recurring guttate psoriasis
Question:
<< there’s a definite link between throat and infections and outbreaks, >> Don’t overlook the possibility that you have a secondary fungus infection. Burning feet are often more than psoriasis. Also, many p treatments allow fungus to grow even more as does antibiotic treatment. I course of Sporonox set me on the road to recovery. Though I still have some plaques on feet and heels of hands, they do not burn and they only itch a little. Cortisone and antibiotics encourage fungal growth. Insist on a test for fungus when you see your derm. Ellen Harding Anderson
Response:
: First time poster. Wondering if anyone has experience with guttate : psoriasis. Like Sad Man, I feel like I’m a member of the lucky 2% of the 2%. : I’m 31 and have had these scaly spots appear off an on for the past 5 years. : The first time I had it checked out, my PCP thought it was secondary : syphillis. Turned out it wasn’t, of course. Though now I kind of wish it had : been. That would have been relatively easy to get rid of. The dermatologist : diagnosed guttate psoriasis, gave me UVB treatments and said it probably : wouldn’t come back after the treatments worked. When it came back again last : winter, it never fully went away after UVB treatment. It was almost entirely : gone this summer. However, last week it came back with a vengeance. : Strangely, it is all over my arms, hands and feet and itches like never : before. I’m anxious to get in to see the dermatologist (why is it so hard to : get an appointment?) and do UVB treatments again, but after reading posts : here I’m a little discouraged about my options. These treatments seem to be : the only hope for me since ointments and creams are tedious and ineffective. : I’m trying to improve my eating habits. I cut out coffee and am taking : Salmon Oil and Acidophilus. I’ve done a bit of research on-line thanks to : the many resources offered here. However, I don’t see much about my : particular brand of P. If anyone has any particular insights or experiences, : I’d love to hear them. : : Thanks, : : Steve : : Same boat here – I’m on a steady diet of UVB (twice weekly, 8 minutes at a time), and have been for the past 4 years. It’s the ONLY thing that works (I take glucosamine sulfate and MSM as well, and I actually believe it’s a combination of the 3 things that does the job for me) and keeps it practically 100% at bay. Bit of a pain in the butt, but the easiest, safest and most complete solution I’ve come up with. If I miss more than 2 visits, the P starts its return.
Response:
hi 32male from sydney i have them allover my legs and arms to wat do u suggest? ive tryed like urself all the creams and wat knots….and nothing now its getting warmer there getting bigger!! any way bye 4 now cheers!. glenn
Response:
>Kim, >Thanks for the tons of information you have provided me. I think maybe I was >overreacting a bit as this is probably the worst flare up I’ve ever had. I >feel so uncomfortable from the itching and the spots all over my body make >me feel ugly.
Pretty understandable to be frustrated and upset to the point of madness : ) > It does seem like this is triggered every time I have a sore throat. >Does that mean I should stay on antibiotics or consider a tonsillectomy?
Well, it definitely makes it something to talk about with the doctor. Staying on antibiotics long term isn’t really a good idea for a bunch of reasons, but they might want to leave you on them a bit longer or try a different one to make sure the infection is really getting totally killed off rather than festering low grade until it pops up again. Ditto with the tonsillectomy. While I don’t think it makes sense as a general P preventative as it’s sometimes suggested for, in a case where there’s a definite link between throat and infections and outbreaks, yeah, it’s probably worth at least considering. It IS a surgery though, which means not risk free. >Stress is probably a major factor as well. From one of the links you >provided, someone mentioned using Celexa, an anti-depressant. I found that >interesting and will ask my PCP about it. I feel limited by my HMO and >financial situation as to all I can access and try. I live in Chicago, so it >would seem *someone* would have narrow band UVB.
Northwestern for one http://www.dermatology.northwestern.edu/html/phototherapy_treatment_c… > What about Anthralin for a >person like me? Any other systemics?
Sorry about the confusion. Anthralin is a topical. The thing with systemics is that they’re pretty much all higher risk than things like UVB and topicals. So they’re usually not used unless the P is pretty severe. Where yours has spread so much so suddenly that may make them an option, but it honestly is a better idea to try some other options first and save the systemics as a default option if nothing else works or the P gets wildly out of control. That being said, the NPF treatment ladder http://www.psoriasis.org/c100.htm will give you an idea of what’s out there. And it’s worth noting that this is the area where there will soon be significant changes with things like the pending approval of Amevive and research into other targeted immunosuppressants. One other thought is PUVA, which is riskier than UVB re: cancer from exposure over the long term, but uses a drug you take orally (although it can be found in a topical form too) – psoralen- to make you more responsive to the benefit of UVA light and works better than UVB for most. Narrow band seems to have replaced it as a primary option in many places though. >I hope my post didn’t feel like I was suggesting that there were no options >available to me. I just find everything a bit overwhelming – especially when >I’m freaking out from a flare up.
