Hi folks, i'm 9 weeks post op and I have an annoying rash on both arms. Only on my arms and hands, little fine bump kind of itchy sometimes. it has been here for about 5 days now. At first I thought maybe hormonal b/c of my mensus but, that is gone now and it appears to getting worse in some areas while "drying out" in other spots?? Anyone have solid advice on what to do with this? I've been taking my vits, protien and H2O as per ordered.

Thanks, Nickyboo.

hi, i too had rash or hives post op for months.. i took predizone for two months to know out what ever it was that was bugging me.. i would claw my self in my sleep at night... I had to go as far as duct taping socks to my hands at night and during the day...
So i would go to the doctor this up coming week and ask for predizone.. it'll help and you can take it this early out... I wasn't two weeks post op when all this started. I would do 30 days of predizone, then go two weeks and the hives would come back... Finally after three months of it i finally got rid of the hives.. :c)
good luck and welcome to the looser bench.
Annmarie  

How weird! I just started developing a  small, itchy rash with the same description as yours on part of my left arm just two days ago. Let me know if you learn anything new about it.

I had this show up three months out on the same spot on both arms - on the forearms - and wrote it off as hives.

A month later, I had blood work done and they discovered a Vitamin A deficiency. My PCP said the rash was due to that deficiency.

Hmm? Vitamin A deficiency huh?  It's a  good thing those Flintstone  chewable vitamins are almost gone.

Seriously though.  I have heard that a Vitamin A deficiency can cause night blindness or even total blindness. But I had not heard about the hives.

From Merck web site:

Vitamin A (retinol) is required for the formation of rhodopsin, a photoreceptor pigment in the retina. Vitamin A helps maintain epithelial tissues. Normally, the liver stores 80 to 90% of the body's vitamin A. To use vitamin A, the body releases it into the circulation bound to prealbumin (transthyretin) and retinol-binding protein. β-Carotene and other provitamin carotenoids, contained in green leafy and yellow vegetables and deep- or bright-colored fruits, are converted to vitamin A. Carotenoids are absorbed better from vegetables when they are cooked or homogenized and served with some fats or oils.

Retinol activity equivalents (RAE) were developed because provitamin A carotenoids have less vitamin A activity than preformed vitamin A. One microgram retinol = 3.33 IU.

Synthetic vitamin analogs (retinoids) are being used increasingly in dermatology. The possible protective role of β-carotene, retinol, and retinoids against some epithelial cancers is under study. However, risk of certain cancers may be increased after β-carotene supplementation.

Vitamin A Deficiency

Vitamin A deficiency can result from inadequate intake, fat malabsorption, or liver disorders. Deficiency impairs immunity and hematopoiesis and causes skin rashes and typical ocular effects (eg, xerophthalmia, night blindness). Diagnosis is based on typical ocular findings and low vitamin A levels. Treatment consists of vitamin A given orally or, if symptoms are severe or malabsorption is the cause, parenterally.

Etiology

Primary vitamin A deficiency is usually caused by prolonged dietary deprivation. It is endemic in areas such as southern and eastern Asia, where rice, devoid of β-carotene, is the staple food. Xerophthalmia due to primary deficiency is a common cause of blindness among young children in developing countries.

Secondary vitamin A deficiency may be due to decreased bioavailability of provitamin A carotenoids or to interference with absorption, storage, or transport of vitamin A. Interference with absorption or storage is likely in sprue, cystic fibrosis, pancreatic insufficiency, duodenal bypass, chronic diarrhea, bile duct obstruction, giardiasis, and cirrhosis. Vitamin A deficiency is common in prolonged protein-energy malnutrition not only because the diet is deficient but also because vitamin A storage and transport is defective. In children with complicated measles, vitamin A can shorten the duration of the disorder and reduce the severity of symptoms and risk of death.

Symptoms and Signs

Impaired dark adaptation of the eyes, which can lead to night blindness, is an early symptom. Xerophthalmia (which is nearly pathognomonic) results from keratinization of the eyes. It involves drying (xerosis) and thickening of the conjunctivae and corneas. Superficial foamy patches composed of epithelial debris and secretions on the exposed bulbar conjunctiva (Bitot's spots) develop. In advanced deficiency, the cornea becomes hazy and can develop erosions, which can lead to its destruction (keratomalacia).

