Corticosteroids make you more susceptible to fungal infections,
particularly in the mouth and throat when taken orally. Enbrel works by
binding a protein involved in the immune response, and I think it's a
t-cell modulatory protein but don't quote me on that (it may have
effects just as strongly on a range of white blood cells, such as
macrophages). People tend to be more susceptible to fungal infections
when they get low neutrophils. I would STRONGLY suggest having blood
work done to make sure that you're not having a bone marrow suppression
reaction to the enbrel (which can be fatal in some cases). If you find
yourself continuing to get fungal infections then ask your doctor to be
put on diflucan (100mg/day is a good starter if your neutrophils are
okay, but I've had to use 200mg/day for a long time).

Ari

I have  a rash that behaves somewhat like chicken pox  that comes and
goes.  Been to 3 dermatologists with three biopsies and still they do
not know what it is.  My theory is that it is something that I had
before RA and now my immune system can no longer keep it dormant.

Steroid creams keep it somewhat under control if I can keep from
scratching it.
Thumper

Hi Harv,

I strongly disagree with that strategy. Even when a common cold caused
me to bleed for six weeks, I did not stop going to the gym (once the
bleeding was more controlled). I caught that cold at a shopping mall (I
know this because I was generally isolated at home during that time).
Unless you've got the funds to set up a good home gym, then going to a
gym is something many of us will have to do to maintain our health and
mobility. Very few of us enjoy going for 10k jogs anymore (I sorely miss
those, especially in winter in new york). If you're getting repeated
infections from the gym then there are several steps that can be taken:

1- do not touch your nose, eyes, ears, or mouth until after you've
washed your hands. This rule must be obeyed at all times, no exceptions.
2- cover all open wounds
3- make sure your gym's hygeine standards are actually being maintained
by the staff
4- bring your own bottle of disinfectant spray and a towel and spritz
the equipment before use
5- do not use the locker rooms by the pool! wrap a towel around you and
put one down on the seat of your car before heading home. Shower off at
home.
6- carry a pack of disinfectant hand wipes with you for wiping down your
hands prior to actions mentioned in point 1 above
7- have your doctor put you on prophylactic antifungal medication (I've
been on this almost continuously for at least five years now)

The gym is one of the safer places you can go because most people there
are not sick (it's difficult to get really into a workout when you're
coughing up large chunks of mucous all over the mirrored wall). There
will always be one or two gym fanatics who will come even when sick, but
in the end you're more likely to get exposed by a coughing service
station attendant when you fill up the car. Further, eating at any
restaurant is a FAR greater risk for much much much more serious
infection than going to the gym, and you do not get the myriad of life
improving benefits of exercise in that bargain.

Cheers,

Ari

I agree with you Mary - I have had frequent rashes (like now!) since
I've been on Enbrel but I'm also on steroids so it's hard to say if
it's one or the other or the combo of both. Diane W