Yup, and that’s the way it sounded – like you were extremely frustrated and overwhelmed. And part of that with P is that there are no easy answers on what to do about it. > Also, my point about comparing myself to Sad Man was not to >mean I was in his group per se, just that I thought my condition was >relatively uncommon.
Dunno if it’s any comfort to know that it really isn’t. It’s the most common type of P among children for example. And I suspect that a lot of doctor diagnoses don’t bother to distinguish between guttate and plaque. >I truly appreciate the information disseminated on the ng. Without it, I >don’t think I’d be able to arm myself with questions for my dermatologist.
Hey, good for you for wanting to go in with them rather than waiting for him to tell you everything you need to know. Don’t be afraid to ask in response to what he suggests too. That’s the one a lot of people miss out on doing. Whatever he recommends, ask him why that and not other options or a combination of them, ask him what the associated side effect possibilities/risks are and make sure you’re clear on how he says to use it (and why, if any of what he says seems wierd). And don’t forget that you have a right to refuse a treatment option you don’t like for whatever reason and ask for an alternative. I respond very badly to the steroid topicals and have had to head butt with more than one doctor over my refusal to use them because of that. let us know how it goes Kim The Psoriasis Newsgroup Resource FAQ can be found at http://www.psoriasisfaq.com but will also be coming soon (twice a month) to a newsgroup near you…
Response:
Kim, Thanks for the tons of information you have provided me. I think maybe I was overreacting a bit as this is probably the worst flare up I’ve ever had. I feel so uncomfortable from the itching and the spots all over my body make me feel ugly. I’m not a shy person and love to be outside, but this is the first time it’s been all over my hands and arms. My hands and feet are the worst. They feel like and feel like they are burning. I just feel so frustrated and depressed. I can’t get in to see my dermatologist until September 3rd. I’m going to see what other options I might have on Monday if I can. It does seem like this is triggered every time I have a sore throat. Does that mean I should stay on antibiotics or consider a tonsillectomy? Stress is probably a major factor as well. From one of the links you provided, someone mentioned using Celexa, an anti-depressant. I found that interesting and will ask my PCP about it. I feel limited by my HMO and financial situation as to all I can access and try. I live in Chicago, so it would seem *someone* would have narrow band UVB. What about Anthralin for a person like me? Any other systemics? Applying creams and ointments are options still, I suppose. But you are right, playing dot to dot is time consuming, irritating and frustrating, especially when it hasn’t worked in the past for me. I guess I’ll have to wait and see. I hope my post didn’t feel like I was suggesting that there were no options available to me. I just find everything a bit overwhelming – especially when I’m freaking out from a flare up. I’m sure people understand. And I know it could be worse. Also, my point about comparing myself to Sad Man was not to mean I was in his group per se, just that I thought my condition was relatively uncommon. I truly appreciate the information disseminated on the ng. Without it, I don’t think I’d be able to arm myself with questions for my dermatologist. Thanks Steve
– Hide quoted text — Show quoted text ->First time poster. Wondering if anyone has experience with guttate >psoriasis. Like Sad Man, I feel like I’m a member of the lucky 2% of the 2%. > Not that it matters, but I think you misunderstood him. What he was > talking about was being one of the minority of those with P who react > negatively to UV. >I’ve done a bit of research on-line thanks to >the many resources offered here. However, I don’t see much about my >particular brand of P. If anyone has any particular insights or experiences, >I’d love to hear them. > I’m actually kind of suprised that you didn’t find much about guttate > as it’s pretty common, especially among kids and with those for whom > an infection is the primary trigger. I suppose part of the reason is > that other than the more common infection link, there isn’t all that > much difference in approaches to that and other forms. > There certainly would be tons of stuff in the ng archives that can be > searched using the links at http://www.pinch.com/skin > e.g. http://pinch.com/skinny?skin=guttate+psoriasis > You might also look at some of the other psoriasis communities, such > as Ed Dewke’s Flake HQ http://www.flakehq.com/ > I’m going to assume you’ve been through the NPF stuff, since you speak > of searching yourself. > You might talk with your doc about trying narrow band UVB rather than > UVB, since that can be more effective for many, including longer > remissions. And perhaps think in terms of a combination therapy to > boost the benefit of the UVB by using it with something else, whether > something that increases photosensitivity like topical tar (CAREFUL > about burning risks though) or just layering in another shot at the