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Skin Rashes and Sjögren's

Skin rashes most certainly occur in the setting of Sjögren’s. As opposed to many of the other autoimmune skin rashes that I see in my autoimmune dermatology clinic, there are no rashes that are specific for Sjögren’s. In other words, I cannot look at a rash in a Sjögren’s patient and immediately tell them that they have Sjögren’s. In comparison, I can often look at a lupus rash and tell the patient they have underlying lupus. That being said, Sjögren’s patients exhibit a variety of skin rashes that are important to recognize and know when to see a board-certified dermatologist.

By and far the most common skin conditions associated with Sjögren’s are xerosis, or clinically dry skin, and eczematous dermatitis. These are caused primarily by barrier dysfunction of the skin. Gentle skin care practices and liberal moisturizers are the best way to prevent these common skin eruptions. When caring for your skin you should take no more than one short, lukewarm shower per day. You should remain in the shower for less than 10 minutes. Soaps like Dove sensitive and VanicreamTM, can be utilized as they will not strip your skin. If a wash cloth is used while bathing, it should be limited to areas that give off body odor like the armpits, genital, and buttock areas, in order to not disrupt the skin barrier. Immediately after getting out of the shower, you should pat dry and then apply a moisturizer. Ointments are the best moisturizers followed by creams. Lotions are not typically moisturizing enough for patients with Sjögren’s. The best ointments are Vaseline® or Aquaphor®. If an ointment is too greasy for your taste, cream moisturizers like CeraVe®, VanicreamTM, Eucerin®, or Aveeno®can be used. For itchy skin, Sarna Original lotion can give immediate relief especially when stored in the refrigerator. If scaly, dry skin is present, utilizing moisturizers with lactic acid, urea, or salicylic acid can be used. Examples include: AmLactin®, CeraVe® SA, and Eucerin® Roughness Relief. If your rash is not responding to moisturizers and gentle skin care practices, a prescription corticosteroid cream or a steroid-sparing anti-inflammatory cream may need to be prescribed by your physician.

If you develop a purple-to-red rash that does not lighten, or blanch, with pressure, ulcerations of the skin, or a purple net pattern on your skin, this should prompt you to see a dermatologist for evaluation. Rashes that are associated with purpura (blood spots) can represent vasculitis, an inflammation of the blood vessels. Although these rashes are not as common as the ones discussed above, they are important to recognize in Sjögren’s patients and should be seen quickly by a dermatologist.

Natalie Wright, MD, FAAD

This information was first printed in the Foundation's patient  newsletter for members. 


Comments

— Dec 1, 2020

I am desperately seeking a dentist. I was seeing a Donated Dental dentist and the coordinator who sets patients up with dentists decided I had more work than "normal". She stopped the dentist before I was done. Since, I have have 3 teeth break off and my entire bridge that holds 4 teeth break off
Immediately, I had a crown fall out. She refused to let the dentist repair just the crown.
Now I am unable to eat much or open my mouth at all.
I'm disabled, so my income just covers my mortgage and bills.
I have been in a very dark place since all of this.
I live alone with my cat, but I am embarrassed to be seen.
It's also painful to have what is left of the broken teeth along with my dry mouth.
I don't know where to turn for help. My Sjogrens is difficult alone.
Do you have any recommendations?
I would appreciate anything,
Sincerely, June Tousignant
june.kt@gmail.com

I'm sorry. I have been having new health issues. Now my skin.
I am afraid of what is next.
I haven't applied for Medicaid. I have Medicare and I wasn't aware I would be eligible for both.
This disease has just been too much for me.
Michigan has a shortage of Rheumatologists, so I am lucky to see my doctor once a year.
I'm seeing a dermatologist for my skin. She is putting me on a biologic.
I will contact my caseworker and see if I can apply for Medicaid also.
Thank you for your suggestion.
I hope your having a summer you can enjoy.

— Feb 25, 2021

I am a Navy Veteran and all of my medical needs are handled by the VA Hospital except for dental. Because I have Sjogrens they will allow them to extract the broken teeth but that's it!. For dental work at VA you must be 100% disabled military related. I am now missing 5 teeth and have two more that need to be pulled. Already it makes it hard to chew food which makes it harder to digest it properly. That causes other medical issues. My business has closed since Covid. Just surviving. Please I need help!

