Hello fellow P warriors….a new member to the fold…..with a few questions
Question:
- Hide quoted text — Show quoted text ->…fast forward 12 years….Over the past year I notied what appeared >to be some red splotches around my torso and seemed to be "creeping’ >up my neck. It was not too noticeable, seemd to turn brown after a few >weeks, did not itch, so I never bothered to do anything about it it. >About a month ago I had a bad infection I believe it was strep and was >treated with Biactin as an antibiotic. After a week of coming off the >Biactin I broke out with red spots all over my torso, arms, legs and >back. I decided to check on the net to find out what the heck this >was, read some info about Gutatte P and thought I should call a derm. >I was refered to one known to treat p very agressively. He looked at >me and said he was pretty sure it was p, but it was not classic plaque >p as they were dots, and not raised off the skin excessively. > Well, you’d already figured that out for yourself <g>. DOES sound like > classic guttate, especially with the infection trigger and past > history. > He gave >me a prescription for TAC .1% apply 2 X’s daily. I have done this for >2 weeks, and no difference. I went back in to have him do a biopsy, >but again he was absolute that it was P, and gave a script for >Azulfadine 1 pill 3x’s daily as I did not want to try MTX as he >suggested I might want to consider. > Yeah well, there are a lot of options in between and I agree that MTX > as first choice seems a bit extreme. Curious, did you ask why the > sulfa as the alternative of choice to mtx? Medline indicates that it’s > a lot more commonly used for PA than P. Have you taken a browse at the > treatment options out there using something like the National > Psoriasis Foundation site at http://www.psoriasis.org? And you can > do the same sort of medline search I did, along with searching the ng > archives, using the links at http://www.pinch.com/skin >Also at the same time, my son had >to go in the hospital for an unexpected surgery, my wife gave birth to >our second child, and I had a comprehensive final for a course in my >MBA program. So, there were a few stress factors going on as well that >I am sure did not help! > JUST a bit. Hope your son’s OK and congrads on the new kid. Had you > responded to stress before? I know that everyone thinks there’s a > direct connection, but not everyone with P has stress as a trigger, > and in fact one of our ng members responds in reverse -stress seems to > make his P worse. Anyway, hope things are calmed down. >It seems that a lot of people have success with different therapies, >but I have not read much about how long everyone uses theit treatments >before seeing results. Is it a week? 2 weeks? 6 months? I am kind of >curious as to how long I should use these things if I am not seeing >results? I am willing to give it time, but I don’t want to load of on >steroid creams and pills usually prescribed for Crohns or RA if I >don’t need to. Also, with the TAC cream, my derm says there is no risk >of rebound due to the amount of time I have used it (2weeks) and the >leel 0.1%. Any thoughts on that too? > It varies a bit by treatment (some will say that the notoriously slow > Dovonex takes as long as 3 months for full effectiveness) but a usual > rule of thumb is that you should see a noticeable difference, if not > full clearing, within 4-6 weeks. 2 Weeks and nada, especially where > the sulfa drug is perhaps a questionable first option and steroids > (TAC) usually show some fairly rapid improvement might be worth asking > the doc about. You should also ask the same questions of your doc, if > for no other reason than to see what his reasponse is. > As to the rebound thing, in general terms he’s right. But this is > somewhat idiocyncratic. I don’t use steroids because I suffer from a > very rapid onset of rebound after very little use and another ng > member has reported similar problems. We’re VERY unusual in that being > the case, but it does vary from person to person. OTOH you may never > see a rebound after usiing steroids for years. Being individual works > both ways. Generally the risk is a function of length of use and > strength of steroid. You sound pretty safe as far as that goes unless > you had a very individual reaction. > Seriously, In your shoes, I’d first make absolutely sure all trace of > the strep is gone, as that may be negating any benefit of treatment. > Then I’d look around a few basic info places like the NPF and the > archives and DaveW’s Psorsite at http://members.aol.com/psorsite/ > to get a better feel for what the options are and then I’d talk with > the doc about why sulfa and not something else and how long he thinks > it should it take to see how much effect. etc. > Oh yeah, welcome to the group : ) > Best > Kim > The Psoriasis Newsgroup Resource FAQ can be found at > http://pfaq.cjb.net > but will also be coming soon (twice a month) to a > newsgroup near you…
Thanks Kim, the information you provided was very informative and compelling. I think I will give my derm a call this week to set up another consultation. I will also check into the strep issue. I still have tonsils and have read that having them removed can aid in future outbreaks, but that seems extreme to me. I will have to check into that a bit further. I went off my TAC for a few days and started up again to see if a few days off would help with the effectiveness, but I have seen no difference. As far as stress goes, I really don’t have much. I never really feel stressed, and when I have, exercise has always been a good outlet for me. I lift weights almost daily and do cardio about 3 times a week, and I think that helps somewhat to manage stress. Thanks for the links as well. I will definitely check them out! James
Response:
>…fast forward 12 years….Over the past year I notied what appeared >to be some red splotches around my torso and seemed to be "creeping’ >up my neck. It was not too noticeable, seemd to turn brown after a few >weeks, did not itch, so I never bothered to do anything about it it. >About a month ago I had a bad infection I believe it was strep and was >treated with Biactin as an antibiotic. After a week of coming off the >Biactin I broke out with red spots all over my torso, arms, legs and >back. I decided to check on the net to find out what the heck this >was, read some info about Gutatte P and thought I should call a derm. >I was refered to one known to treat p very agressively. He looked at >me and said he was pretty sure it was p, but it was not classic plaque >p as they were dots, and not raised off the skin excessively.
