Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Skin exfoliation, Temporomandibular joint syndrome
Clinical narrative: caller's eczema and TMJ was exacerbated; caller's eczema and TMJ was exacerbated; when his eczema was so bad after the vaccine it just happened to be bad last May, and Jun and doctor said with confidence that it was from the vaccine; Had bad, horrible blistering/he had blistering on his fingers; his skin was peeling on his fingers; the pain was worse than ever; This is a spontaneous report received from a contactable reporter(s) (Consumer or other non HCP) from medical information team, Program ID. The reporter is the patient.  A 57-year-old male patient received BNT162b2 (BNT162B2), on 13Apr2021 at 10:45 as dose 2, single (Lot number: EW0151) at the age of 55 years for covid-19 immunisation. The patient's relevant medical history included: "Crohn's", start date: Dec2013 (unspecified if ongoing), notes: gallbladder removed With Crohn's when 1st treated for Lyme by IV this happened with Ceftin he was still on. He was told it was combination.; "gallbladder removed", start date: Dec2013 (unspecified if ongoing), notes: gallbladder removed With Crohn's when 1st treated for Lyme by IV this happened with Ceftin he was still on. He was told it was combination.; "Lyme", start date: 1999 (unspecified if ongoing), notes: Lyme disease since 1999 and was diagnosed in 2013.; "High cholesterol" (unspecified if ongoing); "Blood pressure" (unspecified if ongoing); "underactive thyroid" (unspecified if ongoing); "Pain" (unspecified if ongoing); "body doesn't produce bile acid" (unspecified if ongoing). Concomitant medication(s) included: METHSCOPOLAMINE BROMIDE taken for crohn's disease (ongoing); QUESTRAN taken for bile acid malabsorption, start date: 1983 (ongoing); ATORVASTATIN taken for blood cholesterol increased (ongoing); OLMESARTAN taken for hypertension (ongoing); LEVOTHYROXINE taken for thyroid disorder (ongoing); NAPROSYN [NAPROXEN SODIUM] taken for pain. Vaccination history included: BNT162b2 (DOSE 1, SINGLE), administration date: 23Mar2021, when the patient was 55-year-old, for COVID-19 Immunization, reaction(s): "caller's eczema and TMJ was exacerbated", "caller's eczema and TMJ was exacerbated", "caller's eczema and TMJ was exacerbated", "he had blistering on his fingers/Had bad, horrible blistering", "his skin was peeling on his fingers", "the pain was worse than ever". The following information was reported: TEMPOROMANDIBULAR JOINT SYNDROME (non-serious), CONDITION AGGRAVATED (non-serious), outcome "not recovered" and all described as "caller's eczema and TMJ was exacerbated"; ECZEMA (non-serious), outcome "not recovered", described as "when his eczema was so bad after the vaccine it just happened to be bad last May, and Jun and doctor said with confidence that it was from the vaccine"; BLISTER (non-serious), outcome "unknown", described as "Had bad, horrible blistering/he had blistering on his fingers"; SKIN EXFOLIATION (non-serious), outcome "unknown", described as "his skin was peeling on his fingers"; PAIN (non-serious), outcome "not recovered", described as "the pain was worse than ever". Relevant laboratory tests and procedures are available in the appropriate section.  Additional information: Caller shares that the eczema on his fingers worsens as the seasons transition and that typically there is only little eczema on the months of Jun, Jul, Aug, Sep and at the onset of Oct onwards it gets worse. Now, caller reports that after he got his Pfizer covid 19 shot on Mar and Apr2021, and eventually the booster dose on Nov2021, caller's eczema and TMJ was exacerbated. He reports that his eczema got worse than before the vaccine and that he had blistering on his fingers. Then at around July this year, Olmesartan 20mg even that is too much so he cuts it in half and takes 10mg. Additional Information for Other medicines Levothyroxine: diagnosed in his late 30's around age 39. starting dose was 87mcg he believes. 