Keratinization of the skin and of the mucous membranes in the respiratory, GI, and urinary tracts can occur. Drying, scaling, and follicular thickening of the skin and respiratory infections can result. Immunity is generally impaired.

The younger the patient, the more severe are the effects of vitamin A deficiency. Growth retardation and infections are common among children. Mortality rate can exceed 50% in children with severe vitamin A deficiency.

Diagnosis

• Plasma retinol levels, clinical evaluation, and response to vitamin A

Ocular findings suggest the diagnosis. Dark adaptation can be impaired in other disorders (eg, zinc deficiency, retinitis pigmentosa, severe refractive errors, cataracts, diabetic retinopathy). If dark adaptation is impaired, rod scotometry and electroretinography are done to determine whether vitamin A deficiency is the cause.

Plasma levels of retinol are measured. Normal range is 28 to 86 μg/dL (1 to 3 µmol/L). However, levels decrease only after the deficiency is advanced because the liver contains large stores of vitamin A. Also, decreased levels may result from acute infection, which causes retinol-binding protein and transthyretin (also called prealbumin) levels to decrease transiently. A therapeutic trial of vitamin A may help confirm the diagnosis.

Prevention

The diet should include dark green leafy vegetables, deep- or bright-colored fruits (eg, papayas, oranges), carrots, and yellow vegetables (eg, squash, pumpkin). Vitamin A–fortified milk and cereals, liver, egg yolks, and fish liver oils are helpful. Carotenoids are absorbed better when consumed with some dietary fat. If milk allergy is suspected in infants, they should be given adequate vitamin A in formula feedings. In developing countries, prophylactic supplements of vitamin A palmitate in oil 60,000 RAE (200,000 IU) po every 6 mo are advised for all children between 1 and 5 years of age; infants < 6 mo can be given a one-time dose of 15,000 RAE (50,000 IU), and those aged 6 to 12 mo can be given a one-time dose of 30,000 RAE (100,000 IU).

Treatment

• Vitamin A palmitate

Dietary deficiency is traditionally treated with vitamin A palmitate in oil 60,000 IU po once/day for 2 days, followed by 4500 IU po once/day. If vomiting or malabsorption is present or xerophthalmia is probable, a dose of 50,000 IU for infants < 6 mo, 100,000 IU for infants 6 to 12 mo, or 200,000 IU for children > 12 mo and adults should be given for 2 days, with a third dose at least 2 wk later. The same doses are recommended for infants and children with complicated measles. Infants born of HIV-positive mothers should receive 50,000 IU (15,000 RAE) within 48 h of birth. Prolonged daily administration of large doses, especially to infants, must be avoided because toxicity may result.

For pregnant or lactating women, prophylactic or therapeutic doses should not exceed 10,000 IU (3000 RAE)/day to avoid possible damage to the fetus or infant.

Vitamin A Toxicity

Vitamin A toxicity can be acute (usually due to accidental ingestion by children) or chronic. Both types usually cause headache and increased intracranial pressure. Acute toxicity also causes nausea and vomiting. Chronic toxicity also causes changes in skin, hair, and nails; abnormal liver test results; and, in a fetus, birth defects. Diagnosis is usually clinical. Unless birth defects are present, adjusting the dose almost always leads to complete recovery.

Acute vitamin A toxicity in children may result from taking large doses (> 300,000 IU [>100,000 RAE]), usually accidentally. In adults, acute toxicity has occurred when arctic explorers ingested polar bear or seal livers, which contain several million units of vitamin A.

Chronic toxicity in older children and adults usually develops after doses of > 30,000 RAE (> 100,000 IU)/day have been taken for months. Megavitamin therapy is a possible cause, as are massive daily doses (50,000 to 120,000 RAE [150,000 to 350,000 IU]) of vitamin A or its metabolites, which are sometimes given for nodular acne or other skin disorders. Adults who consume > 1500 RAE (> 4500 IU)/day of vitamin A may develop osteoporosis. Infants who are given excessive doses (6,000 to 20,000 RAE [18,000 to 60,000 IU]/day) of water-miscible vitamin A may develop toxicity within a few weeks. Birth defects occur in children of women receiving isotretinoin Some Trade Names
ACCUTANE
Click for Drug Monograph
(which is related to vitamin A) for acne treatment during pregnancy.