P. > It’s a way to integrate some of the topicals on the most persistant > places to get their benefit without driving yourself playing connect > the dots in applying it everywhere. > You also might want to look for environmental triggers to avoid. The > fact that it never went away after it had before would make me look > for something that might be re-triggering it despite best efforts to > control it. The classic one is infections of course – any chance of > lingering strep or any such thing, or even a mild fungal? How are your > teeth – any chance of something lingering in there? But also think in > terms of things like changing soaps and laundry soaps and > moisturizers. Does stress trigger yours? Maybe some regular relaxation > techniques would help get things under control. As to diet, there IS > no P diet but there certainly are people with dietary triggers, that > vary a great deal. You might want to branch out a bit in looking to > identify if you have any > There actually are a fair number of options to try, ranging from > alternative to the most conventional of meds, although none of them > work for everyone, and some of them may involve things you don’t want > to deal with. The fact that some can be a pain in the butt, such as > applying topicals to scattered guttate doesn’t make them non-options, > just ones that you don’t want to use. And you always have to remember > that most of the people here in the ng are those having the biggest > problems or they wouldn’t have the interest to put time into being > here. So don’t let that make you think its hopeless. > Best > Kim > The Psoriasis Newsgroup Resource FAQ can be found at > http://www.psoriasisfaq.com > but will also be coming soon (twice a month) to a > newsgroup near you…
Response:
>Thanks a bunch Dave ! :- (
Well, if you think about it a little bit, and total up all the 2% things we all have in our lives, you’ll find, not surprisingly, that the odds against someone else being just like you are about 6 billion to one (and getting steeper every day). – Dave W. http://psorsite.com/
Response:
[snip] >MAN !, what an elite club I would belong too then. 2% of the >2% of the 2%. I am SUCH a special person !!! I can hardly contain >myself I’m so freaking happy !!!
If you’re one of the lucky few who have no family history of psoriasis, you can tack on another minority percentage (although it’s not as low as 2%). And if you’re getting psoriatic arthritis, there’s another small percentage to multiply in. Now, have you ever been hit by lightning or attacked by a shark? – Dave W. http://psorsite.com/
Response:
– Hide quoted text — Show quoted text – > [snip] >MAN !, what an elite club I would belong too then. 2% of the >2% of the 2%. I am SUCH a special person !!! I can hardly contain >myself I’m so freaking happy !!! > If you’re one of the lucky few who have no family history of psoriasis, you can > tack on another minority percentage (although it’s not as low as 2%). And if > you’re getting psoriatic arthritis, there’s another small percentage to > multiply in. > Now, have you ever been hit by lightning or attacked by a shark? > – Dave W. > http://psorsite.com/
I was nearly hit by lightning! It hit my block of flats just before I got to the door! Am I lucky or what! Must be true it was in the newspapers – ball lightning apparently. — Checked by AVG anti-virus system (http://www.grisoft.com).
Response:
> First time poster. Wondering if anyone has experience with guttate > psoriasis. Like Sad Man, I feel like I’m a member of the lucky 2% of the 2%.
What I meant by the 2% of the 2% was,…….I’m guessing that approximately 2% of the population has P and that possibly 2% of that 2% do poorly with UVB Rx and or the sun. I’m not sure what the percentage is of guttate amongst us P people but if that were also to be 2%, MAN !, what an elite club I would belong too then. 2% of the 2% of the 2%. I am SUCH a special person !!! I can hardly contain myself I’m so freaking happy !!! Yeah 222, yeah 222, yeah 222, 222, 222, 222, 222 !!!!!! Whoopeeeee !!!!!!!
Response:
>> First time poster. Wondering if anyone has experience with guttate > psoriasis. Like Sad Man, I feel like I’m a member of the lucky 2% of the 2%. >What I meant by the 2% of the 2% was,…….I’m guessing that >approximately 2% of the population has P and that possibly 2% of that >2% do poorly with UVB Rx and or the sun.
FWIW, it’s probably higher. I’m pretty sure that the old NPF site used to give a figure that was something like 16-20% of those with P respond negatively to the sun. > I’m not sure what the >percentage is of guttate amongst us P people but if that were also to >be 2%, MAN !, what an elite club I would belong too then. 2% of the >2% of the 2%. I am SUCH a special person !!! I can hardly contain >myself I’m so freaking happy !!!
Well, you don’t have to put up with the "I wish MY doctor would prescribe a suntan for me <ha ha ha>’ comments. Yeah, I know. Not a lot of comfort. Kim The Psoriasis Newsgroup Resource FAQ can be found at http://www.psoriasisfaq.com but will also be coming soon (twice a month) to a newsgroup near you…
Response:
> If you’re one of the lucky few who have no family history of psoriasis, you can > tack on another minority percentage (although it’s not as low as 2%).
