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Clinicians, if you read anything today, read this: A case of total body contact dermatitis of unknown etiology, hives and dermatographism.
Ellen found my practice after listening to a podcast I did on allergic disease with Dr. Amy Meyers for her Autoimmune Summit. It’s at times like these that I’m glad I do outreach of this nature. I don’t resolve all the various issues that folks come to my office with, but there are certainly those times when “it was meant to be” seems to fit.
For the last year-and-a-half, Ellen had a total body rash so severe that she’d contemplated suicide, despite an otherwise storybook life. (See baseline and follow-up photos below.)
Two baseline photos sent to me on 01-21-2015. Note that these pictures were taken while on prednisone.
Ellen is a married 39 year old woman with two young kids. She called my office out of desperation, she said. She had a total body rash so severe that she’d contemplated suicide, despite an otherwise storybook life. She described her rash as feeling by turns painful/burning/pruritic. Visually, it was red/raised/scaly/crusty with oozing vesicles; sparing only her anterior thighs, hands and face…. It was non-responsive to almost every medication except oral and topical prednisone and about 200mg of Benedryl per day. And even these big guns were limited in their efficacy, only taking the edge off and enabling her to survive her day.
Understandably, however, her dermatologist said that after 18 months, he had to permanently taper her off the steroids. She’d gained over 40 pounds, and her skin was so friable that even the slightest scratch of an itch resulted in bleeding. They’d previously tried Plaquenil (worsened rash), cyclosporine (couldn’t tolerate) and Cellcept (developed severe flu-like symptoms).
What Ellen described as a rash was actually a collection of different skin problems, including contact dermatitis of unknown etiology, eczema (atopic dermatitis), hives and dermatographism.
It turns out that what Ellen described as a rash was actually a collection of different problems, including contact dermatitis of unknown etiology, hives and dermatographism. She’d seen multiple dermatologists, including a top researcher at a local university. Patch testing was positive for eugenol, nickel, fragrance, neosporin, bacitracin and UVB. He suspected her reaction was caused by sun and sunscreen and advised avoidance. She did, to no avail. They also gutted and rebuilt their home’s interior, sparing no expense to remove all possible antigenic materials. Nothing worked.
Literally any item that Ellen came into contact with could leave its mark. Her back was a mirror imprint of her nightgown in the morning. Her purse left a band on her arm after she carried it.
Ellen was reactive to virtually EVERYTHING in her environment. Her dermatographism — unlike what you learn about in school, “I can write my name on her back” – -was more reactive than anything I’ve encountered. Any item she came in contact with could leave its mark. Her back was a mirror imprint of her nightgown in the morning. Her purse left a band on her arm after she carried it.
Her hives were similar in sensitivity. Ellen hadn’t had a hot shower in months, as she’d break-out in full-on hives. Warmth from her car seat heater? Hives on her calves.
Surprisingly, Ellen’s personal history isn’t significant for any remarkable allergies beyond seasonal hay fever; nor is there a very compelling family history. That said, skin prick testing done after the start of the rash, showed positive reactions for almost everything environmental, but no foods.
As I investigated for antecedent and triggering factors, there were two clear smoking guns. Indeed, Ellen herself knew these were big deals. (FYI- I’ve added the timeline to my patient intake forms, so they can start connecting these dots even before we begin talking.)
- Difficile colitis after sushi-triggered food poisoning was a clear antecedent factor in the development of Ellen’s rash.
In 2010, Ellen developed food poisoning after eating sushi. She was hospitalized for a week. After developing C. difficile colitis, she was treated with vancomycin. Her gut function has been a problem ever since; she passes up to six loose BMs daily. The lasting damage to her microflora and gut wall had to be a piece of her extreme hypersensitivity response.
After six months of no sleep, lattes and straight sugar diet, Ellen suddenly developed the rash.
Just preceding the onset of the rash, in mid-2013, Ellen’s year-old infant girl would not sleep for more than 45 minutes at a stretch. Ellen herself got very little sleep through the night, and as a result of this, her food intake deteriorated. Her diet consisted of “lattes and sugar.” After six months of this, Ellen woke up with the rash.
When Ellen came to our clinic, my overriding focus was getting her through the final leg of her steroid taper without the common, but devastating possibility, of rebound dermatitis.
Patch testing pre-treatment.
