Ask a doctor on the topic of General medicine

Question Lupus

January 6, 2020 | 20,00 EUR | answered by Dr. med. Frauke Gehring

Hello Mrs. Gehring, once again I am unfortunately contacting you with a problem probably due to lupus. First of all, regarding the intake of the antibiotic - the sore throat ultimately went away, but of course, it may not have been wise to just take it. Now the lupus has flared up again since yesterday morning and I have a red rash all over my body - if you google subacute lupus, it fits and I had it at the beginning of the disease, my body looked like a piece of art back then. I also had a doctor briefly look at it in the hospital yesterday, but unfortunately, he was not very familiar with lupus, but would attribute it to lupus.

Now to my questions - since yesterday, I have been worried that it may also be a reaction to the antibiotic and I am especially afraid of epidermal necrolysis. I am otherwise fine so far, no blisters have formed or worse signs of illness, it has been over 24 hours since the onset of the rash, can you reassure me in this regard?

Otherwise, just a quick question, should I wait and take a bit more cortisone (also locally) or how should I proceed? Thank you in advance.

Dr. med. Frauke Gehring

Hello,

Unfortunately, you have not described the rash at all, the difference actually lies in its appearance and whether there is itching or not. Itchy, very red and raised nodules, especially on the torso, are very typical of an antibiotic allergy. It can also look different, but the itching distinguishes it from subacute lupus.

Epidermal necrolysis progresses rapidly and fulminant, you do not need to fear that. However, the question of "allergy" should now be clarified through a blood test to prevent more severe allergic reactions. Without a medical assessment, I would not increase the cortisone.

I wish you all the best!

Sincerely, Dr. Gehring