Guttate Psoriasis Questions

[dbhill]

Hello All:

I'm new to this board and new to psoriasis. I'm having my first guttate psoriasis outbreak (as a result of a strep infection) and I'm looking for advice.

I have guttate psoriasis EVERYWHERE - arms, legs, stomach, back, face, scalp, and ears.

First, will this actually clear up on its own or is some type of treatment required? I read a paper that said it will clear up in a matter of weeks. After reading messages on this board, that doesn't seem correct. How long does a typical flare-up last?

What is the current opinion of using prednisone to treat guttate psoriasis?

Once you have an outbreak like this does it keep coming back? I'm trying to prepare myself mentally for having to deal with this for the rest of my life.

Thanks for whatever help you can provide. I've gotten so much good information from this site already. I've been taking oatmeal baths and I think I have every Aveeno product on the market. I'm trying to keep a positive attitude, but it's difficult at times.

Thanks Again,

Daria

[twinieten]

I have guttate psoriasis EVERYWHERE - arms, legs, stomach, back, face, scalp, and ears.

When I first broke out (arms, legs, back, chest, stomach) it was warm out so I bought short shorts and tank tops, and walked to pick my son up from school daily in my get-up. Not a pretty sight ;) but when I read it could help the p, I didn't care.

First, will this actually clear up on its own or is some type of treatment required? I read a paper that said it will clear up in a matter of weeks. After reading messages on this board, that doesn't seem correct. How long does a typical flare-up last?

I've read that it'll clear up on it's own, but I don't know if I buy that. I didn't wait. My derm gave me Olux foam which was very easy to apply but it's a class 4 steroid, very potent. I waited 2 weeks before seeing a derm, and only after using the Olux did it clear up. It took about two or three weeks, if I remember right. I celebrated by shaving my legs. :D

My son's p has not cleared up in years. It will respond well to a new treatment only to get bad again. Only now does it actually look like it's on it's way to healing. Any new spot we go after will typically respond well to topicals depending on location (knees, they'll stick around for months, but trunk, gone in a couple of weeks).

When my son got scalp p, we used a liquid floucinolone that worked really well (good for scalp, ears), cleared it up practically over night. I don't have it anymore, so I've just been using Psoria Gold or Desonide ointment on the spot.

Dulane and others love Suave Natural conditioners for their scalp p, and Sally has been using psorolin or 777 oil on her scalp with good results. There are a few threads going about scalp p right now. Probably you have already checked them out.

What is the current opinion of using prednisone to treat guttate psoriasis?

I dont' know for sure, but I think prednisone is bad news for p.

Once you have an outbreak like this does it keep coming back? I'm trying to prepare myself mentally for having to deal with this for the rest of my life.

It varies from person to person. Mine went away and hasn't come back completly (2 years). I get a few spots every now and then which respond well to Psoria Gold alone. I have a plaque on my elbow that hangs around but doesn't bother me. My son has pretty severe hand p, and random other spots which seem to be responding well to antibiotics, PUVA, topical steroids and Psoria Gold in combonation.

You may want to check out the psorolin thread.

I'm trying to keep a positive attitude, but it's difficult at times.

It's alot easier with a group like this!

[MikeK]

Hi Daria,

Welcome to the Board! :cool: Nice to meet you. I'm sorry to hear about your diagnosis. :(

You asked:First, will this actually clear up on its own or is some type of treatment required?This is one of those "it depends" questions. Psoriasis is a very individual disease. Some people are lucky and they recover without treatment. Other people need to treat their disease very aggressively. Hopefully you'll be one of the lucky ones.

You asked:What is the current opinion of using prednisone to treat guttate psoriasis?When used correctly prednisone can be used to calm a serious psoriasis flare. If prednisone is not used correctly it can actually cause what's called a "rebound flare" that makes the initial outbreak seem minor by comparison. The correct way to use prednisone is to gradually reduce the dosage. Here's a link to a previous discussion: http://www.psoriasis.org/forum/showthread.php?p=184469&highlight=taper#post184469.