When she came to my office, my overriding focus was getting her through the final leg of her steroid taper without the fairly common, but devastating possibility, of rebound dermatitis. We had about two weeks to prepare her body. Not enough time for lots of labs, but we ordered them anyway. They would guide us later.
Of course, I anticipated finding nutrient deficiencies after years-long chronic diarrhea; IgE food allergies (yes, despite the skin prick testing being negative) and IgG sensitivities; and dysbiosis, intestinal permeability. I also suspected food cross reactions with her myriad environmental allergies (nickel, latex, pollens, etc.), and a possible histamine and/or lactose intolerance. Since her home environment was impeccably clean, we didn’t need to look there.
Ellen had started a full Paleo diet prior to our appointment. This dietary change did NOT benefit her skin, although there was mild gut improvement.
Remember that Ellen found our clinic through the Autoimmune Summit. She was savvy with regard to her health. She’d already stopped gluten for some time and had started a full Paleo diet. These dietary changes did NOT benefit her skin, although there were some mild gut improvements. (Dairy seemed to worsen diarrhea.)
As you can imagine, after I removed all the possible food reactions, Ellen was left eating basically leaves and twigs. Not quite. But her diet was Spartan in the beginning. And for this kind of therapeutic- and temporary- restriction, unless you have the time to figure out these diets yourself and determine nutrient sufficiency (not to mention recipes, shopping lists, palatability, restaurant options, etc., etc.), you need a whip-smart nutritionist on your team who works very closely with the patient. Her diet also needed to be organic and preservative/additive-free, as much as humanly possible.
In the beginning, I stopped the various supplements she was already on so we could monitor skin. I was careful in prescribing a simple, traceable starting protocol of hypoallergenic nutrients primarily geared toward dampening the possibility of rebound dermatitis. These included an essential amino acids blend, diamine oxidase (for possible histamine intolerance), and very low dose probiotics (lactobacillus and bifido-specific species for allergy). Homeopathic sulfur (for itch), cromolyn sulfate (mast cell stabilizer), and bicarbonate (anti-histamine) were all prescribed as needed. I also added a prescriptive ceramide topical and dilute bleach baths.
The sulfur, bleach baths, ceramide topical were reported as useful; bicarbonate and cromolyn sulfate were never used. Ellen responded to our protocol so rapidly, she stopped steroids before the end of her prescribed taper. She never experienced rebound dermatitis. Not surprisingly, Ellen lost over 40 pounds — the steroid induced weight gain — over the course of about ten weeks. Her diet was not calorie restricted.
Below are Ellen’s baseline and follow-up photos. Note that she had a mid-treatment flare after having cantaloupe and Boar’s Head salami. I believe the offender was most likely the cantaloupe, given its potent cross-reactivity with certain pollen, although the additives in salami could’ve been at issue.
Currently, Ellen’s skin is clear. She experiences transient, mild rashes on occasion, but she describes herself as totally better. We are currently expanding her diet very carefully — nickel and histamine containing foods appear to be fine, although they may have been an issue early on; she tolerates many of the common antigenic foods, like egg and soy. We continue to rebuild her gut and improve her nutrient status. Her supplement protocol is more involved, as I am no longer concerned with rebound rash; and she’s much less reactive. We’ve started sublingual immunotherapy for environmental and food antigens.
In conclusion: If this case has been interesting to you, Stay Tuned! I intend to write about it in greater detail for publication, will include her laboratory results and will cite references.
02-09-15. First follow up photo. Much improvement! Life is good. Off prednisone and Benadryl for about 20 days.
Mild flare after eating cantaloupe. 02-19-15
03-20-2015 Follow-up photo. Relief! Note the 40+ pound weight loss!
*Note-If you are wondering, this patient arrived at my practice already on a gluten and dairy-free Paleo diet. It wasn’t the answer here.
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I always learn such clinical pearls from Dr. Kara. It’s like a CEU in a blog, a refresher as well as new clinical insights every time. Your patients are lucky, Dr. Fitzgerald!
Thank you Sarah!
My mom has this SAME exact rash!!!!!! It’s been ongoing for years! But recently she stopped her steroids !! Is there anything you can reccomend for her to put on her skin for a lotion?? Her allergist suggested Vaseline, but that’s closing her pores and making her worse !
Great article!! It’s a keeper, saved it to read back on!
