Stages

Posted Sat 19 Aug 2023 10.55 by WiltshireNigel

Have had the problem, head to toe, or 9 months now. Until 5 weeks ago only treatment has been 1 month selected site steroid cream and advice to use Dermol 600 emollient and frequent use of Dermol moisturiser. Just started, Risankizumab injections. However I have no idea what is good or bad skin wise. I am scaly, fully peeling, pink and shiny or dandruff like. What are the stages and which is the one showing improvement? Thank you in advance for information. I sometimes think my local Dermatology department wouldn't tell me if it was raining outside. Frustrating.

Posted Sat 19 Aug 2023 14.59 by Steview
A P sufferer for over 30 years, through good and bad times.

Firstly well done to be prescribed biologics if you have only had P for 9 months. Now stages of clearance could vary but as P starts to respond to treatment in my experience with plaque P is that the edges of the plaque start to thin out and start to heal (new pink skin) As this continues the rest of the plaque thins out and healthy skinny starts to show through. Once the new skin is smooth it can be a different shade compared to the existing clear skin. The skin tone should match up over time. That was my experience anyway. Good luck with the treatment.

Posted Sat 19 Aug 2023 19.27 by mt382

Hi again Steview! Nothing to add to the OP, but it is odd how much of a lottery it seems to be with biologics. I'm a month into my acitretin, but mentioned headaches in an email and were off to biologics now. I don't know if it's trust specific or just down to the individual Dr.

Posted Sun 20 Aug 2023 22.33 by WiltshireNigel

By area I suppose but also the severity?

Posted Sun 20 Aug 2023 22.46 by Steview
A P sufferer for over 30 years, through good and bad times.

Hi Mt382, that is good news, at least you have given acitretin a go. Who knows whether it is Trust or Dr specific. They have their own budgets to meet I suppose and of course there are the NICE guidelines. Do you know which biologic you are in line for? @WiltshireNigel, yes the severity could influence a decision but there are many sufferers in the UK with sever cases that have to follow the NICE guidelines. You have been very fortunate to go onto biologics so soon if you haven't tried systemics. Good luck both of you.

Posted Mon 21 Aug 2023 21.46 by mt382

Hi Steview, Humira first, then who knows how long for. My Dr was quite understanding of my own position - a clinical, patient facing role with lots of exposure to disease, and agreed that whacking my immune system (not to mention energy levels) with metho or cyclosporin would not be in best interest. I asked her specifically whether patients need to go through systemics first and she said "you only really need to try one". We're also regularly taught that NICE guidelines aren't dictation, and doctors can basically so whatever they want if they're comfortable justifying it. Just writing this so others can read and really push for biologics if that be their preference. Anyway - this is highjacking the thread a little. My psoriasis has basically begun to clear on acitretin - I had an immediate shedding of skin from plaques and a gradual imperceptible fade, but of all the meds I imagine acitretin clears differently to immunosuppressants so probably not that comparable. Maybe loss of thick scales is first?

Posted Tue 22 Aug 2023 17.06 by WiltshireNigel

I am so new and u knowledgeable. Today I am flaking everywhere. Should I exfoliate? What should happen next? Should I be moisturising? Sorry but I have been given none of this information. Thanks for all answers and advice above.

Posted Tue 22 Aug 2023 20.43 by Steview
A P sufferer for over 30 years, through good and bad times.

@WiltshireNigel If you bathe in the dermal 600 that should help with thick patches. What should you do now? This depends how well you respond to the meds, just let it do its work Definately keep moisturising. You may also need some steroid cream for any stubborn patches to help it along. Even when you get clearance it is still good practice to moisturise once or twice a day.

Posted Fri 25 Aug 2023 11.08 by OhNo_NotAgain?

@WiltshireNigel: I would recommend mositurise rather than exfoliate, certainly as an intial regime. I would also suggest that you look at the top of this page and click on "information and support". The Psoriasis Association has a lot of good information to help you, you can even contact them directly (details at the bottom of this page).

Posted Sat 26 Aug 2023 09.11 by mt382

I'm not new to psoriasis but surely exfoliating risks triggering further inflammation via the koebner phenomenon? Unless I've misunderstood what exfoliating is. I must say, I've tired these past years of topical. Emotionally I just can't take it anymore. This is one of the reasons I finally decided to go near systemics. Funnily enough, since st9pping the acitretin my psoriasis is clearing. The half-life Is so long that the levels in my blood will still be very high so I suppose I'm still technically "on it". To further add to stages of clearance mine are now flattening and shrinking inward

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