Shingles and rheumatoid arthritis: what to know

Shingles is a reactivation of the chickenpox virus in a nerve, usually causing burning, tingling, or pain followed by a one-sided blistering rash. Rheumatoid arthritis is an inflammatory condition that can cause joint pain, swelling, and stiffness. The conditions are different, but rheumatoid arthritis medicines that suppress immune activity may change how an infection is managed. A rash can be mistaken for another problem, so describe its location, onset, pain, and any fever to a clinician.

Contact your doctor promptly if shingles is suspected, because antiviral treatment may be time-sensitive. Do not stop, restart, or change a rheumatoid arthritis medicine without instructions from the prescribing team. Keep the rash clean and covered, wash hands, and avoid close contact with people who are pregnant, immunocompromised, or not immune to chickenpox until lesions have crusted. Ask whether pain relief, vaccination planning, or a medication review is appropriate.

Seek urgent assessment for a rash near the eye or ear, facial weakness, confusion, severe headache, widespread blisters, breathing difficulty, or rapidly worsening illness. Prompt care is also needed for fever with a spreading red rash or inability to drink. New or severe joint swelling should be reported separately so infection and an arthritis flare are not assumed to be the same thing.

Ask which rheumatoid arthritis medicines need special instructions during shingles, how to protect household contacts, and whether vaccination is suitable later. Bring your medicine list and mention prior chickenpox or shingles, the rash start time, and any eye, ear, or facial symptoms.