Try an organic product with just a few ingredients. Start with a “patch test” — use a little bit on a small area to determine tolerance. Some folks in my practice use just plain oils like olive or coconut. See how mom does and let us know what works. Eventually, I’ll blog on this great topic 🙂
Wow! Amazing results for Ellen. She was lucky to have found you. What’s she’s gone through sounds awful. I’ve been itchy for about 2 years and suspect it is histamine intolerance. Do you have any suggestions or tools on youwebsite that may provide some guidance on what to do? Thank you.
Hi Maria,
Sorry to hear! Itchy skin can have many causes. If you suspect histamine intolerance then trying a low histamine diet and lowering other histamine triggers might be a good first step. However this may not be the only factor, and avoidance alone isn’t going to resolve the root cause of the itch. That would likely need some investigation and addressing too.
My best,
DrKF
Hello… my name is Ginny… I too have developed some sort of rash/hives… it came all of a sudden… I itch from sun up to sundown… my skin is so tender it hurts to sit down. The rash is mostly on my face, neck , both arms (upper and lower), lower legs, and tops of my feet… it was so bad about a week ago, I had the hives on the palms of my hands! I’ve had this going on a month with very little relief from itching and burning… my skin is very scaly and I’ve scratched so much I have open sores and severe swelling.. my skin just bleeds with the smallest bump! I’ve been to the doctors and dermatologist several times… oh just keep taking the prednisone and visteral and everything should clear up soon are the answers I keep getting!!! I’ve been on prednisone now for over a year due to pyoderma gangrenosum on my lower extremities… I’ve developed the “moon face” and gaid over 50 pounds… if anyone has any advice on what else I can do to resolve this skin problem, I’d greatly appreciate it!!!!
Hi Ginny! We are so sorry to hear about that! Unfortunately, we cannot answer or address personal medical questions here. We do however offer really incredible nutrition packages that may be of interest to you. Learn more about them here: https://www.drkarafitzgerald.com/online-store/ (scroll down a bit).
Best of luck and hope to hear from you soon!
Ginny, you can also come to our clinic or consult with us remotely if you need to (email Rhonda at frontdesk@drkarafitzgerald.com) if you are interested. It does indeed sound like you could use some good Functional Medicine asap. Keep us posted on what you do. DrKF
Great presentation! Looking forward to the longer writeup in your usual well done way. Ellen was both lucky & did commendable hard work for self help by finding you and taking the leap. Quick results from a great team.
Thank you, Dr Mitchell!
After seeing this I believe this is what I’m suffering from Frequently take infections of steroids followed by steroid dose pack Soon after dosepack is finished my rash ,& hives come back worse each time!
Im no expert, but my wife dealt with many of these symptoms as a result of a toxic mold exposure. If symptoms persist, it might be prudent to conduct labs to determine the presence of fungus, bacteria & staph and consider something like the shoeman protocol.
I have the same skin rash though not as bad … extremely frustrating and I’m terrified to eat anything at this point … have been in an ambulance 4 times this year and used my epi pen
I have a very similar rash and have suffered c-diff treated with vancomycin and metronidazole a few years back. I’ve been to 3 dermatologists and 3 endocrinologists thinking it may be linked to my autoimmune disease. This article is giving me hope! Can you give me more specifics on what you did to fully cure this rash? Was it an autoimmune protocol diet? How was the gut healed? Was there medication? Thanks for your help!
Hello, I’m so happy to hear that this has given you an optimistic perspective! Each case is unique, and our approach is to apply a full Functional Medicine/whole systems approach to address each patient’s unique needs. The protocols are personalized dietary and lifestyle plan based on potential triggers and isolating environmental factors as well, while simultaneously addressing all other aspects like gut healing and dysbiosis. For Ellen it took working with the nutritionist to dial in the nutrition plan and isolate her triggers (food sensitivities, metals, and food cross reactivity to environmental allergies).