2 times over last 18 years has felt metabolism change and increase and dose now is 112mcg once a day for last year or two.Caller states in 1999 his eczema started, and he didn't know he had an infiltration of a tick. Went to dermatologist and tried topical after topical and was sent to another dermatologist and no one understood what was causing it. The drugs would help a little. In 2013 he pulled a tick out of his leg and got very sick. Went to internist and finally got to a Lyme specialist. He had muscle aches, flu like symptoms, a lot of things and the eczema on his fingers still going on. New doctor probed about eczema and her conclusion was he had a tick infiltration since 1999 and no one ever surmised that could have caused the eczema. He had the known tick bite in 2013 and surmised the eczema was from a bite in 1999. Has been treated for chronic Lyme since 2013. The eczema retreats from June to September and is back Oct through May. It's bad in cold weather. Gallbladder removed With Crohn's when 1st treated for Lyme by IV this happened with Ceftin he was still on. He was told it was combinationHe had the Covid vaccine in Mar2021 and Apr2021 and was approaching the warm weather, but it went out of control. Had bad, horrible blistering, his skin was peeling on his fingers and the pain was worse than ever. Lyme doctor sent him to dermatology, and he went to 3 and no one could get a solution. Tried Dupixent injections and that did nothing. The Lyme doctor treated him with Azithromycin 500mg a day and Ceftin 2000mg a day; 250mg tablets. He has a coinfection called (Name withheld) and is on Ceftin but that doesn't work on the (Name withheld), so he has a day of no Ceftin and takes Amoxicillin. In Sep2022 when he got 20 days extra, on day 11 his eczema is gone and on day 12 he didn't take Ceftin and took amoxicillin and saw the eczema came back a little. Day 13-16 he took Ceftin and day 17 took Amoxicillin and the eczema was worse again as bad as ever. It was decided no Amoxicillin again after the 17th day. On day 26 the eczema went away again. Day 30 saw doctor knew health insurance would cover Paxlovid again. Today is day 39 and he has no eczema. He has not used Amoxicillin, just Ceftin and Azithromycin.The pharmacist doesn't feel comfortable and doesn't want to get in trouble to do this month what was done last month for the Paxlovid. Wanted to call and explain what has been learned about eczema and tomorrow is day 40 and no he had no Paxlovid until insurance can cover again in 20 days. He is the only person gone beyond because it's not for Covid. When caller first called and listened to make sure what the side effects could be states that ever since Lyme his doctor takes blood regularly and looks at liver numbers. There have been other drugs he has gone on for Lyme that could affect the liver also. He knows there was another drug a dermatologist put him on at (country name withheld) a year ago with blistering called Diflucan.The Lyme doctor wasn't happy about that, and he got a horrible reaction to it and was off it in 10 days. Took Dupixent for 6 months and the doctor said they never had someone on it for 6 months without positive response. This was after Diflucan. He wants to take it if no long-term side effects. Wants to find out how to get it. He gets metallic taste in his mouth from time to time. He will live with it if the eczema is gone. It comes and goes. He will get it 15-20 minutes and put something in his mouth and won't have it again for several hours. He got the Omicron variant last year which is strange. He was on the 14-60 days when immunity is strongest. It was minor, the vaccines definitely hampered it down. His first symptoms were 29Dec2021. All symptoms were gone by late day 02Jan2022, like a light cold. His doctor has continued him on azithromycin 250mg twice a day. Most days he is on Ceftin. Caller states the actual name of the medication is Cefuroxime Axetil and he takes 10- 250mg tablets a day. Once in a while for the coinfection Bartonella they send blood. His dermatologist in 2013 got a report back and she informed him he has 2 coinfections Babesia and Bartonella. Bartonella is a challenge. Most medications don't treat both. You have to manage by going off some medications a day to 3 days and back and forth. He is not going on Amoxicillin. Can't say any symptoms or sick since then, he is so focused on getting rid of eczema he hasn't gone back to it. Takes