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Woman on anti-hypertensive medications with rashes and severe itching

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My mother..age 59 takes medications for high blood pressure, cholestrol. For past few months she has rashes and severe itching on her skin. Photos attached. She was taking Atenolol(50mg) for more than 5 years, but during the fifth year, her blood pressure was still staying high, plus she started getting skin problems. So doctor switched the meds. She also has very high triglyceride. The main problem bothering her now is the skin issues. She has gone to three skin specialists but they each said a different thing. One said it is fungal, another said its ezcema, and third doctor said it could be psorasis or something else. So we don't even know whether it is an isolated issue or a side effect of one of her medications. Can you please suggest something? She is in lot of misery with the itch and now its spreading everywhere, including elbows, ankles, back.

Her stats:
Blood pressure 140/90 ( most days )
Triglyceride : 463
Total cholestrol 250
HDL : 50
LDL : 86
VDL : 92.6
Hemoglobin : 13.6

Meds she is taking:
1)Blood pressure: Olmesartan medoxomil 40mg
2)cholestrol medicine rosuvastatin 10 mg

Meds for skin:
1. One time shot of Kenacoat (40ml )
2. Morning time: Fluconazole tablets ..as anti infection. She took it for a couple of days But stopped taking. No adverse reaction, she was just tired of too many meds.
3. Night time : Levocetirizene
4. Betamethasone Dipropionate 0.05% augmented. ( only this has helped control her itch )

Category: Dermatologist

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Category: Cosmetic and Plastic Surgeon
 21 Doctors Online

Hello,

Thanks for posting your query at DoctorSpring. I can understand your concern.

From a couple of pictures, it does seem that she has lesions of psoriasis.

However, the pictures are not very clear, if you could send a few clear ones, it would be very helpful.

The sites are classic for psoriasis.

From the history, you have provided I understand that the itching is only on the areas where there are rashes.

She can take another antihistamine like hydroxyzine to relieve the itching.

Also regular application of an emollient like vaseline will be useful.

The betamethasone cream can be continued on the affected areas.

Also she can discuss with her physician about starting omega 3 fatty acid supplements. They are useful in controlling the triglyceride levels also.

Hope this helps, please feel free to discuss further.

Take care.


Patient replied :

Hi doctor Kruti,
Thank you for your prompt reply. She is trying to send more pics, but it might not happen soon. I don't want to keep you on hold for this consultation. Just a couple of follow up questions:
1. She says that when she forgot to take Fluconazole tablets for one day, she had intense itching and restlessness. So how long should she continue taking that medication for?
2. Off late she gets a sensation of intense pricking in random places and then after a while that area has tiny red/black spots. what could those be?
3. Does she need any dietary changes? She has started getting severe gas and acid reflux off late probably as medication side effect. Her diet is very clean, no fried food. Only healthy home made, no spice less salty food.


Hello,

Thanks for your reply. I can understand her concern.

However, fluconazole need not be continued. We do not give more than four doses usually.
Each dose is given once a week for four weeks.
Fluconazole by itself doesn't control the itching.

The red spots are mainly caused due to itching, the hydroxyzine tablets and a moisturizer will help with that.

In view of the skin concern, she doesn't need any dietary changes.

But if she is getting reflux secondary to medications, I recommend that you request her physician to review her medications.

Please let me know if I can address any other concern for you.

Take care


Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Experience: 
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
Dr. Kruti Jobanputra Banodkar and 4 other Medical Specialists are ready to help you

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