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Alzeheimers disease with related prurigo nodularis

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Posted 5/19/2005 4:06 AM (GMT 0)
Hello,

I am really new to to this site.  I am interested in a discussion on Alzheimers disease with related prurigo nodularis.  I work in a community where we provide care for Alzheimers patients.  Over the past several months several of the residents have developed a "rash".  When these residents are sent out to their PMD's they return with a diagnosis of: dermatitis, eczema, papular rash, etc....  This "rash" seems to be spreading and we have had several cultured fro scabbies with a negative diagnosis.  A number of steroid creams have been prescribed by their physicians, none of which have really solvd the problem.  Several of the caregiving team have also been affected with this same "rash" and are positive that it is scabbies even though there has not been one diagnosis of such, and are extremely upset that the medical community in which we live offers little to no help.

The state and public health dept have also been envolved and can offer no help. 

This evening my boss went to her dermatologist and was diagnosed with prurigo nodualris.  Does anyone know if this is a related problem with the mental debilitation of the Alzeheimer's disease?  I know that it is affects the peripheral nerves as with shingles, and is a histamine over production.

Does anyone know anything about any relation?

Can anyone HELP????

Post Edited By Moderator (Admin) : 5/19/2005 8:17:11 PM (GMT-6)

Posted 5/20/2005 2:15 AM (GMT 0)
I have never heard of the condition . . .but I'm not health care professional either. I have a derm site that I go to for things. . . I'll check it out and if it has any info, I'll share the link.
Posted 5/20/2005 2:29 AM (GMT 0)
Hi and Welcome to the HW forum ..........I too have not heard of this before and I was a geriatric nurse for many years........as AR posted there are sites for dermy Q's and you can do a google search to see if you can find out anything ........sorry couldnt be more help,and I hope you get some answers .....I too will check a few sites I go to for my skin problems and see what it says............meanwhile keep us posted and let us know if you have any luck at all .....Take Care and God BLess......Lyn
Posted 5/20/2005 2:33 AM (GMT 0)
Well . . . I was unsuccessful in finding the picture . . . but there may be more information at this site.

http://www.dermis.net


I have found a wealth of info there. You might find more if some time were put into it. Sorry, I thought I might quickly find it.

Sorry I couldn't help.
Posted 8/8/2005 1:36 AM (GMT 0)

Hi,

I hope that you are still checking in about this condition-my mother was diagnosed with Alzheimer's Disease about three years ago and was taking medication for it (exelon and namenda) until recently-about a year ago she started getting this "rash".  At first she was treated for scabies and then later for allergic reaction-it became such a problem that her physician recommended that she be taken off of ALL her medications-the skin condition has improved, but her memory and overall well being has not.  Please, if anyone knows any treatment, let me know--Also, her identical sister has Alzeheimer's Disease and takes the same medications and has not had this reaction (they do not live near one another). 

Posted 8/8/2005 3:44 AM (GMT 0)
Hello Sounder and welcome to the Alzheimer's forum at Healing Well.

I'm sorry I don't know anything about that reaction to nemanda. My dad does take that same drug, but he is steadily declining mentally. So sad. But we really try to enjoy each day with him.

One thing I can think of is that many meds can cause many people to be sensative to the sun. Does your mom spend much time outside. If she is sun sensative because of the meds, she could get a rash with just a few minutes of exposure. Or some people just burn easily. Not sure about that med though. See if the side affects list sun sensativity.

I see you have two loved ones with Alz . . . I'm sooo sorry Sounder. I hope your are still able to enjoy your time with your mom. Dad and I have been working jig-saw puzzles. He likes to spread the glue over them after we complete them . . . we just do the 25 or 50 piece puzzles so he can enjoy the glueing each time. He doesn't really do well with the puzzle but I guide him with the pieces and we enjoy our time together. He also likes to paint figurines . . . they are quite unique!!

I hope you have found some activities that mom enjoys as well. Oh, we also went for a pedicure one time, he liked that too.

Let us know what you do with your mom.