a day or 2 off Ceftin and takes 875mg 3 times a day of Amoxicillin. He discovered when off Ceftin and on Amoxicillin with Paxlovid the Paxlovid doesn't work like it does with Ceftin. Since he found that out, he hasn't taken Amoxicillin since day 17 this time around and is now on day 39 and missed 1 day of it because he couldn't get a prescription filled. That would have been day 26 and started on day 27. Today might be day 40 and tomorrow day 41. Has Crohn's that was diagnosed at 18 years old which is autoimmune, and he does take meds for that. For being 57 years old with Lyme and Crohn's he is in fairly good health. Side effect of Lyme is increased blood pressure and takes a very low dose blood pressure medication. Would go to the clinic for infusion of antibiotics and would check his blood pressure all the time and occasionally it would spike. Was normally 120/70 but Lyme's causes it once in a while to 140/90. Sometimes from the Lyme TMJ and eczema he has pain, and he takes Naprosyn, never more than 1 a day as needed. Today he took 1 as he has a lot of muscle pain in his torso and upper body. He's feeling so lousy from Lyme, it's beating the hell out of him, and the eczema is non-stop. Ceftin he is referring to throughout call is really Cefuroxime Axetil. For several years he received azithromycin and Ceftin through an IV and on days he couldn't get to the clinic he would take the oral medication. They felt IV was beneficial as it circumvents the organs and gets to infection more effectively than pills. At some point his insurance wouldn't pay for IV anymore in 2016. Has only taken oral since then. Caller clarifies the IV form was Ceftin. Had horrible eczema and was on Dupixent that didn't work from Nov2021 through Apr2022 this year, it did nothing. He was watching TV in June and saw an ad for a new topical for eczema called Opzelura (ruxolitinid) cream 1.5%. He jumped through hoops to get it covered. His dermatologist gave him a tiny sample that lasted 3-4 days and it seemed to be working a little bit. He went on this late Jun2022. Every drug has side effects and this one has about 50 and he happened to get the most common, how a topical creates cold like symptoms like sneezing, coughing like that sure enough he got the 1 side effect. All of Jul he had a runny nose. No sneeze, no cough. Could not get rid of it. Doctor sent him to ENT in Aug2022 and was put on Flonase and another nasal Iprotamine Bromide. The combination over 20-30 days but those sprays got the runny nose to go away. Convinced it was a side effect of that topical. Manufacturer NDC 50881-007-04. Does not see lot or expiry, there is a patient sticker on the box. Started Jun2022 when told doctor about runny nose, saw commercial and #1 side effect was cold including runny nose. In Jul2022 he stopped using it. He wasn't on it more than 2-3 weeks. He had cold in Jun2022, and the cold went away, he was fine and then the runny nose came. He started the medication after the cold. Dupixent - inject 1 pen every 14 days under the skin 300mg/2ml each injection. every box has 2. NDC 0024-5915-00 lot 1F105A or F5A pretty sure it's a 5. expiry 31Jan2024. First taken 01Nov2021 last taken 18Apr2022. He took it every other Monday. States had bad reaction. He was started on Prednisone, and he got really sick from that. Took it for 10 days and doctor said to stop it and not take it anymore. When he takes Prednisone, he gets fatigue which if Lyme and one leads to another and he didn't go on it. Diflucan - he took right before in Oct2021. Does not have manufacturer, dose, NDC, lot or expiry to provide. It didn't work and he got very sick from it. Suspect Product: Pfizer Covid 19 vaccines: 1st dose on 23Mar2021 at 10:45am, lot ENG206 or EN6206. Does not have NDC or expiry to provide.2nd dose on 13Apr2021 at (withheld) at 10:45am. lot EW0151. Does not have NDC or expiry to provide.Doctor is insistent that all patients get the vaccine even if it exacerbates it's critical to get the vaccine and save a life because they are all immune compromised. When his eczema was out of control, after she said other patients, she treats with other things she is seeing the same thing over and over again, but life is more important.