Understanding Multiple Sclerosis (MS) Skin Lesions

While Multiple Sclerosis (MS) doesn’t cause skin lesions, some aspects of MS or MS treatment can be associated with an increased risk of skin lesions, hives, and other skin problems. Treatment options may help.

Multiple sclerosis (MS) is a chronic disease of the nervous system. It can cause a range of symptoms, from fatigue and muscle spasms to itching, numbness, and even vision, bowel, and cognitive problems.

MS may increase the risk of certain skin lesions, usually because of irritation from excessive scratching or as a side effect of some MS medications. Treatments for MS lesions vary and may be different from typical treatments for rashes and hives triggered by other causes.

Learn more about MS.

A skin lesion is a small or large section of skin that differs from the surrounding skin. It could be a dry patch, hives, or other irritation.

An MS skin lesion is one that develops as a result of having MS, as opposed to skin that’s injured by a scrape or burn or that changes because of an acne breakout or a condition such as psoriasis or eczema.

A skin lesion triggered by MS medications may present as hives and as red and swollen bumps, often on the face.

The itching sensation that often accompanies MS also can cause someone to scratch their skin too much in looking for relief. Symptoms may then include raised, thickened areas of skin that can become cracked. Bleeding and infection may follow.

There are several causes of MS skin lesions, including:

Pruritus

For people with MS, itchy skin, also known as pruritus, is a type of dysesthesia, an abnormal sensation triggered by changes in the central nervous system. In addition to itchiness, dysesthesia can feel like pain, numbness, or tingling.

A 2018 study suggests that about 80% of people with MS experience some type of sensory symptoms such as itching, tingling, and abnormal sensitivity to heat and cold.

MS affects the central nervous system by harming the myelin, a fatty sheath that surrounds and protects nerve fibers. As a result, the nerve fibers themselves are changed. Specific nerve fibers affected by MS lead to various MS symptoms, including dysesthesia.

Side effects of oral medications

Medications you take to treat MS may also cause MS skin lesions. MS medications associated with skin lesion side effects include:

• cladribine
• alemtuzumab (rarely used because of serious and potentially life threatening side effects)
• natalizumab (rarely used because of serious and potentially life threatening side effects)

Injection site reaction

Some MS medications are self-injected and can cause bruising or swelling in the area of injection. A site reaction is different from the side effect of systemic rash that’s caused by some MS medications. Site reactions can cause redness or a rash, and the complications can be severe.

Immune system suppression

Most MS treatments, such as maintenance disease-modifying therapy and steroids used during an attack, suppress the immune system.

Skin infections can occur when the immune system is weakened, and these skin infections may cause symptoms such as:

• changes in skin color
• itching
• rash
• redness
• sensitivity
• bleeding

To diagnose MS skin lesions, a doctor or healthcare professional will:

• examine the affected area of skin
• discuss other symptoms you have, if any
• list your current medications
• review your medical history

A doctor will also investigate other causes for your skin lesions such as:

• possible injection site infection
• another autoimmune disease that causes skin changes
• severe and harmful scratching
• medications for other conditions

The treatment for MS skin lesions will depend on what’s causing them.

If MS medications are causing skin lesions, the first approach may be to stop the drugs. A doctor may recommend an alternative medication that’s not associated with a high risk of hives or other risks.

If the MS skin lesions are mild, a doctor may prescribe medications to treat the hives or skin reactions. Antihistamines are among the medications that are sometimes used. Histamines are substances the body releases in response to infections and allergies.

Histamines can cause symptoms such as:

• congestion
• hives
• itching
• skin rashes
• sneezing
• watery eyes

Antihistamines blunt the effects of histamines. If an antihistamine isn’t effective, a doctor may then recommend taking a short course of corticosteroids, which reduce inflammation and symptoms such as hives.

Other medications that may help reduce skin lesions include:

• corticosteroids
• omalizumab, an injectable medication for chronic hives and other inflammatory conditions
• topical antifungal
• medications for specific autoimmune disorders

Because skin lesions can develop in anyone with MS, there’s no single risk factor that makes one person more likely than another to develop them. Likewise, there are no factors that overwhelmingly raise the risk of developing MS.

MS is a disease of the immune system, and scientists are still trying to understand why certain people develop MS. Certain genetic traits may raise the risk of MS, but MS isn’t considered an inheritable condition such as cystic fibrosis or Huntington’s disease.

MS skin lesions won’t affect the course of MS. However, they can cause complications if they’re not treated, so it’s important to respond as soon as possible to the onset of skin lesions or other new MS symptoms.