Although carotene is converted to vitamin A in the body, excessive ingestion of carotene causes carotenemia, not vitamin A toxicity. Carotenemia is usually asymptomatic but may lead to carotenodermia, in which the skin becomes yellow. When taken as a supplement, β-carotene has been associated with increased cancer risk; risk does not appear to increase when carotenoids are consumed in fruits and vegetables.

Symptoms and Signs

Although symptoms may vary, headache and rash usually develop during acute or chronic toxicity. Acute toxicity causes increased intracranial pressure. Drowsiness, irritability, abdominal pain, nausea, and vomiting are common. Sometimes the skin subsequently peels.

Early symptoms of chronic toxicity are sparsely distributed, coarse hair; alopecia of the eyebrows; dry, rough skin; dry eyes; and cracked lips. Later, severe headache, pseudotumor cerebri, and generalized weakness develop. Cortical hyperostosis of bone and arthralgia may occur, especially in children. Fractures may occur easily, especially in the elderly. In children, toxicity can cause pruritus, anorexia, and failure to thrive. Hepatomegaly and splenomegaly may occur.

In carotenodermia, the skin (but not the sclera) becomes deep yellow, especially on the palms and soles.

Diagnosis

I'm sorry, were you replying to me?

To be fair, when I found out I had deficiencies, I was deficient in iron, Vitamins A, B1 and D - and yes, my PCP told me that a rash that occurs on both arms in the same places can be present in a Vitamin A deficiency. I didn't research it further than that, but I can say that once I added the iron+A tabs (Ferrex 150 twice a day), the rashes disappeared and haven't been back. Again, this was three months post-op when I had an ulcer on my jejunum diagnosed and treated, so I wasn't getting proper nutrition in any way due to not being able to keep anything down.

Now, upon further research via Wiki (which is where the information you've copied and pasted is also located if you Wiki-search Vitamin A), I'm seeing that pruritis and rashes are definite signs of iron and Vitamin D deficiencies (or more accurately, hypocalcemia), so it's possible my rashes were due to that.

Iron deficiency anemia

Either way, once I added more supplements, the rashes and itchiness due to the rashes disappeared. Whether that was due to my iron, B1, D or A deficiencies, I guess I won't know for sure unless I stop taking everything which isn't going to happen.

Here's a table of rashes - signs and symptoms, locations - that may help.

