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Butterfly rash

LadyRacer
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Hello I had 4 rounds of FLOT - last one 24 April 25 then total gastrectomy on 10 July. Successfully removed adenocarcinoma in fundus of stomach - no residual cancer found.
 My GP arranged a Vitamin B12 injection for me - no blood test first - since then I’ve had a Butterfly rash on my face. I hoped it was due to excess B12 but it hasn’t reduced - B12 injection was 2 months ago. If anything it’s getting worse. 
I’m wondering if it could be due to B3 deficiency? The skin on my face is also very dry. 
would it be appropriate to try a B3 (nicotinamide) supplement? The only meds I take are propranolol 10mg per day and 2x Altrajuice. I used to take a multivitamin but stopped that after the injection as I couldn’t find one with no B12.
Any advice would be gratefully received. I did have blood tests and stool test for EPI - 3 weeks ago but no results yet and no other symptoms.

this rash gets worse at night 

  • Hi LadyRacer,

     

    Thank you for getting in touch with us and welcome back to our online community.  I hope you are finding it to be helpful and supportive.  My name is Adrienne and I’m one of the Cancer Information Nurse Specialists at Macmillan. 

     

    It’s great to hear that your treatment and surgery have been successful.  I am sorry to hear about the rash on your face since having the Vitamin B12 injection 2 months ago.

     

    Exocrine pancreatic insufficiency (EPI) can lead to deficiencies in vitamins A, D, E and K due to impaired digestion of dietary fats.  A vitamin B3 (niacin) deficiency is less common as B vitamins are water soluble (able to be dissolved in the water in the body) and not fat soluble.  That being said, although rare it’s not impossible.  If your blood and stool tests come back as positive for EPI then your GP can do further tests to check the levels of niacin in the blood.

     

    Dermatitis caused by a vitamin B3 deficiency usually starts red and inflamed, similar to sunburn and affects sun exposed areas (hands, feet, face and neck).  This can then become dry, scaly and can even have itchy sores.

     

    It’s important to speak to your doctor before taking any kind of supplement.  Even over the counter supplements can have serious side-effects and be dangerous for some people.  Although you mentioned the medication you are taking, we don’t have access to your medical records and past medical history.  Therefore we would be unable recommend whether or not to take nicotinamide. 

     

    It may be best to wait for your test results before trying a supplement or speak to your GP sooner for advice.  They are best placed to offer help and support around this.  It may even be possible for your doctor to take photos of the rash on your face and consult with a dermatologist.  They can do this through an electronic system called NHS Advice and Guidance. 

     

    I hope this information was even a little helpful.  Please don’t hesitate to get back in touch with us at any time.

     

    Take care and best wishes,

     

    Adrienne

    Cancer Information Nurse Specialist

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or email us. 

    Ref:  AMc/AP

  • Thank you for the advice, I’ve contacted the upper GI nurses who arranged the EPI test but no results yet - ill try to take a photo of the rash too.

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