Prednisone & lowered immune response

I started typing a response but I don't think my response went so here it is again.

About 6 months after starting Prednisone, I noticed that underneath a watch that I was wearing on my left wrist 24 hours a day, there was an expanding redness that also itched. The dermatologist first thought it was contact dermatitis which is fairly common caused by costume jewelry.

But with the ointment he gave me, it wasn't getting better and was actually getting worse.

They then figured that it was actually a form of bacterial fungal infection and they gave me another ointment and over about a month, it has mostly cleared up. I'm sure the prednisone was at least a partial cause since I had never had anything similar to this previously.

Pred does lower your immune system, so one should be extra careful. Even a small scratch can get infected. I use antibacterial cream even on tiny scratches just to be on a safe side.

All sorts of minor irritations can arise, fungal infections as well as bacterial ones. Your immune system is suppressed while on Pred so Nick's right about taking care of anything that breaks the skin. You may find that you bruise easily too. One thing to watch is nausea and vomiting - if you are unlucky enough to get a bug up your dosage of Pred to help combat infection (your adrenals normally produce more cortisone at such times but yours are controlled by the amount of Pred you're taking. I was advised to go from 11mgs to 15 mgs for three days, then drop back. I was also told to go to A&E if vomiting continued for a steroid injection as a sudden loss of Pred can lead to kidney failure. I'm not being alarmist and none of this may relate to you but I like to be fore-armed, which is why this Forum is so very useful. Healthunlocked is another excellent forum you may like where it is much easier to type your queries and responses! Best of luck.

I had a couple of insect bites when on early days with pred which took ages to go away. Usually I'm not troubled by things like this. Also came down with more colds, and once succumbed to a stomach bug, which is extremely unusual in our family. However, touching wood as I say this, now that I'm at a much lower dose I seem to be back to my usual self, resisting the bugs of various kinds which go around.... Yes, you do need to be more careful and keep any cut or abrasion very clean. Who knows how we get some of these things, no visible sign of entry of the bacteria in your case. Hope it's healing as expected.

Some people do develop infections more easily and pred may suppress the body's immune response to fight it.

Bursitis is a common feature of PMR - and bursae can become infected. And it can happen whether you are on pred or not. So it is possible - but may not be.

Well, this was a wake-up call for me,

I had assumed that only a skin cut at the site of an infection would be a factor but realize that any skin break can cause infection to present elsewhere. I did have a small scrape on my right hand that could easily have been a site for entry of staph bacteria which affected my left arm bursae.

And reading about how this can amplify to a serious septic condition has made me very aware and careful going forward. I'm wondering why I wasn't cautioned about this health risk when I has my first rheumatologist appointment a few weeks ago . Perhaps mine is a rare case of serious infection related to prednisone.