Dr Terry Wahl’s approach to autoimmune disease is a good place to start to learn more about autoimmune diet. Consider working with a FxMed practitioner with experience in layering plans to address allergic disease. You can use the “find a practitioner” feature on the Institute for Functional Medicine’s website at http://IFM.org or you can contact our office for in person or remote options for consultations. ~Lara Zakaria RPh MS CNS CN CDN
I have suffered with eczema for 60 years however the last three have been hell. Recently diagnosed with Systemic nickel allergy and angioedema to go along with the excels. I have had gives, angio and extensive eczema for the last three years.. I am on s nickel free diet which is horrible and poor quality foods.. is there anyway I can detox the nickel.. Thank you
So sorry to hear that, sounds frustrating! Reducing Nickle exposure and detoxification support is certainly part of the picture, but we also want to address healing the gut, removing/reducing other sensitivities, and addressing inflammation. Generally we see when we approach systemically and work on the whole picture, sensitivity and inflammatory response is significantly reduced and tolerance and symptoms improve.
this looks and sounds like. I broke out with this rash last year in October. I’ve been on /off prednisone for about a year. I’ve been off now for about 3 weeks. I’m bright red – sun burn rash and peeling.very dry and itchy. My homeopath has me on supplements and elimination diet.. seeing small improvements but this rash is stubborn and painful. Warm bath actually feels great… I’m using avocado oil too – which gives me some comfort during the day, but its always weeping. Any suggestions? I’ve been seen by dermatology (3), allergist and now homeopath.
Nancy, it’s time for a full functional approach- testing/evaluating for ALL reactions (environmental and food) and different pathways of reaction (not just classic allergy), plus gut, nutrient status, toxin exposures, hormones if indicated, etc. You are more than welcome to work with a provider here,at our practice. (check out our FAQ page for details) You can also research other functional med clinicians on the IFM’s website: functionalmedicine.com. Keep me posted on how you make out- DrKF
Hi Dr. Fitzgerald. Very interesting article. I have had an ongoing rash for the last year but only on my face. It appears red, raised and somewhat scaly. It’s on my forehead, cheeks and chin area. I have taken about 4 courses of prednisone and it works very well to clear the rash but about 3-4 days after finishing the course, it reappears. My dermatologist is now recommending that I see an allergist. I have done my share of research and this article comes close to the answer I’ve been hoping for. I am approaching 40 and I’ve never had any skin conditions all my life. Is there any input you may have for me? Greatly appreciated!
So frustrating that you need to deal with this! The immediate thought that comes to mind is that the prednisone is masking the underlying symptoms that cause the rash to flare, but doesn’t address the root cause. As you saw in this case, you would want to focus on addressing underlying food/environmental allergies or sensitivities, as well as potential dysbiosis (gut bacterial/yeast imbalance), while we also address any nutrient deficiencies that play a role. If you can, I would recommend following up with a Functionally trained allergist who can address with the full Functional Medicine approach – you can find one near you using the search feature at http://IFM.org. You’re also welcome to investigate our offerings here in the clinic, either in person with our physicians https://www.drkarafitzgerald.com/our-clinic/functional-medicine-services/ or remotely with our Clinical Nutritionists https://www.drkarafitzgerald.com/our-clinic/nutrition-services/.
Hi , this information helps me a lot to get rid of this skin problem and I have been very thankful to you for providing this solution. Keep updating thankyou.
Hello
Thank you for the article. My teenage son has dermatographia. He itches mostly at night when he is trying to sleep! Y. I’ll do almost anything to help him but we will find it very hard to afford a ND and nutritionist.
You mentioned: The sulfur, bleach baths, ceramide topical were reported as useful; bicarbonate and cromolyn sulfate were never used. But I’m curious about these other things you mentioned: an essential amino acids blend (PS- what were they??), diamine oxidase (for possible histamine intolerance) and pro-biotics. You didn’t note if those 3 things had an effect? Did they help? Does she basically have to keep using all 6 of those protocols every day (sulfur, bleach baths, ceramide, amino acids, diamine oxidas and probiotics??
Also, the part about the diet was a bit confusing. seems paleo and gluten free made no difference. You reduce her diet intake a lot – But after that I’m very fuzzy on what she was allowed to eat and not eat. Simply put- are there common things to avoid for this? or is it just to eat more organic and less sugar (which seemed to help trigger it in the beginning)?
I”m not relying on you to make a diagnosis, obviously- just trying to find out more about this case things which I might try on my own. any more details would be greatly, greatly appreciated.
Shannon,
We have a functional nutrition residency program. The senior nutritionist residents are available to work with you (and are closely monitored by a full staff nutritionist). Your son is a great candidate for this program….The cost of the resident services is very reasonable- and they work hard! The doctors in our practice (including me) share our opinions on the residents cases in our weekly Clinical Rounds. Consider scheduling an appt! DrKF
Hi – I am very interested in reading the further publication of this case and blog . Could you please send me the link? Thank you!
