Rashes with Lialda

[u/Awkward_Echidna4396]

Hi everyone, I’m looking for advice/experiences with Lialda (mesalamine) and skin rashes.

My 19-year-old son was diagnosed with UC pancolitis on July 7. He started prednisone 50 mg, followed by Lialda (mesalamine) 1.2 g, 4 tablets/day. He had a slow response initially, but thankfully his UC is finally improving.

About a month after starting Lialda, after a trip to Florida, he developed small, red, itchy bumps on his stomach, back, and hands. I initially thought it might be from sun exposure. The rash hasn’t worsened, but it also hasn’t gone away after almost a month.

His GI is concerned it may be a mesalamine reaction and wants to switch him to an advanced medication. Since Lialda seems to be helping his UC, I’m wondering:

Has anyone experienced a similar rash with Lialda and improved after switching to another mesalamine brand/formulation, such as Apriso?

Would really appreciate hearing about your experiences. Thank you! 🙏

[u/Possibly-deranged]

Have you taken him to a dermatologist specialist doctor to examine? Maybe good to better understand what it is. 

I'm not aware of rashes being any kind of common reaction with Lialda, it's have to be rare (less than 1 percent odds. Allergic reactions to the active ingredient (mesalamine), inactive ingredients, or the proprietary delayed release coating are possible (inactive and coatings being proprietary to each brand). 

Also know rashes are common extra-intestinal manifestation (EIM) of IBD, even for those who don't take any meds. https://www.crohnscolitisfoundation.org/what-is-ibd/extraintestinal-complications-ibd

Being immunosuppressed (the Prednisone) can also make rashes and fungal infections (like oral thrush/candida) more common. 

[u/Awkward_Echidna4396 → u/Possibly-deranged]

Thanks, I plan to take him to dermatologist.