Does MS itself cause hives or other skin lesions?

Though MS can affect many parts of the body, the disease itself doesn’t cause skin changes. The skin lesions experienced by individuals with MS are usually attributable to excessive itching, medication side effects, or other medical conditions.

Is it possible to reduce itching without medications?

Because the pruritus brought on by MS isn’t a typical skin condition, moisturizers and soothing lotions may not be as effective. However, they may be helpful in easing the irritation caused by a lot of scratching. Learning to manage stress is also associated with MS symptom reduction.

What type of doctors treat MS symptoms?

Because MS affects so many systems in the body, you may be best served by a team of specialists, including:

• neurologist
• pain specialist
• dermatologist
• ophthalmologist
• gastroenterologist
• mental health profession

MS is a challenging disease, but by being proactive about your care and taking your medications as directed, you may be able to reduce symptoms, such as skin lesions, and improve your quality of life.

MS skin lesions are indirect complications of the disease and are usually treatable. Keep in mind that that not all cases of hives, rashes, or other skin problems will be related to MS. Food allergies, sunburn, and many other factors can trigger skin lesions, so be sure to get a thorough medical evaluation if these symptoms appear.

Can multiple sclerosis (MS) cause skin symptoms?

Multiple sclerosis (MS) is a chronic condition that affects the brain and spinal cord, which are part of the central nervous system. Certain treatments for this condition may cause skin hives or rashes for some people.

This article explores MS and its symptoms in more detail, as well as treatment options and preventive measures.

MS develops when the immune system blocks nerve fibers and myelin sheath, the fatty substance that protects the nerve cells.

There are about 2.8 million people with MS around the world.

The different forms of MS include:

• Clinically isolated syndrome: This refers to the first episode of symptoms that people experience when there is an inflammation in the central nervous system. This may last 24 hours but does not always lead to MS.
• Relapsing-remitting MS: This form of MS causes attacks that improve, with some residual effects. During attacks, symptoms can worsen, or new symptoms may appear. This form of MS is lifelong, and attacks can last for weeks or months.
• Primary progressive MS: Those who have this type of MS experience gradually worsening symptoms, and they do not have frequent attacks.
• Secondary progressive MS: This type of MS begins with a pattern of relapsing-remitting MS for years, which then begins to change to a pattern of progressive MS.

Learn more about the types of MS here.

Symptoms of MS

MS can be mild, but in some cases, people may not be able to speak, write, or walk anymore.

The National Institute of Neurological Disorders and Stroke (NINDS) states that the disorder is unpredictable, and the first symptoms, such as decreased or blurry vision, may appear between the ages of 20 and 40.

People who have MS may experience several symptoms, including:

• muscle stiffness
• muscle spasms
• blurred vision
• problems with memory or concentration
• numbness

These may improve for some time but come back later on. Sometimes, these symptoms may also worsen.

Diagnosis of MS

A person should see a doctor if their symptoms are causing discomfort or interfering with their routine. According to the National Multiple Sclerosis Society (NMSS), neurological damage can also occur in the early stages, so early treatment is important.

To diagnose MS, doctors need to do the following:

• Identify signs of damage to at least two separate areas of the central nervous system.
• Identify that the damage occurred at different points in time.
• Rule out other possible causes for the damage.

Doctors will take a person’s medical history and can perform neurological exams that test walking, balance, swallowing, and facial sensation. They may also use blood tests to rule out other potential conditions.

Drugs such as duloxetine, gabapentin, and carbamazepine may benefit people with neuropathic pain.

Doctors or dermatologists may also prescribe the following to treat hives:

• Antihistamines: These medications are available without a prescription. They can help reduce itching and swelling. These include:
  • cetirizine
  • loratadine
  • Benadryl
• Corticosteroids: Drugs like prednisone may help reduce inflammation and itching.
• Anti-itch lotion or cream: These creams provide temporary relief when the skin is itchy, such as E45.
• Omalizumab: This drug is available as an injection and can help when antihistamines do not provide relief.
• Auto-injector: An EpiPen may benefit people with life threatening allergies.

Read more about MS treatment guidelines.

While MS does not cause skin symptoms, some MS medications can cause skin symptoms, such as hives, rashes, and tingling.

