diagnosed as eczema

[cathytoss]

Hello! I'm fifty years old, female. I have a patch of skin, well, two, one on my thigh just above my right knee slightly off center and on on my upper left arm sometimes over the shoulder. not usually at the same time, the skin gets red hot and slightly raised and maniacally itchy. early on, i was in the hospital for nearly four weeks, because i scratched and it got infected and they did try and find out what it was. after the hospital stay, i was told it's eczema. when i don't scratch and it runs on its own, it then bubbles and gets itchier, then pops and peels. only within these patches. and not in sequence and not a regular number of days and not in sync with a cycle. it feels like fire. the area is starting to get that scar kinda look (i'm pretty pale) i guess from all the peeling. I've been given moisturizers and antihistamines to sleep with and told to not scratch, and discharged from derm.
it's not dry. it's not scaly. i'm allergic to nickel and it's not the same as that rash. it never moves and never goes outside these boundaries. every once in a while i get a week where neither patch is going.
two questions i guess. one is, i did a trial of methotrexate, but my liver jumped up to over 500 alt even with the folic acid and that was only two weeks into titration. what are the other immunosuppressants that i could try that maybe aren't liver based? my gp is open to me coming in with suggestions that he then takes a look at. ah, ten minutes. two would be, is this eczema? that's my question, overall, but i understand we are on the internet.
thanks for reading!
kind regards,
cath tyler

[Dr Adil Sheraz]

Dear Cathy

Thank you for your question.

Its sounds like you may have discoid eczema. This type of eczema often occurs in circular patches and can effect any part of the body. It can blister and also become infected, resulting in pain and weeping from the patches.

Of course without looking at the patches it is difficult to make a definitive diagnosis. A biopsy can sometimes help if there is any doubt.

Immune suppressants for eczema should be started by your dermatologist, there a variety of blood tests and a chest x ray that often needs to be done before starting certain immune suppressants.

Other options to consider would be Mycophenolate Mofetil, Azathioprine or Ciclosporin. All of these can have an impact on various organs and systems, such as the liver, kidney or blood counts. Therefore careful and regular monitoring is required. This is something that many dermatologists do on a regular basis.

UVB phototherapy can also be helpful in certain cases.

However as mentioned you would need to see your dermatologists, who will assess your suitability to one of the immune suppressants, and indeed assess whether you even need an immune suppressant!

I hope this helps.

Wish you the best of luck.

Dr Adil Sheraz