Is there anything that can be done for someone that is allergic/ sensitive to almost everything including all supplements & probiotics? I have contact dermatitis allergies to almost everything, every environmental allergy possible, constipation, candida issues & insomnia. I’ve been gluten free for 8 yrs which in the begining helped with gas & bloating issues. The more I restricted the diet the more sensitivies I got. I did allergy shots 4 yrs ago that didnt help anything so I stopped. Then again for the last year but I started to have throat narrowing the further I got into them so stopped at the year mark. 2 Years ago I started to get a burning lip & face with most fruits & vegetables & itchy rash on the face. A low nickel diet is helping but that is more avoidance of foods, especially vegetables. I can tolerate Just Thrive probiotic & that’s it. Every other probiotic causes small boil like pimples on my body. All supplements cause the boils or a itchy rash. I have tried baking soda in water for heart burn & I tolerate that. You mentioned bicarbonate for this patient, how do you have patients use that?
I’m so sorry t hear that you’ve been going through all that. It’s not easy, but I commend you on taking initiative to research it and try to get to the bottom of it. We do see this fairly commonly in our clinic. Often there’s an underlying trigger that is causing this excessive reactivity that needs to be addressed. Often it may be an underlying chronic infection (like EBV, CBV, Lyme, mold, to name a few examples) or rooted in the microbiome (SIBO, dysbiosis, parasite, etc). Nutrient status can also play into the picture, of course. I would suggest working with a Functional doctor or nutritionist to help you identify this root cause. They should also help guide you on first, increasing your tolerance to prevent developing more serious reactivity, and gradually and safely expanding your diet. My concern is that if you’re being forced to continuously avoid foods to manage your reactivity, you’ll will not only increasing reactivity overall but also will be in a situation where you’re limited on nutrient sources and in a way making things harder to manage. Reach out to our office manager if you’d like to learn about the options available to work with our team remotely if needed.
My story is very similar. The all over body rash that I get only stays away after steroid shots and prednisone packs. Then it comes back with a vengeance. I’ve been dealing with this for about two or three years now. It’s worse than it’s ever been. It’s enough to make me want to go mad. Sometimes I really do feel like I’m going crazy, . and I just wanna cry nonstop. I don’t know for certain but I think that an allergic anaphylactic reaction I had to an anabiotic and then getting mono the next year could have been triggers because I haven’t been the same since. I have seasonal allergies but nothing significant. I’ve had the patch test and have very similar allergies as your case study. I thought maybe it was a nickel food allergy and I was going to focus on that but now I’m not sure. I believe it is food related related but in a very complex way. I’m desperate beyond words. I live in Kentucky, but can u help me!
Aww, Melissa- that is such a tough story! Yes, we do offer some remote consultation (in fact, that was the case in this blog). reach out to Rhonda at frontdesk@drkarafitzgerald.com
DrKF
Hi there,
I’ve had Dermatographia for 2 years now and I’m desperate to find something to help with it. I’ve seen in the comments that you have a functional nutrition residency program. However, I live in New Zealand so was wondering if this is something that can be done online?
Many thanks
Hannah,
you can absolutely work with our nutrition team – just reach out to frontdesk@drkarafitzgerald.com to schedule an appointment! DrKF
Hi I’ve been diagnosed to have acute urticaria since 5 weeks and have been having rashes and itching almost everyday. I was started on high dose antihistamines and steroids due to laryngeal oedema. I’ve been on steroids since 5 weeks but I’ve already developed some side effects.
I am a vegetarian and my allergy test are inconclusive and I havent been able to find out the cause.
I read your article and could relate to what a person goes through when the rashes appear.
I would like to get your opinion on my condition too so that I can get rid of the rashes which just wknt quit.
Thank u
Adhya,
I recommend you consult with a functional medicine clinician- you need a good, thorough work-up and plan. You can find fxmed clinicians at http://www.functionalmedicine.org Best, DrKF
Oh how I wish you were closer to Illinois!! I have been fighting an unexplained rash, severe nonstop itching, pimply sores since Nov 2018. It’s the worst on my right arm, shoulder & shoulder blade, but my left arm breaks out too. I’ve had 2 dermatologist says it’s eczema. I am also dealing with a lot of unexplained chronic shooting/stabbing pain in my right pelvic area, a shooting, stabbing pain in my right breast/armpit area & a full thickness tear in my right shoulder. I have numerous other “minor” issues going on too but not listing all!