Anti-itch lotion or cream side effects

Anti-itch creams tend to relieve itching symptoms, but creams such as E45 can also cause other skin-related symptoms:

• burning sensation
• redness
• pus
• dermatitis

Omalizumab side effects

Omalizumab injection may cause side effects, such as:

• the skin on the injection site may have:
  • pain
  • redness
  • swelling
  • burning sensation
  • bruising
• pain in the:
  • joints
  • arms
  • legs
  • ear
• fatigue
• headache
• nausea
• swelling inside of the:
  • nose
  • throat
  • sinuses
• abdominal pain
• nosebleeds

Some side effects can be serious, such as:

• fever
• muscle aches
• rash
• swollen glands
• shortness of breath
• coughing up blood
• skin sores
• numbness
• tingling in hands and feet

A person should consult immediate medical attention if they experience any of these symptoms after receiving the injection.

Alemtuzumab side effects

Alemtuzumab can cause skin itching and rashes. These symptoms usually disappear after the person stops the treatment.

A 2020 case study explains how one 40-year-old woman experienced hives and swelling on her lips and face after treatment with alemtuzumab. The symptoms lasted for 3 months, and the person also received treatment for hives.

Dimethyl fumarate side effects

Dimethyl fumarate is another drug doctors may prescribe for MS. It decreases inflammation and prevents nerve damage.

Doctors may prescribe it to people with relapsing forms of MS. However, side effects may affect the skin such as:

• itching
• redness
• hives
• rashes

Azathioprine side effects

Azathioprine is another MS drug that can cause skin symptoms. Side effects may include:

• skin rashes
• cytopenia
• liver toxicity

Below are some drugs that have the potential to cause skin effects, as well as additional symptoms.

Corticosteroid side effects

Short-term side effects of corticosteroids are usually mild and tend to disappear after a person finishes treatment.

Potential side effects affecting the skin include rash and flushed skin. Additional effects which affect the rest of the body are:

• a metallic taste in the mouth
• digestion issues such as indigestion and abdominal pain
• insomnia
• mood swings
• restlessness
• anxiety
• increased appetite
• headache
• heart palpitations
• chest pain
• edema of the ankles

Long-term steroid treatment may lead to further potential side effects and complications affecting the skin such as acne and:

• weight gain
• cataracts
• osteoporosis
• diabetes

A person should discuss the potential side effects of steroids with a doctor before starting treatment.

Antihistamine side effects

Antihistamine does not tend to affect the skin but potential side effects of drowsy antihistamines include:

• drowsiness
• reduced coordination, reflexes, and judgment
• dry mouth
• blurred vision
• difficulty urinating

The side effects of nondrowsy antihistamines may include some of the above, as well as headaches, and sickness.

Alemtuzumab and dimethyl fumarate

These drugs are examples of disease-modifying therapy (DMT) to treat MS relapses. People receive them as an infusion where doctors administer the medication directly into a person’s veins (intravenous).

Azathioprine

This drug is also an example of a DMT, but people take it orally.

There are a number of conditions that a person with MS may be at risk of, including:

Neurological pain

The NMSS also notes that it is common for people with MS to have numbness or a pins and needles sensation. This can affect any part of the body.

Neurological pain in MS does not cause a rash or sores, but it can be severe. In some cases, it can feel like burning or it may have a serious effect on quality of life.

Treatment can include medications like antidepressants and anticonvulsants that are used to treat neuropathic pain. Some people might also benefit from:

• pain injections
• acupuncture
• physical therapy

Pressure ulcers

People who are immobile due to MS, in a wheelchair or in bed for prolonged periods of time can develop pressure ulcers. A pressure ulcer is an area of the skin or tissue that is dead or dying because blood has stopped flowing to the area.

These may cause pain, but if sensation is impaired it might not be painful, and that can cause it to be unnoticed and get worse. If left untreated, these can cause serious health problems, and extend to the fatty tissue or bone.

Prevention involves scheduling turning positions and using soft padding on bony areas. If any skin sore begin to develop, a healthcare professional should treat it promptly to avoid it becoming infected.

Risk of autoimmune diseases

Comorbidities are common in people with MS, including:

• depression and anxiety
• cardiovascular disease
• epilepsy
• metabolic disorders
• autoimmune diseases

Skin symptoms are not part of MS itself, but autoimmune diseases can cause these symptoms to occur.

For people who experience neuropathy-related pain, discomfort, and altered sensations, the following strategies may help:

• wearing loose clothing
• massage
• hot or cold therapy
• stretching exercises
• stress-relief
• low impact physical activity

Avoiding skin symptoms due to medication may be difficult but talking with a doctor about a medication’s potential risks and side effects can help. Knowing the potential for skin reactions can make it easier to spot problems before they become severe.