You asked:Once you have an outbreak like this does it keep coming back? I'm trying to prepare myself mentally for having to deal with this for the rest of my life.Once again, psoriasis is a very individual disease. Some people are lucky and they only experience an initial outbreak and then it never comes back again. I hope and pray that you're one of the lucky ones.

You mentioned that your psoriasis was triggered by a strep infection. Unfortunately, your story is far too common around here. :( More then a few people have posted that either their psoriasis (or their child's psoriasis) was either triggered by or gets worse when they have some sort of infection. (Just about any infection can trigger a psoriasis outbreak, but strep is the usual culprit.) Many of these same also people report that their psoriasis (or their child's psoriasis) won't respond to treatment until the underlying infection is taken care of. They also report that very often the psoriasis outbreak is the only sign that they have infection because they are asymptomatic for the infection. (I.E., They don't have a sore throat or fever in the case of strep.) The point of all this is to let you know that you have to listen to your body. If your psoriasis isn't responding to treatment or if you experience another outbreak and you don't feel sick then you need to get a strep test. Insist on a culture because the so called light treatments are often unreliable. Some people have to get a blood test (called an ASO blood test) to confirm that they have strep. Here's the links to some previous discussions:

Here's a link to some previous discussions about psoriasis and infections:

http://www.psoriasis.org/forum/showthread.php?t=7538&highlight=importance+strep+test;

http://www.psoriasis.org/forum/showthread.php?t=3074&highlight=presentation+strep;

http://www.psoriasis.org/forum/showthread.php?t=4988&highlight=uti; and

http://www.psoriasis.org/forum/showthread.php?t=18602&highlight=aso. (The ASO blood test is discussed in this thread.)

You also need to be aware that certain medications (i.e., beta blockers that some people take for high blood pressure, etc.) are known triggers for psoriasis. Here's a link to a previous discussion about psoriasis and beta blockers: http://www.psoriasis.org/forum/showthread.php?t=3503&highlight=inderal. I'm also seen posts from at least one person whose psoriasis was triggered by an anti-malarial drug (http://www.psoriasis.org/forum/showthread.php?t=18739&highlight=malarial) and from at least one person whose psoriasis was triggered by Lipitor: http://www.psoriasis.org/forum/showthread.php?p=221451&highlight=Lipitor#post221451.

Finally, here's a link to the NPF's discussion of psoriasis triggers: http://www.psoriasis.org/about/living/triggers/.

Guttate psoriasis very often responds to UVB light treatments. Light treatments can be a pain (literally -- some people have been burned by them) because you'd have to go three times a week -- for several months -- for treatments. They don't work for everyone and you may run into insurance issues, but they can also be a very effective weapon in your battle with psoriasis. Home units are available and are often covered by insurance. (As I mentioned, some people don't respond well to light treatments so most doctors and insurance companies generally require that most people undergo their initial light treatments at a doctor's office. Several people have posted here that they were able to waive that requirement and they were able to get coverage for a home unit without going to a doctor's office for treatments. The NPF has an insurance advocacy service that goes to bat for people who are having insurance issues. Here's a link to the NPF's discussion of UVB treatments: http://www.psoriasis.org/treatment/psoriasis/phototherapy/.

Finally, I find that the kind soap and laundry products that I use makes all the difference in the world. Antibacterial and deoderant soaps, for example tend to irritate my psoriasis and make it drier and itchier then it already is. I've had similar problems with the dyes and fragrances in detergent and dryer sheets, etc. I havnen't had any laundry related problems since I switched to "free and clear" laundry products. And, here's a link to a previous discussion about psoriasis and soap: http://www.psoriasis.org/forum/showthread.php?t=13629.

I'm sorry that this has turned into such a novel. You're probaby suffering from information overload. :rolleyes: I hope that it helps in some small way. Good luck. Keep us posted. Let us know if you have any other questions and please don't be a stranger.

Mike

[lovinlife]

Hello Daria. I too broke out for the first time with guttate P about ten years ago after a strep throat infection. I was covered from head to toe in P. UVB and a big old tub of topical hydrocortisone that my derm prescribed cleared me very quickly... 3-4 weeks as I recall. I never cleared 100% and have been battling with plaque P, inverse P, scalp P, etc... with topical steroids.