I am convinced that my unexplained health challenges stem back to having Essure (permanent birth control) in my body from 2008 to 2016, as my problems all point to a heavy metal toxicity (they were made of nickel). I had them removed in Feb 2016 by a partial hysterectomy.
I am one who tries to do as much as I can naturally with food & supplements but it’s tiresome trying to figure what to avoid, what I can have, is it food, something topical or something else?! Not to mention expensive too! I, too, am just about to the end of my rope especially adding in that I’ve pretty much gained my weight back too!
Gina,
Reach out and schedule with us if you can. We offer remote consultations. DrKF
frontdesk@drkarafitzgerald.com
I am not seeing patients at the moment (working on our research study) but I am present in all of our clinic and physician rounds, so I will be involved in your care should you work with us. Consider starting with the nutrition team, and if cost is an issue, work with a nutrition resident. DrKF
Dr Kara, I have developed a rash just like those shown at the top of the article. …
I have been to a NAET PRACTITIONER on and off for about 2 years now. I have found that I have endless food sensitivities (most are high in histamine) and have tried to eat accordingly. I recently developed a rash around my mouth that would not go away. I took a steroid pack and it cleared, only to come back around my neck, which slowly spread down my chest and arms. So I thought, instead of going straight to the steroids, I would get to the bottom of this with my homeopathic Dr. First thing he said to me was…’that’s a histamine intolerance issue’. I went though some desensitizing and have been taking HistDAO(for the histamine intolerance), along with adhering to a low histamine diet. nothing was helping … so, I turned to steroids shots and then a steroid cream. I have just began the steroid cream regimen, but am terrified of a rebound. I have run out of the HistDAO and am hoping you might have a product to replace it along with a probiotic suggestion. This rash is overwhelming. Just like all these others…no sleep, constant itching, my skin has thinned horribly, pain.. I was also wondering if I have no sensitivities to collagen if that would help my skin. thank you.
Sorry to hear – that sounds so uncomfortable and painful. Histamine intolerance often occurs when there’s dysbiosis (imbalance of good and bad bacteria) in GI resulting in an overgrowth of bacteria that produce histamine to a level our body can’t keep up with. HistDAO and low histamine diets are one part of the solution, we usually then work on a GI protocol to address the microbial imbalance and heal the gut. Ultimately our goal is to expand the diet, improve tolerance, heal the gut and skin, and balance the immune response. More about our GI approach here https://www.google.com/amp/s/www.drkarafitzgerald.com/2017/05/31/our-6r-program-six-steps-to-save-your-health-through-your-gut/amp/ Our nutrition team is available remotely if you’re looking for support https://www.drkarafitzgerald.com/our-clinic/nutrition-services/
Do steroids help for possible dermagraphism or make them worse? My doctor suggested trying them and I would but then I read that you can get worse. I have no where to turn and I am getting so depressed. I have three boys to raise and a full time job. I’m just having a hard time.