MS is a health condition that affects the central nervous system.

Symptoms include muscle stiffness, spasms, and numbness.

Some people may also develop skin rashes, hives, or tingling because of certain MS treatments. If medication is causing skin symptoms, doctors may recommend medications to help relieve and reduce itching, such as creams, antihistamines, or injectables.

causes and symptoms, diagnosis, treatment and prevention

Beautiful clean facial skin is not accidentally considered one of the indicators of health. Any tangible changes in the work of organs and systems affect its condition. Often – persistent rash. Cosmetic preparations are powerless in solving an external problem, since it is only a symptom.

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A rash on the face is an inflammation of the sebaceous glands. They secrete a special secret – sebum. Ideally, this is a balanced mixture of various substances produced by the body – fatty acids, steroids, cholesterol, epithelial particles. Such a “lubrication” protects the skin surface from harmful bacteria, serves as an ideal nutrient microflora for it.

Deterioration in the work of organs provokes a change in the qualitative and quantitative composition of the secret, contributes to the violation of its outflow. Sebum from a protector of the skin becomes a focus of infection. And on the face there is the largest number of sebaceous glands (up to 900 in one square centimeter). The largest of them are located in the area of ​​the forehead, chin, cheeks, wings of the nose, nasolabial folds. Not surprisingly, the rash also “loves” these areas.

A dermatologist’s recommendations for effective treatment will definitely include a referral to a gastroenterologist. In some cases, the help of a ENT or endocrinologist is also needed. But the restoration of the normal functioning of the gastrointestinal tract is the first condition for eliminating the rash.

What internal problems of the body will tell about a rash on the face

A gastroenterologist can draw preliminary conclusions even on the basis of acne localization:

• Chin. One of the reasons may be incomplete absorption of food. This leads to the release of toxins.
• The area of ​​the lips reflects the problems of the entire digestive system (dysbacteriosis, constipation, intestinal colic).
• Nose. A rash in different areas will tell about failures in the hormonal and cardiovascular systems, troubles with the intestines.
• Forehead and bridge of the nose (T-zone). Rashes can be the result of intoxication caused by malnutrition (passion for sweet, fried and fatty foods, etc.), uncontrolled intake of antibiotics, vitamins and hormones. There may be disturbances in the functioning of the stomach, gallbladder, pancreas, liver. Acne above the eyebrow is a signal that the intestines are irritated.

Thus, the desire to eliminate a visible defect helps to solve much more dangerous and unpleasant problems.

Methods for the treatment of rashes on the face

Modern gastroenterology has an extensive range of means to eliminate the causes of rashes. In each case, accurate diagnosis and treatment is carried out according to individual indications and may include various methods:

• microbiological examination;
• Ultrasound of internal organs;
• diet therapy;
• drug treatment;
• physiotherapy;
• herbal medicine and others.

Our center is uniquely positioned to address any gastroenterological problem. Applications are accepted around the clock. We are ready to provide professional assistance as soon as possible.

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Gastroenterology

Endoscopic examinations of the gastrointestinal tract are very informative. With the help of devices equipped with video cameras, doctors can thoroughly examine the organs of the gastrointestinal tract from the inside, which greatly increases the effectiveness of the prevention and treatment of diseases.

Gastroenterologist, hepatologist, doctor of medical sciences Sergey Yuryevich Yermolov assures: eating in restaurants is normal and even healthy. We are used to hearing other advice – cook your own food at home, control food, do not abuse catering. This is all true. But having lunch or dinner in a good restaurant, observing the measure, is not at all harmful.

The New Year is coming. The holiday is fun and delicious. But in order not to go straight to the hospital from the table, doctors recommend checking the digestive system in advance. Why – explains the gastroenterologist, doctor of functional diagnostics, head of the therapy department of the EMS clinic Alexey Nikolaevich Karlin.

Perhaps there is no person who does not know what to take with a cold or headache. Everyone has their “proven means”. Yes, and advertising suggests solutions for any ailment.
You can also ask for advice from friends, a pharmacist at a pharmacy or simply on the Internet. But is everything so simple and convenient? For what diseases can self-treatment be dangerous?
EMS also has a pharmacy, and our pharmacists regularly encounter requests from patients for advice on medicines, and doctors then deal with the results of self-treatment.

What is measles?

Measles is an acute infectious disease that manifests itself with a temperature above 39 degrees, severe intoxication, sore throat, cough and characteristic rash. The disease is caused by a virus that enters the body through the mucous membranes of the mouth, nose, and eyes. You can get measles only once in your life, after which a strong immunity is developed in the body.