Well, you’d already figured that out for yourself <g>. DOES sound like classic guttate, especially with the infection trigger and past history. > He gave >me a prescription for TAC .1% apply 2 X’s daily. I have done this for >2 weeks, and no difference. I went back in to have him do a biopsy, >but again he was absolute that it was P, and gave a script for >Azulfadine 1 pill 3x’s daily as I did not want to try MTX as he >suggested I might want to consider.
Yeah well, there are a lot of options in between and I agree that MTX as first choice seems a bit extreme. Curious, did you ask why the sulfa as the alternative of choice to mtx? Medline indicates that it’s a lot more commonly used for PA than P. Have you taken a browse at the treatment options out there using something like the National Psoriasis Foundation site at http://www.psoriasis.org? And you can do the same sort of medline search I did, along with searching the ng archives, using the links at http://www.pinch.com/skin >Also at the same time, my son had >to go in the hospital for an unexpected surgery, my wife gave birth to >our second child, and I had a comprehensive final for a course in my >MBA program. So, there were a few stress factors going on as well that >I am sure did not help!
JUST a bit. Hope your son’s OK and congrads on the new kid. Had you responded to stress before? I know that everyone thinks there’s a direct connection, but not everyone with P has stress as a trigger, and in fact one of our ng members responds in reverse -stress seems to make his P worse. Anyway, hope things are calmed down. >It seems that a lot of people have success with different therapies, >but I have not read much about how long everyone uses theit treatments >before seeing results. Is it a week? 2 weeks? 6 months? I am kind of >curious as to how long I should use these things if I am not seeing >results? I am willing to give it time, but I don’t want to load of on >steroid creams and pills usually prescribed for Crohns or RA if I >don’t need to. Also, with the TAC cream, my derm says there is no risk >of rebound due to the amount of time I have used it (2weeks) and the >leel 0.1%. Any thoughts on that too?
It varies a bit by treatment (some will say that the notoriously slow Dovonex takes as long as 3 months for full effectiveness) but a usual rule of thumb is that you should see a noticeable difference, if not full clearing, within 4-6 weeks. 2 Weeks and nada, especially where the sulfa drug is perhaps a questionable first option and steroids (TAC) usually show some fairly rapid improvement might be worth asking the doc about. You should also ask the same questions of your doc, if for no other reason than to see what his reasponse is. As to the rebound thing, in general terms he’s right. But this is somewhat idiocyncratic. I don’t use steroids because I suffer from a very rapid onset of rebound after very little use and another ng member has reported similar problems. We’re VERY unusual in that being the case, but it does vary from person to person. OTOH you may never see a rebound after usiing steroids for years. Being individual works both ways. Generally the risk is a function of length of use and strength of steroid. You sound pretty safe as far as that goes unless you had a very individual reaction. Seriously, In your shoes, I’d first make absolutely sure all trace of the strep is gone, as that may be negating any benefit of treatment. Then I’d look around a few basic info places like the NPF and the archives and DaveW’s Psorsite at http://members.aol.com/psorsite/ to get a better feel for what the options are and then I’d talk with the doc about why sulfa and not something else and how long he thinks it should it take to see how much effect. etc. Oh yeah, welcome to the group : ) Best Kim The Psoriasis Newsgroup Resource FAQ can be found at http://pfaq.cjb.net but will also be coming soon (twice a month) to a newsgroup near you…
Response:
When I was very young I am told that I had several small psoriasis outbreaks (do not recall them, probably subconsciously blocked from memory) When I was about 17 I had an outbreak on my Torso and a couple small spots on my legs. I am in AZ so I headed out to the sun to try and tan over the spots to cover it up. I was not aware at the time of the possible UVB benefits for p. I also used coal tar Denovrex shampoo and some OTC hydrocrtisone. Worked great at the time and seemed to clear up in a couple weeks….. …fast forward 12 years….Over the past year I notied what appeared to be some red splotches around my torso and seemed to be "creeping’ up my neck. It was not too noticeable, seemd to turn brown after a few weeks, did not itch, so I never bothered to do anything about it it. About a month ago I had a bad infection I believe it was strep and was treated with Biactin as an antibiotic. After a week of coming off the Biactin I broke out with red spots all over my torso, arms, legs and back. I decided to check on the net to find out what the heck this was, read some info about Gutatte P and thought I should call a derm. I was refered to one known to treat p very agressively. He looked at me and said he was pretty sure it was p, but it was not classic plaque p as they were dots, and not raised off the skin excessively. He gave me a prescription for TAC .1% apply 2 X’s daily. I have done this for 2 weeks, and no difference. I went back in to have him do a biopsy, but again he was absolute that it was P, and gave a script for Azulfadine 1 pill 3x’s daily as I did not want to try MTX as he suggested I might want to consider. Also at the same time, my son had to go in the hospital for an unexpected surgery, my wife gave birth to our second child, and I had a comprehensive final for a course in my MBA program. So, there were a few stress factors going on as well that I am sure did not help! I have been using the TAC and Azulfadine for a week and have seen no difference. As mentiuoned earlier I live in AZ, so I get plenty of sun on the weekends, (I cannot get a sky light in my office, so I am in the shade M-F). The sun seems to have helped my arms some, as well as some localized spots on my chest. It seems that a lot of people have success with different therapies, but I have not read much about how long everyone uses theit treatments before seeing results. Is it a week? 2 weeks? 6 months? I am kind of curious as to how long I should use these things if I am not seeing results? I am willing to give it time, but I don’t want to load of on steroid creams and pills usually prescribed for Crohns or RA if I don’t need to. Also, with the TAC cream, my derm says there is no risk of rebound due to the amount of time I have used it (2weeks) and the leel 0.1%. Any thoughts on that too? Driezeinaz
Response:
Related Posts