Showering
I'm a 33-year-old female and I'm curious if anyone has experienced something similar. After I shower, I often notice a reddish rash appearing on my legs. However, today there were also numerous purple spots alongside the typical redness. Unfortunately, I can't upload images here, but I'll share them in the comments for those interested in what I'm describing.