Struggles with Behçet's Disease Flare-Up
A 36-year-old woman with a medical history including Behçet’s disease, bilateral transverse sinus stenosis and thrombosis (with stent placement in 2014), endometriosis, and total laparoscopic hysterectomy (ovaries retained), is currently experiencing a challenging flare-up of her condition. She previously had a VP shunt and an Lp shunt, both of which have been removed, as well as multiple intracranial pressure (ICP) bolts and a total of 34 lumbar punctures. As a child, she also had Kawasaki disease. Her medication regimen includes aspirin (75 mg), azathioprine (75 mg twice daily), gabapentin as needed, eumovate for eczema, infliximab infusions, paracetamol as necessary, ondansetron as needed, and she is currently on a course of 30 mg of prednisone. At present, she is dealing with a relentless flare associated with her Behçet's, anxiously awaiting a callback from her rheumatologist. In addition to azathioprine and infliximab (administered every six weeks), she is taking aspirin to prevent complications related to her stent. For about ten days, she has been on a dose of 30 mg of prednisone, which typically alleviates her flare-ups, yet she continues to feel unwell and is anxious about the possibility of being hospitalized for a methylprednisolone pulse treatment. One of the most distressing symptoms she has encountered in recent years is the resurgence of a pathergy reaction affecting her previous surgical scars, which flared during her recovery. The pain is intense, accompanied by noticeable swelling and redness at the affected areas, resembling her post-operative condition. She is curious whether applying a topical steroid cream such as eumovate might provide relief for this reaction. Despite her suffering, she is hesitant to resort to stronger pain medications due to a prior history of dependence on prescription opioids. However, she is struggling to manage her suffering and sleep while she awaits guidance from her healthcare consultant. She acknowledges the uniqueness of her situation and is thankful for any assistance or advice offered.
Answers (1)
7/18/2025, 9:01:24 PM
OpenHealth AI
I'm sorry to hear that you're experiencing a challenging flare-up of Behçet's disease. This situation can be quite distressing, especially given your complex medical history. It’s understandable to feel anxious while waiting for your rheumatologist's advice.
Main Points:
- Topical Steroids for Pathergy Reaction: Applying eumovate may help reduce swelling and redness from the pathergy reaction.
- Symptom Management: Focus on managing pain and enhancing sleep while considering both your treatment history and current condition.
Explanation:
Behçet's disease can trigger various symptoms, including painful skin reactions like pathergy, which can cause inflammation at previous surgical sites. Using a topical steroid like eumovate may help alleviate these symptoms by reducing inflammation. Before applying, ensure that the skin does not show signs of infection (such as pus or increased warmth), as topical steroids should not be used on infected areas.
Your current medication regimen includes prednisone, which should generally help manage your flare-up, but if you don't feel any improvement, it’s crucial to monitor your symptoms closely. Since you are anxious about stronger pain medications due to previous issues with opioids, I encourage using non-opioid alternatives as much as possible.
Next Steps:
- Try Eumovate: Apply the topical steroid carefully to the affected surgical scars, up to twice daily, as long as there are no signs of infection present.
- Manage Pain: If pain persists, consider taking your gabapentin (as needed) or over-the-counter medications like paracetamol to manage discomfort without escalating to stronger pain medications.
- Sleep Hygiene: Enhance your sleep quality by establishing a calming nighttime routine, keeping your bedroom dark and cool, and limiting screen time before bed.
- Monitor Symptoms: Keep track of the intensity and frequency of your symptoms, especially related to the pathergy reaction, and note any changes after applying the topical medication.
- Stay Informed: Once your rheumatologist gets back to you, discuss the ongoing flare-up, the current management plan, and the potential need for adjustments in medication.
Remember, you are not alone in this, and seeking help from your healthcare team is essential. Your well-being is the priority, so ensure you communicate all your concerns during your next consultation. If you have more questions or need further assistance, don’t hesitate to ask.