As everyone mentioned, P varies and people respond differently to treatments. I hope you get the answers and support you need here. Good luck!

[RichJ]

hi daria,
sorry i can't help much but welcome to the p family. you have met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you

have a good weekend all

richard

[dbhill]

Thank you everyone for your thoughtful responses.

After reading a little more (thank you for the links MikeD :-) and talking with my general practitioner, I've decided to try the Rx for prednisone. They did prescribe a low dose for 5 days (starting at 40mg) and tapering off by 10mg every two days. I should be off the stuff completely in 11 days. I'm going to keep an eye on my skin near the end and run (not walk) to the doctor if I see any changes.

Keeping my fingers crossed and hoping this works.

Drea, I really give you credit for walking around with shorts and a tank top while having your gp outbreak. I haven't even been able to wear short sleeves since my outbreak started. I'm usually not a vain person, but this is really making me feel insecure. Off the topic, I love the icon you use by your name. My mother's family is Ukrainian and I have memories of my grandmother making Pysanki eggs during Easter. I unfortunately have not kept up the tradition at my house.

Thank you again for taking the time to respond to my questions. Can't tell you how comforting it is to know that I'm not alone.

Warm Regards,

Daria

[mom2IS]

I've been covered with Guttate for about 2 months now. I ordered some dead sea salts from Amazon, brand Masada, that helped. I just started UVB last week and it might be helping a bit too, at least it's not worse.

Good luck!

[dbhill]

Just wanted to follow-up on my previous post.

The prednisone helped initially. Especially on my face and chest. However, when I started to reduce the dosage the patches on my face got red again. Since I am STILL waiting to see a dermatologist (I go next week), I went back to my primary care physican and they gave me clobex lotion. I've been using that since Tuesday and I'm finally starting to clear!

I've also gone to a tanning salon a couple of times. I found that five minutes in a stand up bed helps even out my skin color a bit. Especially on my face, the guttate was making it very red and blothcy.

Lovinlife - I'm sorry that you have had to battle psoriasis for 10 years. Is is constant or do you have some periods of remission?

Mom2IS - Is the UVB treatment helping? I recently started taking epsom salt baths and thought I saw a difference. I'm waiting for an order of dead sea salt from San Francisco Bath Salt.

I'm feeling a little bit more in control of this, but I'm still scared of what might happen next. Yesterday, I started to feel a sore throat coming on and I freaked. So worried that I'm going to get strep again and start this whole process all over ...

Hope everyone is having a pleasant holiday weekend.

Daria

[Tat2U]

I started with this P at age 13 and it would come for a month or two and then be gone for a few years and then do the same thing. I am now 31. I never had strep in my life. Then 3 years ago, my son got strep, and I had a breakout and have had it ever since, even though I didn't get strep. That was 3 years ago. Psoriasis has so many variations in the way it flares to the way it responds to treatment. Everyone is different, and that makes it hard to even guess how yours will be. I wish you luck and clearer skin!

Wellcome, there are some really cool people on this message board!

[twinieten]

Just wanted to follow-up on my previous post.

The prednisone helped initially. Especially on my face and chest. However, when I started to reduce the dosage the patches on my face got red again. Since I am STILL waiting to see a dermatologist (I go next week), I went back to my primary care physican and they gave me clobex lotion. I've been using that since Tuesday and I'm finally starting to clear!

I've also gone to a tanning salon a couple of times. I found that five minutes in a stand up bed helps even out my skin color a bit. Especially on my face, the guttate was making it very red and blothcy.

Lovinlife - I'm sorry that you have had to battle psoriasis for 10 years. Is is constant or do you have some periods of remission?

Mom2IS - Is the UVB treatment helping? I recently started taking epsom salt baths and thought I saw a difference. I'm waiting for an order of dead sea salt from San Francisco Bath Salt.

I'm feeling a little bit more in control of this, but I'm still scared of what might happen next. Yesterday, I started to feel a sore throat coming on and I freaked. So worried that I'm going to get strep again and start this whole process all over ...

Hope everyone is having a pleasant holiday weekend.

Daria

I hope you're not putting Clobex on your face! It's a strong steroid and can cause skin thinning amoung other problems. Don't use it on your face. You can use an OTC hydrocortizone!