Measles is one of the most contagious diseases in the world. Almost 100% of people in contact with the patient become infected. Measles most often affects children of preschool age. If a person has not been ill with measles and has not been vaccinated against it, he can get this disease at any age. Children of the first six months of life get sick with measles extremely rarely (they are under the protection of the mother’s immunity, which was transmitted to them through the placenta).

Incubation period (from the moment of infection to the onset of symptoms) is 10-18 days, the maximum is 21 days.

Ways and factors of transmission. Transmission of infection occurs by airborne droplets.

Droplets of mucus and exudate released during coughing, sneezing, screaming, crying, talking and containing the measles virus from the patient through the air enter the mucous membranes of the nasopharynx and upper respiratory tract of susceptible people. Infection is possible both in close contact with the patient, and when staying in rooms adjacent to the patient. This is due to the fact that the virus is released as part of a fine aerosol and can be transferred to other rooms and floors with air currents. Due to the low persistence of the virus in the environment, there is practically no measles infection through contaminated objects Persons who have not had measles and are not vaccinated against measles remain highly susceptible to measles throughout their lives and can become ill at any age.

Source of infection – only a sick person, whose infectious period can be 11 (maximum 16) days:

• the virus begins to be shed in the last 2 days of the incubation period;
• is excreted to the maximum extent during the prodromal (catarrhal) period within 3-4 days;
• in the first 5 days of the rash period. With the development of measles pneumonia, the period of contagiousness is extended to 10 days from the onset of the rash.

The measles rash is called maculopapular exanthema. Against the background of healthy unaltered skin, irregularly shaped pink nodules appear, rising above the skin. Papules of measles have a flat surface and are surrounded by reddish spots. They quickly increase in size and merge with each other.

The initial or prodromal period (3-4 days) is characterized by an increase in body temperature up to 38–39°C, weakness, general malaise, loss of appetite. The runny nose intensifies, a rough “barking” cough appears, the hyperemia of the conjunctiva is pronounced. Measles enanthema appears in the form of small red spots located on the mucous membrane of the soft and hard palate and Belsky-Filatov-Koplik spots pathognomonic for measles. They appear 2-3 days before the appearance of rashes on the skin. These spots are more often localized on the mucous membrane of the cheeks. They are small whitish, slightly raised spots above the level of the mucous membrane, surrounded by a narrow reddish border, and firmly sit on the mucous membrane. In appearance, they resemble semolina or bran. With the appearance of a rash on the skin, they disappear.

Symptoms. Measles rash is characterized by stages of rash:

• on the 1st day, elements of the rash appear on the face, behind the ears, neck;
• on the 2nd day – on the trunk, arms and thighs;
• on the 3rd day, the rash covers the shins and feet, and the face begins to turn pale.

The most dense elements of the rash are located on the face, neck and upper body.

Lesions consist of small papules (about 2 mm) surrounded by irregularly shaped macules, usually more than 10 mm in diameter.

The elements of the rash tend to merge, forming complex shapes with scalloped edges. However, even with the thickest rash, you can find areas of completely normal skin.

Pronounced conjunctivitis is characteristic, sometimes with purulent discharge, gluing eyelashes in the morning.

Prevention. Vaccination is the mainstay of measles prevention. Scheduled vaccination of children is carried out at the age of 12 months, revaccination – at 6 years.

If you have not had measles and there is only one known vaccination, it is worth getting another vaccination before traveling abroad, especially to regions unfavorable for measles. To develop immunity, such a vaccination must be done at least two weeks before the trip.

A person who has been vaccinated against measles has a negligible chance of getting sick. Even if such a person becomes ill, the vaccination will help to exclude a lethal outcome, complications and the disease will proceed in a milder form.

An unfavorable measles situation is emerging in Ukraine, Serbia, Romania, Italy, UK, Greece, Germany, Latvia, Poland, France and Sweden.

In general, more than 20 thousand cases of measles were registered in European countries last year, about 40 of them were fatal. The largest number of measles cases in 2017 was noted in Italy (5004) and Romania (5560). More than 60% of cases are people under the age of 20. More than 80% of the patients were not vaccinated against measles, which led to the spread of the infection in Europe.

If you have a fever, a rash, a sore throat, a cough, an inflamed mucous membrane of the eye, you should immediately consult a doctor. And if you have been to the EU countries or Ukraine before, you also need to tell the doctor about this.