Well, as a matter of fact, neither of my parents and none of my actually he’s only a half brother, from a different father so it was my mother who passed on the legacy, somehow without getting it herself and without her parents having it. Thanks Mom. My aunt on my mothers side is in her sixties and is just starting to have some scalp P. Just thought of another minority situation. I’m a nurse of the male persuasion. Not too many of us around and on top of that, I’m a heterosexual male nurse. Well, well, well, I’m just a really special guy huh? As far as the lightning, well, it’s finally raining today and I think I better stay inside. So now I have to stay inside in good whether AND bad. Thanks a bunch Dave ! :- (
Response:
First time poster. Wondering if anyone has experience with guttate psoriasis. Like Sad Man, I feel like I’m a member of the lucky 2% of the 2%. I’m 31 and have had these scaly spots appear off an on for the past 5 years. The first time I had it checked out, my PCP thought it was secondary syphillis. Turned out it wasn’t, of course. Though now I kind of wish it had been. That would have been relatively easy to get rid of. The dermatologist diagnosed guttate psoriasis, gave me UVB treatments and said it probably wouldn’t come back after the treatments worked. When it came back again last winter, it never fully went away after UVB treatment. It was almost entirely gone this summer. However, last week it came back with a vengeance. Strangely, it is all over my arms, hands and feet and itches like never before. I’m anxious to get in to see the dermatologist (why is it so hard to get an appointment?) and do UVB treatments again, but after reading posts here I’m a little discouraged about my options. These treatments seem to be the only hope for me since ointments and creams are tedious and ineffective. I’m trying to improve my eating habits. I cut out coffee and am taking Salmon Oil and Acidophilus. I’ve done a bit of research on-line thanks to the many resources offered here. However, I don’t see much about my particular brand of P. If anyone has any particular insights or experiences, I’d love to hear them. Thanks, Steve
Response:
>First time poster. Wondering if anyone has experience with guttate >psoriasis. Like Sad Man, I feel like I’m a member of the lucky 2% of the 2%.
Not that it matters, but I think you misunderstood him. What he was talking about was being one of the minority of those with P who react negatively to UV. >I’ve done a bit of research on-line thanks to >the many resources offered here. However, I don’t see much about my >particular brand of P. If anyone has any particular insights or experiences, >I’d love to hear them.
I’m actually kind of suprised that you didn’t find much about guttate as it’s pretty common, especially among kids and with those for whom an infection is the primary trigger. I suppose part of the reason is that other than the more common infection link, there isn’t all that much difference in approaches to that and other forms. There certainly would be tons of stuff in the ng archives that can be searched using the links at http://www.pinch.com/skin e.g. http://pinch.com/skinny?skin=guttate+psoriasis You might also look at some of the other psoriasis communities, such as Ed Dewke’s Flake HQ http://www.flakehq.com/ I’m going to assume you’ve been through the NPF stuff, since you speak of searching yourself. You might talk with your doc about trying narrow band UVB rather than UVB, since that can be more effective for many, including longer remissions. And perhaps think in terms of a combination therapy to boost the benefit of the UVB by using it with something else, whether something that increases photosensitivity like topical tar (CAREFUL about burning risks though) or just layering in another shot at the P. It’s a way to integrate some of the topicals on the most persistant places to get their benefit without driving yourself playing connect the dots in applying it everywhere. You also might want to look for environmental triggers to avoid. The fact that it never went away after it had before would make me look for something that might be re-triggering it despite best efforts to control it. The classic one is infections of course – any chance of lingering strep or any such thing, or even a mild fungal? How are your teeth – any chance of something lingering in there? But also think in terms of things like changing soaps and laundry soaps and moisturizers. Does stress trigger yours? Maybe some regular relaxation techniques would help get things under control. As to diet, there IS no P diet but there certainly are people with dietary triggers, that vary a great deal. You might want to branch out a bit in looking to identify if you have any There actually are a fair number of options to try, ranging from alternative to the most conventional of meds, although none of them work for everyone, and some of them may involve things you don’t want to deal with. The fact that some can be a pain in the butt, such as applying topicals to scattered guttate doesn’t make them non-options, just ones that you don’t want to use. And you always have to remember that most of the people here in the ng are those having the biggest problems or they wouldn’t have the interest to put time into being here. So don’t let that make you think its hopeless. Best Kim The Psoriasis Newsgroup Resource FAQ can be found at http://www.psoriasisfaq.com but will also be coming soon (twice a month) to a newsgroup near you…
Response:
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