I am sorry to hear, Kris. Find an FxMed clinician if at all possible. Steroids are OK short term, especially if you need some relief (you DO!). They will not cure the dermatographism, however. DrKF. Consider working with our nutrition team, also. There is likely a food influence. (email frontdesk@drkarafitzgerald.com)
Hello,
I have been having a skin inflammation for past 5 months. Last year I went through very emotional break up and I have stopped eating almost completely, I couldn’t sleep, focus, I was constantly stressed. In February I have developed skin issues and that only worsen since. I have been constantly at that doctors started initially with antibiotics ( two courses) then corticosteroids cream, then fungal cream and corticosteroids pills, with antihistamine. After taking corticosteroids pills for 5 days my skin completely cleared but 5 days later since stopping them I’m back to flares up on my knees, my face, elbows, my buttocks pretty much everywhere. I think it’s definitely related to my gut but I don’t know where to start?? I’m really desperate as I hate my body like this! Could you please help
I am so sorry to hear, Dominika! It’s multifactorial. Probably dysbiosis, leaky gut, allergies and some nutrient insufficiencies. Plus (of course) the intense stress you’ve experienced, which actually worsens the other things I’ve mentioned. You need a full functional approach. You are welcome to work with our team remotely- a doc and/or a nutritionist (reach out to frontdesk@drkarafitzgerald.com) Or look for a functional clinician in your area at functionalmedicine.org. Good luck. You CAN recover from this. DrKF
when I saw the picture posted of this woman’s rash – it gave me hope! hope that i had finally found someone that has a rash identical to what my daughter has been experiencing the past 3 years. Her too – she gave up gluten, dairy, soy, corn, rice, and all of the above – she was literally living on salad and chicken and homemade arrowroot bread – it helped mildly – but her flare ups still come and each time with a stronger vengeance. She was on prednisone at least 8 times in the past 2 years – was the only time she had any “normalcy” in her life – as soon as she was off it – the rash would come back with a vengeance. We have been to allergists, naturopaths, herbalists, dermatologists, etc who have tried to help with supplements, drugs etc but nothing works. She has done AIP, Paelo, GF , KETO , you name it! They take our money for 6 months and then send us home to “continue protocol”. She has done bleach baths, epsom salt baths, she wears no make up – and uses about $200 of aquaphor or vaseline a month to keep her skin lathered but nothing helps. The diets would work about 65% but never 100% clear – functional medicine doctors where we live are hella expensive and not covered by insurance – so how is one supposed to get help without having to put a mortgage on your house to get some help? what can we do at home to help ? Thank you.
That’s so incredibly frustrating that she’s not been able to find the right support at such an expense! Sometimes these cases can be quite complex and finding the exact trigger challenging. Ideally, a practitioner would be able to help you navigate those, make adjustments, and carefully walk you through the nuances of the plan, diet, and lifestyle piece. We also find that sometimes, these same restrictions can worsen sensitivities so careful guidance is essential.
I hope you and your daughter can find the support you need. Our amazing nutrition team is available for remote consultations and are well-versed in enacting these protocols whenever you might be ready for support. https://www.drkarafitzgerald.com/our-clinic/nutrition-services/
Feel free to reach out to us if you’d like more information about a 15 min consult.
So what her diagnosis? I am having thr same problem that started with c diff and vanco. And have been covered in splotchy hives ever since.
Lauren,
No single diagnosis, but all second to C diff colitis, so it could be labeled as post C diff sequelae. DrKF
Hi, I came across your article and I feel like this is exactly what happened to me 6 months ago. In June, out of nowhere, I developed an all over body rash so severe it look like I was dipped in acid. Doctors put me on prednisone for 14 days which helped but I’ve been on a gluten, egg and dairy free diet with still not a lot of help to my skin ever since. I am miserable and my self confidence is zero. I’m not sure where to go as doctors just say it’s ‘eczema’ but I’ve had eczema my whole life and this is entirely different. Do you have any more information or suggestions on What I can say to my doctor for treatment?
Katie,
If possible, work with one of our nutrition team (and/or docs) remotely. At least for a few sessions to try and nail down what you need to do- your doctor can take over once your plan has been established. DrKF
Reach out to us for details on establishing with our clinic at: frontdesk@drkarafitzgerald.com
Absolutely wonderful for her recovery and your thoroughness!
I am a 72-year-old male that has recently acquired a red rash over most of my body that an online doctor diagnosed as contact dermatitis doctor prescribed prednisone 21 doses of 10 mg but after taking half the Prednisone have not seen a change. I read your article very interesting and just wondered was the conclusion that the woman’s rash came from something she ate.
Gary, her rash seems mutlifactorial: profound stress, significant gut issues (after food poisoning) with antibiotics lead to increased, but not lasting, sensitivities to multiple foods. After our work, she was able to expand her diet quite a bit. DrKF
I had a severe poison oak reaction where I had to go to the emergency room, they gave me a corticosteroid shot and prescribed me prednisone 50mg/7 days. I was hesitant to take the prednisone because of all the bad things I have heard about it. A week after the shot I was still in agony so I took the prednisone. I must of had an allergic response to the prednisone because the itching persisted as well as swelling in my knee and slight swelling in my eye. I only took the prednisone for 6 days but am still having the effects ( 5 weeks later ). I developed redness on my face, that’s a bit blotchy. I was experiencing flushing, but that has recently gone away, I am being extra careful with my diet at the moment too. I’m hoping the redness/rosacea like rash dissipates soon, and I am hoping it is the prednisone working it’s way out of my system. It truly is wonderful that we can heal ourselves through nutrition and self-care!
