Steroids and Psoriasis

dreamdaisy

I have PA, but mostly just the A, very little of the P. In the past I have had it on my scalp, my soles, the palms and a little patch on the inside of my left ankle. I went to dermatology in January 2007 and I remember them saying that one drug I should not take is oral steroids as they are very bad for P, they tend to fire it up.

In the past few days I have become convinced that the humira had finally given up the ghost: my left knee is now consistantly 3-4" bigger than my right, lots of luvverly fluid swishing around in it, plus my right ankle is also swollen. I have been on a larger dose of pred for 3 weeks now, and indeed the psoriasis is emerging. The patch on my left ankle has grown, and this morning, after my shower and some remarkable contortions, I found some on the sole of my right foot. Deep joy.

Can steroids trigger a flare despite being on an anti TNF? That's my question, can anyone help? I shall post the helpline too. Any replies welcome! DD

speedalong

Oh DD, wish I knew ...

hope you get some answers ...

Speedy

kevlar

Hiya DD,
I'm a little confused about the advice on taking steroids being bad for your P.

I have used steriod based creams and scalp application for many years to combat my P and it has been reasonably effective.

I understand there is a difference between topical applications and oral administration but steriods are steriods. The active ingredient is the same however you take it. (?) Or not?

I'm afraid I don't know what TNF is, so not much help there. But have you tried the various creams applied directly to the effected areas?

dreamdaisy

Hi kevlar (from Gavlar?) thanks for your reply. Yup, I'm doing the creams but they don't do much I have to say. I rarely get psoriasis and when I do it is an absolute **** to get rid of! I do get it in awkward places, maybe that's the problem.

Yes, dermatology were quite adamant that oral steroids, which, let's face it, deliver an almighty kick up the backside to the whole body, are bad for P and that makes sense. Prednisalone stimulates, and the last thing you need with rapid skin renewal is stimulation. I'm not sure what percentage of the cream is steroid-based: I'll have to have a look! As I am currently taking a reasonably large daily dose this led to my musings.

The anti TNF stuff I referred to is an arthritis treatment. In RA and PA a substance is found in the blood stream called TNF - tumour necrosing factor. Anti TNFs were developed to stop this being produced, thus reducing the symptoms of arthritis. Most are based on mouse proteins, mabine, hence inflixiMAB, adalimuMAB, rituxiMAB etc. DD

kevlar

DD you poor soul.

Thanks for the info, you are well ahead of me on anything concerning Arthur.

Very sorry to hear about your fat knee, I've got a Trolls foot attached to the bottom of my leg if that's any consolation.

The steroid cream and scalp lotion I use are 0.1% active ingredient. Doesn't sound a lot but they are considered fairly 'strong' med's in the battle against Psoriasis. I'm told they are not recomended for long term use (they tend to thin the skin) but I have been using them for years.

I also moisturise, I'm probably telling you nothing you don't know already, I can but try. I find moisturising helps, it doesn't make psoriasis go away but does help. I use baby oil.

Gavlar? You are making me feel ignorant now!
I looked it up and assume it's something to do with Tracey and Gavin, sorry, I've never watched it.

Finally.....kevlar is a composite material (plastic), lightweight but very strong, used for bullet proof jackets and soldiers helmets for instance. My name is Kevin and I was given this nickname many years ago when I was lightweight and strong, (I did say many years ago!).

Hope you feel better soon DD.

XX

tillytop

tillytop wrote:

Hey DD
Just looked on the Psoriasis Association Website and found the following info which confirms what you say:
"Steroids are powerful anti-inflammatory drugs, so can have a dramatic effect in treating an acute flare-up of arthritis. In some cases, they are also used long term in low doses to try to keep a balance between the benefits and the potential side effects. If steroids are used in high doses, careful monitoring of the skin psoriasis is essential because rapid changes in steroid dose can cause problems, with dramatic worsening of the skin sometimes to the point of pustular psoriasis and erythroderma."
Couldn't see any mention though of whether anti-tnfs would prevent this happening. Hope someone is able to come up with an answer for you.
Tilly x

woodbon

Hi, Sometimes the skin can become infected, and sore. I have seen this in people I've looked after. They can change the cream to see if that works or give oral antibiotics, if its not responding.
]
I hope that you find some relief soon. Love Sue

marion1952

Hi DD

Sorry - have only just spotted this thread... gosh - a Catch 22 situation, as you say, vis a vis the pred setting off the psoriasis!! I didn't know that..

Sorry - have no suggestions whatsoever - it sounds a nightmare for you at the moment ..

Marion

dreamdaisy

kevlar (yes, you're right, G&S) tilly, woodbon and marion, thank you so much for your replies. It's so nice to have it confirmed that I am not barking! I am reducing the pred earlier and quicker than my consultant wanted but I'm living with the effects, not her. After a good few years of playing this truly appalling game I now ignore the rules and do my own thing. It sometimes works! I have, however, sprouted a new patch on the inside of my right ankle, I suppose it goes compliments the stuff under that foot.

My hairdresser has just cut the mane, and tactfully didn't mention the lumpy red, bleeding and raw spots on the scalp. The little girl who had to wash my hair was not so sure about it - poor thing, I think I've scarred her for life. I told her it wasn't catching but to wear gloves if she wished. She did. I don't blame her. I wouldn't want to touch me either. DD

skezier

Oh DD I so hope it all calms down for you soon. Sending you hopes and healing vibes. Luv and a ((( ))) Cris xx

frogmorton

Oh DD

Poor you

But you do look rather gorgeous now



Think it was worth it.

Had nothing to say of much use till I saw how nice you looked and I hope you mucking around with your meds (as you do!) helps

Love

Toni xx

dreamdaisy

I just muck about for the hell of it. I've suddenly swung to tetchy so I'm off for a while. Odd how it goes, isn't it? One minute quite bright, the next, peeved for no reason! DD

skezier

Hi DD,

Long term conditions can do that to you flower and I hope you soon feel bright again. Cris x

speedalong

DD, what a roller coaster ride. Hope you feel cheery again soon and your meds-tweaking starts to work.

Speedy

annie_mial

dreamdaisy wrote:

I just muck about for the hell of it. I've suddenly swung to tetchy so I'm off for a while. Odd how it goes, isn't it? One minute quite bright, the next, peeved for no reason! DD

DD, high dose steroids cause sudden mood swings with me. I always try to get the dose down more quickly than they want me to, but so far this time it is working well for me.

Annie

dreamdaisy

I'm glad about that annie (that it's working) 'cos you did go through a very rough patch, didn't you? Are the neighbours behaving? DD

annie_mial

Yes, DD, no probs with the neighbours now.......we found out that they had actually been on honeymoon and that all their friends had turned up at the airport at stupid o'clock to welcome them home, so we forgave them.

I've still got problems with legs.....knees, ankles, feet, but think it is partly due to the heat. Awaiting a Rheumy appointment with some trepidation.

However, I do feel much better in myself these days and it does help me cope..........you are going through the grinder so much just now. Hope that holiday helps and that you really, really enjoy it. I know that area quite well, so happy hols!

Annie