Hi Steve,
I had bad experience with Donated Dental services, but you should qualify.
They have dentists who volunteer in most States.
They will out you on a waiting list, but it's worth it. You see a dentist who is supposed to fix everything including cleaning
When they release you, they are supposed to put you in a position where you don't need any dental work.
They work with labs that also volunteer their time and expense.
I hope this helps.
Sincerely, June

— Dec 12, 2021

I'm an active well preserved 73 yr old woman, but have had a rash since February when I got first Pfiser Covid vaccine. Dermatologist first diagnosed as rosacea on face from mask and psoriasis on arms. Rash continued, moving around upper body, sometimes legs and was then thought to be insect bites. No bedbugs or fleas, but maybe midges from walks near lake? Dr. finally biopsied in fall and not finding insect cause, referred to my GP who took blood tests and found Sjorgen's antibodies. Just finally saw a rheumatologist who is putting me on Hydroxychloroquine. I have already been seeing knee specialists for sharp siezures in rt knee, have lots of indigestion (gerd )and wake tired despite good sleep, really tired by afternoon , which I used to joke was maybe l.t. covid from a covid like siege I had 1.2020. But is it unusual for Sjogren's to mainly manifest as a rash that looks like insect bites and should we be on alert for other areas the Sjogren's might be affecting ? My eyes and mouth are amply moist, and teeth strong.

Hello there, Sjoggies with Rashes, I began my sjogren's journey by having skin problems years ago, and all of the lovely expensive creams I was given did nothing to sooth the agony of itchy skin and nasty rashes. Eventually, and I do mean that word, I was seen by a dermatologist who like some others, did a biopsy and also removed a patch which was quite ugly to see, and the results showed I had bowen's disorder, a mild skin cancer that does not cause any other of the more serious types of cancer symptoms. It is surface skin, just surfing my body. It does look horrible and I have to wear long sleeves at all times, because the sun light burns my skin like it was 100 F, when it's only 18-20 C.
Now, I have also been offered some bandaging which comes with its own kind of lotion to moisturise the skin by way of saturation with it. No room for my skin to escape the moisturisation. I'll be going for this when the virus Covid-19 allows me to go into the building, rather than by phone conversations and camera visuals. I have found another solution that helps me, but may not be for everybody. I drink ice cold water, by the full glass, no half measures. Usually it involves 3-4 pints, and then it calms down the itch to tolerable. Before that, I could easily run a two minute mile! By the way, I don't and can't run anywhere! This has to have something to do with hydration when the body has dried up all of the moisture in my skin, as it does when attacking an organ. The skin being the largest of all. At first, it was embarrassing to even present to a doctor, as it feels as though I do not clean myself properly by the appearance of red itchy and scratched skin. It is a sorry sight which family and friends find shocking to witness. I am very fair skinned and fair haired so as a child would burn in no time at all. The dermatologist suspects the problem was developing all of those years ago in my skin as it was subjected to UV light, but children just want to play out, not wait for parental skin covering in creams. I also have lost almost all of my teeth, they just fall out and not from any pain in their roots, my jaw has shrunk so I cannot have any implants or bridges or dentures. My mouth cannot accept them. My eyes are also affected giving me blurred vision and a degree of vision loss from long term problems, which I have recently found out have developed a small cataract. My symptoms are vast, and amazing to see, but that is just silly old me. I hope you have some reassurance of not being alone with these mysteries.
Take Care of You as no one else will do it the right way.

So sorry this has happened to you. I have not been diagnosed yet with Sjogrens but I know I have it. I going to the dermatologist again with my agonizing itchy skin and scalp. I seriously feel like I’m going crazy. Take care

Hi I have sjorgrens, and lupus, without psoriasis and psoriatic arthritis, just getting arthritis shouldn’t cause you to get psoriatic arthritis however if you have had it for a long time it usually manifest’s over year’s. Otherwise I would suggest that you have your thyroid tested it can cause many problems like tiredness or fatigue. Sjorgrens can cause many different kinds of rashes, go to a dermatologist and don’t take more than a ten minute shower un luke warm water the water has fluoride and chlorine. My other concern is that you said that you take walks around around the lake, that immediately brought to mind lime disease, could you have been bitten by a tick? If so there’s a blood test for that! I always take photos of any type of rash including face rash, lupus causes and butterfly rash around the face and it’s also accompanied by sjorgrens disease! It’s very hard to diagnose but looks up the 29 signs of lupus and lupus butterfly rash it may help. I hope that this helps you in some way! Good luck!

— Jun 5, 2022

Hi I was just diagnosed with sjorgens with just sjorgens im not sure if lupus will cling on to it I became so depressed my boyfriend left me because I started getting this red dots and hives I refuse to go on any medication just creams and eyes drops we should really push the foundation or even get on the news nothing is getting done except giving us poison thats why I refuse to take these drugs im just lost in shock i was supposed to be married but my body was to ugly im assuming there's no cure for the symptoms but everybody stay strong pray for a cure as we all deserve.

— Jul 8, 2022

My skin was suffering from many skin rashes. I consulted many doctors but nothing could make it. I am looking forward to making an appointment with you and getting your advice. Please share your number! or email me.

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