Ellen your courage of sharing your journey has helped me in so many ways. I’m battling what I believe to be a similar skin allergen issue also. So overwhelmed
My Husband has been having similar Body rashes and severe itching for about two or three years . Without Prednizone he gets no relief ! His Rash and Itching is horrible and he cannot enjoy life anymore. He has been to more than two Dermatologists and Allergists who simply say well I guess you will have to stay on Cortizone forever.
He is 80 years old , has AFIB, Sensitivity to All Prescriptions and takes reduced amounts than most adults require. HIs Digestive system is sensitive to many things but no one can identify any one thing . He is so tired of not being able to sleep without Benadryl or Zanax. He recently weined himself off the Prednizone but is so miserable he may have to go back on it.
HELP US PLEASE ! We live in Sarasota Florida and will travel to someone who could help or if you could refer us to someone in Florida that could help we would be so Appreciative!!
There are multiple things to consider here to potentially bring him some relief. I’d suggest starting by visiting the Institute for Functional Medicine’s find a provider page at IFM.org. From there you should be able to find a physician nearby who’s training the Functional Medicine approach and help. If you’re able to get to Connecticut or are interested in telemedicine, you’re welcome to contact our front desk for information about working with one of our clinicians at frontdesk@drkarafitzgerald.com.
Looks like topical steroid withdrawl syndrome which could have been brought on from the prednisone.
https://www.itsan.org/
I have LIPUS SLE and when I get a flare up, the first thing I am described is Prednisone, within 30-40 minutes I start itching, my upperbody skin turns red and huge hives start bulging.
I need steriods and anti inflammatory meds
sometimes during flare-ups,what would you suggest? Huge thanks for this very informative documented and detailed info.
Best regards
Lindi from South Africa
Hi,
Poor Ellen. Thankful you could help her.
I have had keto rash for months and it’s getting worse. Down my back and now down my arms.
Seen two docs. No real help yet. I was doing Carnivore and stopped. My diet is clean. Take a ton of supplements. I suspect I am insulin resistant. Insulin is not taking in my proteins.
My albumin was low. How could that be eating
Meat for nine months.
I am taking digestive enzymes and other things for my gut. No change.
Any suggestions?
The itching is terrific
Hi Joan. Thank you for reading and commenting! Unfortunately, we’re unable to provide specific medical advice online. There are too many variables to consider, especially in such complex conditions. As you can see with Ellen, she also arrived at the clinic eating healthfully and that wasn’t working out for her (we did a customized food plan with our nutrition team for her, along with all of the other interventions described above). We suggest you continue looking for/working with a provider trained in Functional Medicine who can walk this journey with you and provide safe and effective support. You can also contact our clinic here: https://www.drkarafitzgerald.com/contact-2/ and learn more about our expert team: https://www.drkarafitzgerald.com/our-clinic/sandy-hook-team/ Or you can find a local provider at http://IFM.org. All the best and hope you feel better soon!
Could we find out directly from Ellen if the sushi was from raw or frozen fish?
I developed this rash on my upper and lower back 8 months ago, I eat very clean, workout, do all the “right” things. It’s been horrible, I have been to 3 doctors, and the same dermatologist twice. I feel like no one is giving me any help on what’s causing it etc, I was on 5 days of steroids the first time, then a steroid ointment the second time, then 21 days of steroids along with a 10 course of antibiotics. I was so clear after that and was relived thinking it was over. Well it came back slowly. The dermatologist then put me on curavae cream which I mixed with a topical steroid she prescribed. Well it helped a little but as soon as the 3 weeks was over it’s back in full swing. I’m so over it, it’s embarrassing, itchy, I’m at the end of my rope. I feel hopeless. 🙁 I was basically told at 55 it’s eczema that can just happen. I just want it to go away.
We are sorry to hear that! We would highly recommend a functional medicine approach to seek out the potential root causes of the rash. Often, there’s a need to go beyond simply eating/living clean to investigate food sensitivities and intolerances, microbial imbalances, and more. – Team DrKF
Can you share a link to your publication on this. would be interested to see the detail on your approach to this case. Have someone with a similar case.