Blessings!
Posted 8/8/2005 4:06 AM (GMT 0)
I did some lit search:

In 1880, Hardaway first described a kind of chronic, hard and globular skin nodules which were characterised clinically by an intense itch . The disease was named prurigo nodularis by Hyde in 1909 . Lately, many studies were performed to detect its causes and mechanisms. Some factors, such as emotional stress, seem to be contributory in certain cases. Around 80% of the patients have an atopic constitution and it has been claimed that in 20% the condition starts after an insect bite . Histologically, the disease is characterized by irregular acanthosis, hyperkeratosis and an inflammatory cell infiltration. The neurohistological changes includes a massive neural hyperplasia , which has been further verified by neuronal peptide staining as well as protein gene product 9.5 (PGP 9.5) and nerve growth factor receptor (NGFr) staining [5, 6, 7]. Recently, mast cells, neutrophils and eosinophils were investigated in order to enlighten the mechanism of the disease [8]. But, the etiology is still not clear.

Treatment of prurigo nodularisnext term with topical capsaicin
Sonja Ständer MDb, Thomas Luger MDa and Dieter Metze MDb
From the Department of Dermatology,a and the Ludwig Boltzmann Institute for Cell Biology and Immunobiology of the Skin,b University of Muenster.
Available online 15 May 2002.

Abstract:
Background: Prurigo nodularis is an eruption of lichenified or excoriated nodules caused by intractable pruritus that is difficult to treat. Therefore the antipruritic efficacy of capsaicin seemed to be of particular interest because this alkaloid, extractable from red pepper, interferes with the perception of pruritus and pain by depletion of neuropeptides in small sensory cutaneous nerves. Objective: The aim of this concentration- and regimen-ranging study was to evaluate the efficacy, safety, and practicability of capsaicin in the topical treatment of prurigo nodularis in a large series of patients. Methods: A total of 33 patients with prurigo nodularis of various origins were selected to receive capsaicin (0.025% to 0.3%) 4 to 6 times daily for 2 weeks up to 10 months. The consecutive follow-up period was up to 6 months. In 7 patients, skin biopsy specimens were taken before, during, and after therapy and investigated histologically, immunohistochemically, and ultrastructurally. Results: All 33 patients could be evaluated for efficacy. After cessation of the symptoms of neurogenic inflammation, such as burning sensations or erythema, all of them experienced a complete elimination of pruritus within 12 days. In addition, capsaicin largely contributed to the gradual healing of the skin lesions. After discontinuation of the therapy, pruritus returned in 16 of 33 patients within 2 months. At the ultrastructural level, no degenerative changes of cutaneous nerves could be found during or after capsaicin therapy. Depletion of substance P was demonstrated by confocal laser scanning microscopy thus confirming the specific effect of capsaicin in vivo. Conclusion: Topical treatment of prurigo nodularis with capsaicin proved to be an effective and safe regimen resulting in clearing of the skin lesions. (J Am Acad Dermatol 2001;44:471-8.)



The connection of this disease with Alzheimers may be due to the meds taken to treat Alzheimers.

cholinesterase inhibitors (Razadyne, Exelon, Aricept, Cognex): prevent breakdown of acetylcholine
Namenda: N-methyl D-aspartate (NMDA) antagonist, regulating glutamate

Both groups increase neurotransmitters to counter neurodegredation and might be responsible for the neural hyperplasia as stated in the above article, resulting in prurigo nodularis.

Not a doctor, but I hope this helps some.
Ben
Posted 8/8/2005 4:07 AM (GMT 0)
err not sure why my font got all screwed.
Posted 8/8/2005 9:37 AM (GMT 0)
Ben Hi and welcome to HW ...........thank you for your input and the resaearch . My Mom doesnt have this as yet ,but is steadily going downhill . Hope to see you post often and you will find great peeps on here for support.....God Bless......Lyn
Posted 8/9/2005 7:14 PM (GMT 0)
I put the name in my browser & found a site with picturs.I had a rashy type mess on my face lately,Dr thinks it was Impetago, but i didn't have the blisters.It caused my face to swell up,lips any foods I ate burned like fire,inside & out.Dr ordered Bactroban cream & it helped but still have a few hard crusted areas on my chin.Itch??OMG yes but I would just press kleenex agaisnt it & it did help.
I was dx in 1996 with AD.
Posted 8/12/2005 1:30 AM (GMT 0)
 

Post Edited By Moderator (Admin) : 8/12/2005 9:13:26 AM (GMT-6)

Posted 8/12/2005 3:13 PM (GMT 0)
FlipIt,
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