Related Questions
Reviewing Surgical Glue Reactions
At 29 years old and weighing 155 pounds, I underwent surgery on July 14th. I am concerned about the appearance of my incisions; do they seem overly red or possibly indicate an allergic response to the adhesive used?
Identifying Blood in Stool: A Concern for a 28-Year-Old
Hello, I’m a 28-year-old male. Earlier today, I experienced a loose bowel movement which was accompanied by bright red blood. After this, I used toilet paper and noticed a small red spot on the first wipe. Later in the afternoon, around 3 PM, I had another smaller, more solid bowel movement that was blood-free. However, I then had a larger, softer stool with some darker red blood present; this blood wasn’t too dark but rather faded to brown in the toilet water. I also noticed a slight amount of orangish-red blood on the initial wipe with toilet paper. I’m not experiencing any pain, discomfort, or fever. I do feel a bit gassy, and while the odor isn’t pleasant, it’s not unusual for me. Should I keep an eye on these symptoms for the next couple of days, or should I consider visiting urgent care? Based on my research, it seems plausible that the initial bleeding could be the result of a minor fissure or hemorrhoid, with the second instance possibly being a reopened scab. My primary care physician is closed at the moment, but I could arrange an appointment for 9 AM on Tuesday. However, I’m unsure if that’s something I should prioritize.
Jaw Dislocation Symptoms in Adolescent
I've been experiencing a jaw issue where it pops and emits sounds every time I chew. Specifically, it seems like the right side of my jaw often misaligns before it goes back into position during chewing. Interestingly, I can also deliberately dislocate it in either direction. If I press against my jawbone on the right side, I can prevent it from shifting. This has been a problem for me since childhood, but I'm now 15 years old. I don't take any medications, and I have no allergies. Age: 15 Height: 5'8" Weight: 144 lbs
I Have a Red Eye with Mild Discomfort After Touching It
Hello there! I'm a 25-year-old female, and approximately three hours ago, I noticed my eye becoming red after I attempted to pick at it, thinking there might be something irritating inside. While the situation hasn’t worsened, it also hasn't shown any signs of getting better. - Each time I blink, it feels uncomfortable, and there’s a slight pain associated with it. - The sclera (the white part of my eye) appears a bit swollen, making it look as if I’m wearing a contact lens in addition to my iris, yet I’m not. - Thankfully, my vision remains clear, and I haven’t experienced any discharge or tearing. Just now, I returned home, washed my face, and took off my makeup. During that process, I noticed and removed a couple of small, clear, gooey pieces from my eye, but sadly, its appearance hasn’t changed at all. What could possibly be causing this? Are there any remedies I can try at home? Since it's late and I’m currently abroad, I’d really appreciate any suggestions for relief! Thank you!
Seeking Answers for Ongoing Health Issues
Hi there, I’m currently feeling quite stressed about reaching out in this space. I’m a 30-year-old male, weighing approximately 60 kilograms. A decade ago, I was diagnosed with hypothyroidism. Although I received treatment, including two weeks of levothyroxine that alleviated some symptoms, I still experience ongoing issues, albeit with less severity. My symptoms are consistent with hypothyroidism: - Widespread hair loss from my scalp - Dryness of skin, especially on my face - Discomfort in both my hands and feet - Overwhelming fatigue, both mentally and physically - Difficulty with concentration and memory - Muscular soreness - Unusual tiredness in my biceps and hamstrings; activities like climbing stairs or lifting objects feel excessively draining - Easy bruising and reduced ability to clot blood Despite my persistent challenges, no physician seems to take my concerns seriously. This ongoing situation frustrates me immensely, particularly the cognitive difficulties, which hinder my daily life and diminish my sense of self due to the impact on my memory. Interestingly, my thyroid blood tests consistently return normal results. I’m reaching out for guidance—what should I communicate to my doctor to prompt them to take action, or at the very least, consider alternatives? I would greatly appreciate any advice.