Can Ankylosing Spondylitis Cause Recurring Boils?

Will ankylosing spondylitis continuously cause boils?

Hello Doctor, I was diagnosed with ankylosing spondylitis in April this year.
After taking medication for half a month, I suddenly developed a boil in the groin area, which required surgical intervention.
I took antibiotics for 10 days, thinking I had cured it, but a month later, it recurred in a different location.
After another 10 days of oral antibiotics and topical ointment, it healed, but the following month, another one appeared from a different site.
Could the boils be related to ankylosing spondylitis? I only took the medication for a month because I experienced gastrointestinal discomfort, having diarrhea 6-10 times a day, and I paused the treatment.
After a gastroenterology check, there were no significant issues.
Is it possible that my body hasn't adapted to the medication, causing these skin issues? I am concerned about bacterial infections, so I wash with water after using the restroom and have replaced all my underwear, yet they keep recurring every month, which is quite distressing.

Chang, 30~39 year old female. Ask Date: 2024/07/31

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
I believe the relationship with medication is relatively low; it may be more related to ankylosing spondylitis or related rheumatic diseases.
I suggest discussing this with your physician and paying attention to whether you have recurrent oral ulcers.
Please provide this information to your doctor to assist in their assessment.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2024/07/31

More Info

Ankylosing Spondylitis (AS) is a type of inflammatory arthritis that primarily affects the spine and the sacroiliac joints in the pelvis. It can lead to chronic pain and stiffness, particularly in the lower back and hips. While AS is primarily a musculoskeletal disorder, it can have systemic effects, including potential impacts on the immune system.
The recurring boils you are experiencing may not be directly caused by Ankylosing Spondylitis itself, but rather could be related to several factors associated with the condition and its treatment. Boils, or furuncles, are typically caused by bacterial infections, most commonly Staphylococcus aureus. When the immune system is compromised or altered, whether due to an underlying condition like AS or as a side effect of medications used to treat it, the body may become more susceptible to infections, including skin infections that lead to boils.

In your case, the fact that you have experienced multiple episodes of boils after starting treatment for AS raises a few considerations:
1. Medication Side Effects: Some medications used to treat AS, particularly non-steroidal anti-inflammatory drugs (NSAIDs) or biologics, can have side effects that affect the gastrointestinal system and the immune response. If you experienced gastrointestinal discomfort and diarrhea, it may indicate that your body was reacting to the medication, which could potentially affect your overall health and immune function.

2. Skin Hygiene and Care: You mentioned that you are taking precautions with hygiene, such as washing after using the restroom and changing underwear. While these practices are important, if there is an underlying issue with your immune system or skin integrity, it may not be sufficient to prevent the recurrence of boils.
3. Underlying Conditions: Conditions like AS can sometimes be associated with other autoimmune or inflammatory conditions that may affect the skin or immune response. It may be beneficial to discuss with your healthcare provider whether further evaluation for other underlying conditions is warranted.

4. Consultation with Specialists: Given the recurring nature of your boils, it may be helpful to consult with a dermatologist. They can provide insights into why these infections are occurring and may suggest topical or systemic treatments to help manage and prevent future outbreaks. Additionally, they can assess whether there are any specific skin care routines or medications that could be beneficial for you.

5. Monitoring and Adjusting Treatment: Since you had to pause your AS medication due to gastrointestinal issues, it is crucial to communicate this with your rheumatologist. They may be able to adjust your treatment plan or suggest alternative medications that are less likely to cause gastrointestinal side effects while still effectively managing your AS.

In summary, while Ankylosing Spondylitis itself may not directly cause recurring boils, the interplay between your condition, the medications you are taking, and your immune response could contribute to the problem. It is essential to work closely with your healthcare providers to address both your AS and the recurring skin infections to find a comprehensive treatment plan that works for you.

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