diflucan mechanism of action

Skin changes with Sjogren's

Question:  My dermatologist diagnosed SLE and Sjogrens in 09/2009.  First rheumatologist concurred
in dx but I had to change rheumy due to his personal illness.  New rheumy agrees
about Sjogrens but not 100% sure about SLE as I have no obvious organ
involvement or overt RA issues.  The Sjogrens is becoming more pronounced.

Because of a reddish "blotch" on my upper left left arm, my rheumy sent me back
to the dermatologist.  In addition, I have now begun developing edema in my
upper left arm.  They have done a couple biopsies as they aren't sure what it
is.  The preliminary dx is lymphederma. There is a 3" difference in
circumference between upper arms.

My research into this doesn't yield much info into a Sjogrens / lymphederma
connection - especially in the upper arm.  Any suggestions or ideras?


Apologies for delayed response. Lymphedema/lymphederma is not something we usually associate with autoimmunity and is not something I've seen in Sjs even with pseudolymphoma and a high lymphocyte burden. However, anything that blocks lymphatic drainage such as enlarged lymphnodes possibly could lead to lymphedema. Also, if there was inflammation or infection in the lymphatic system this could have the same result. However, in my experience this is not seen.

An erythematous patch on the skin could possibly be morphea (thick connective tissue), and if the process was deep enough could possibly interfere with lymphatic drainage. The skin bx would have shown increased fibrous tissue, unless it was very early in the process, where edema is the more pronounced feature.

If you reply with the results of the skin bx and any autoantibody data, I may have further thoughts.

I am assuming your primary care physician has ruled out any other causes of a lymphatic blockage


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  • Cody Bidez says:

    I have sjogren's and have been using Enbrel for 6 years. However, my sjogren's is not typical. Similar to RA, my sjogren's symptoms disappear whenever I become pregnant. Doctor's did not believe me for 2 years until someone finally took a chance and put me on Enbrel. It has resolved all of my symptoms and even more that I didn't realize were due to the underlying condition.I have tried going off Enbrel, but within a week I have a migraine headache. I feel wonderful since being on it.I hope this helps someone else as well.

  • prim allen says:

    I have been having a long list of problems over more than 10 years and it is only 18months ago that
    SJ became the answer.My biggest problem at the moment is my lips inside and out! Really lumpy and swollen inside and I seem to grind my teeth all the time. I need to have gum or suck special sweets.Any thoughts to help. I have been rinsing my mouth with pilocarpine,it seems to help a little.The peeling lips I keep using every cream that I can find.

  • Celine Epi says:

    It took me a bit longer than 10 years to be diagnosed, but after using nearly every drop and ointment available, I am still suffering. I have tubes in three ducts and my Opth. wants to cauterize the remaining duct. I am surviving by using CVS non preservative tears and ointment. I am also having dry lips and like you I am using every thing from coco butter to vaselyne, My latest find for this year is Nivea"a kiss of moisture", it feel great on, but it doesn't last. I carry water everywhere I go, but I continue to be thirsty. I also have RA using Methotraxate for 10 years and minimal pain.

  • Celine Epi says:

    It doesn't surprise me that you found a connection with your pregnancies probably confirming a hormonal link. My symptoms began at pre-menopausal age and it took over 10 year diagnosed. I was exhausted all the time. I thought I had lime's decease or ....,
    Did you take Enbrol while pregnant too? Did you have pain or just the dry eyes?

  • Christiane says:

    I have Sjogren and my face of all places breaks out with little buttons filled with clear liquid. Is this common and what can I do?

  • drcarteron says:

    I don't think "buttons filled with clear liquid" is common. Can't recall anyone who has shared this with me.

    That being said....the spectrum of skin manifestations is wide that has been reported in Sjogrens. They can range from the common dry, itchy skin to allergic type (Urticaria)...to photosensitive (especially with SSA (Ro)+)...to autoimmune, including infiltrating clusters of lymphocytes.

    Food or other triggers might be playing a role.

    Would start with a Dermatologist opinion and go from there.

    Sjogrens Resource:

    dr c

  • L4N3 says:

    I have the same thing. Went to a dermatologist, he was baffled, so far no answers.

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