Skin disease	Symptoms	Usual area of body
Acne	Rosacea	Flushed appearance or Redness around cheeks, chin, forehead or nose
Boil	Painful red bump or a cluster of painful red bumps	Anywhere
Cellulitis	Red, tender and swollen areas of skin	Around a cut, scrape or skin breach
Insect bite	Red and/or itchy bumps on the skin	Anywhere and can be sprinked randomly
Allergic reaction	Irregular, raised or flat red sores that appeared after taking medicine/drugs or eating certain foods	Anywhere
Hives	Bumps formed suddenly	Anywhere but usually first noticed on face
Seborrheic dermatitis	Bumps and swelling	Near glands
Cradle Cap	Dry, scaly skin	Scalp of recently born babies
Irritant contact dermatitis	Red, itchy, scaly or oily rash	Eyebrows, nose, edge of the scalp, point of contact with jewelery, perfume or clothing.
Allergic Contact Dermatitis caused by poison ivy, oak or sumac	Red, itchy, scaly or oily rash; can also be weeping or leathery.	Anywhere that came in contact with the irritant either directly or via transfer (eg. from contaminated clothing.)
Allergic purpura	Small red dots on the skin, or larger, bruise-like spots that appeared after taking medicine	Anywhere
Pityriasis Rosea	Started with a single scaly, red and slightly itchy spot, and within a few days, did large numbers of smaller patches of the rash, some red and/or others tan	Chest and abdomen
Dermatitis herpetiformis	Intensely itchy rash with red bumps and blisters	Elbows, knees, back or buttocks
Erythema nodosum	Large red bumps that seem to bruise and are tender to touch	Anywhere
Psoriasis	White, scaly rash over red, irritated skin	Elbows and knees
Erythema multiforme	Red, blotchy rash, with "target like" hives or sores.	Anywhere
Measles	Red rash that is raised with a fever or sore throat.	Usually starts first on the forehead and face and spreads downward.
Chickenpox	Multiple blisters with a fever, cough, aches, tiredness and sore throat.	Usually starts first on the face, chest and back and spreads downward.
Shingles	Red blisters that are very painful and may crust	Anywhere
Fifth Disease	Started as a fever and then developed a bright red rash	Cheeks
Warts	Soft bumps forming that don't itch and have no other symptoms	Anywhere
Ringworm	Bald spot on the scalp or a ring of itchy red skin	Anywhere
Syphilis	Rash that is red but not itchy	Palms of hands or soles of feet
Jock itch, yeast infection or diaper rash	Red itchy rash	Groin
Tinea versicolor	Light coloured patches	Anywhere
Impetigo	Crusted, tan-colored sores	Near nose or lip
Scabies	Bite-like sores that itch and spread intensely	Usually start on hands or feet and spread everywhere
Rocky Mountain spotted fever	A fine rash with a fever and headache	Usually start on arms and legs including the hands and feet
Lupus erythematosus	A butterfly rash with achy joints	Forehead and cheeks
Jaundice or sign of hepatitis	Yellowish	Skin, whites of eyes and mouth
Bruise	Blue or black area after being hit	Anywhere
Actinic keratoses	Scaly, pink, gray or tan patches or bumps	Face, scalp or on the backs or the hands
Keloid or hypertrophic scar	Scar that has grown larger than expected	Anywhere
Lipoma	Soft or rubbery growth	Anywhere
Milia	Lots of white spots	On the face of a baby
Molluscum or contagiosum	Small, firm, round bumps with pits in the center that may sit on tiny stalks	Anywhere
Sebaceous cyst	Bump with a white dome under the skin	Scalp, nape of the neck or upper back
Skin tag	Soft, fleshy growth, lump or bump	Face, neck, armpits or groin
Xanthelasma	Yellow area under the skin	Under eyelids
Melanoma	Dark bump that may have started within a mole or blemish, or, a spot or mole that has changed in color, size, shape or is painful or itchy	Anywhere
Basal cell carcinoma	Fleshy, growing mass	Areas exposed to the sun
Squamous cell carcinoma	Unusual growth that is red, scaly or crusted	Face, lip or chin
Kaposi's sarcoma	Dark or black raised spots on the skin that keep growing or have appeared recently	Anywhere
Erythema annulare centrifugum (EAC)	Pink-red ring or bullseye marks	Anywhere

The table is from this aritcle on Wiki.

Dry itchy skin is a definite sign of Vitamin A deficiency, Herc, but upon further (and quick - just worked third shift and I have to work again at 3 pm) research, I'm thinking it was caused more by the iron deficiency than anything.

Regardless, the OP should talk to her PCP and see what can be done about it. if nothing else, there are topicals that can ease the symptoms a bit.

Hi.  I had a rash on my upper arms a few weeks ago.  It was right after Christmas so I thought I was having an allergic reaction to some lotion I got as a gift.  HUMMM, very interesting.  The rash cleared up but the skin there is very dry.  My next appt is in Feb and they will be doing bloodwork 2 weeks before that appt so I will be interested to see how all that looks.  I will def have to remember to ask about the rash thing.

Thanks folks for the replies...I will start getting some vitamin A in. I will be sure and ask the Dr. about this since I'm about to have my first labs drawn up on Feb.15.

Hey, Nicky!!!  The body needs fat in the diet to keep things lubed up.  At this stage of the game, you are malabsorbing fats like crazy and probably limiting them in your diet, as well.  You need to add some good, healthy monounsaturated fats to your eating.  Consider olive oil and the like.