But, I"m glad it's working for you! Call the derm and see if there have been any cancellations, see if you can get in earlier.

[twinieten]

I started with this P at age 13 and it would come for a month or two and then be gone for a few years and then do the same thing. I am now 31. I never had strep in my life. Then 3 years ago, my son got strep, and I had a breakout and have had it ever since, even though I didn't get strep. That was 3 years ago. Psoriasis has so many variations in the way it flares to the way it responds to treatment. Everyone is different, and that makes it hard to even guess how yours will be. I wish you luck and clearer skin!

Wellcome, there are some really cool people on this message board!

Were you tested? Was your son tested? Is it possible he or you are carriers and asymptomatic?

[dbhill]

I hope you're not putting Clobex on your face! It's a strong steroid and can cause skin thinning amoung other problems. Don't use it on your face. You can use an OTC hydrocortizone!

Thank you for clairify this Drea. I am NOT using the Clobex on my face. Yes, this is a very strong steroid. The package insert makes it clear that you should treat this stuff seriously, use it sparingly, and not apply it to your face or underarms.

For some reason though my face is clearing too. Maybe it's because of the steriod I'm absorbing through my skin?

[twinieten]

Thank you for clairify this Drea. I am NOT using the Clobex on my face. Yes, this is a very strong steroid. The package insert makes it clear that you should treat this stuff seriously, use it sparingly, and not apply it to your face or underarms.

For some reason though my face is clearing too. Maybe it's because of the steriod I'm absorbing through my skin?

I was pretty "stupid" about the whole thing. The doctor sent me home with the prescription for the cream, told me to apply it twice a day, and sent me on my way. I did not read the insert or look anything up on the internet. I just did was I told, and I did use the stuff on my face. Thank goodness it did not cause damage! With my son, I just kept going and waiting for his p to clear, using Clobex semi- regularly. For a year! UGH! I am annoyed with my son's derm (his old one) for not stressing the seriousness of this medication, but I can only blame myself for not being an educated patient and parent. Thank goodness the stuff did not cause damage to my son's skin and as far as I can tell, has not had any other negetive side effects on his system. I haven't made that mistake again! Now I make sure to read the insert and educate myself about everything!

[Dulane]

Strep causes cavities.

I suspect we all have strep cruising around in us. Perhaps better dental health will help, but I am convinced if you clean up your diet to avoid things that allow strep to flourish, it would also help deter psoriatic outbreaks.

Of course, that would be the same anti-inflammatory diet that many of us use for therapy. Plus foods like ginger, garlic, coconut oil, oregano oil, grapefruit seed extract, etc. And topical anti-bacterials, too. Like tea tree oil, etc.

:rolleyes:

[twinieten]

Strep causes cavities.

I suspect we all have strep cruising around in us. Perhaps better dental health will help, but I am convinced if you clean up your diet to avoid things that allow strep to flourish, it would also help deter psoriatic outbreaks.

Of course, that would be the same anti-inflammatory diet that many of us use for therapy. Plus foods like ginger, garlic, coconut oil, oregano oil, grapefruit seed extract, etc. And topical anti-bacterials, too. Like tea tree oil, etc.

:rolleyes:

I use toothpaste containing xylitol and I keep xylitol gum handy. Trident has even come out with a xylitol gum! The strep that causes cavities is different than the strep that causes strep throat. I don't know if that matters. My doctor and dentist would both say that one has nothing to do with another, but I wonder.... everything is connected, afterall. A good diet, good oral health... it certainly can't hurt.

[bsblover223]

i recently was diagnosed wihth P and i was advised not to get light treatment from my derm and rather to get lots and lots of sun! i also use prescribed creams, but ive discovered that the sun really really helps! everyday i can im out in the sun tanning and i had a very sever case which started a month ago all over my body and it is now almost all gone! i hope it never comes back but well see!
have any of u ever tried just getting a lot of sun to clear it up??

[RichJ]

hi bsblover223,
im sorry that i can't help much but welcome to the p family. you have meet some of the wonderful people on here and will find alot of great info. welcome and nice to meet you.

try and have a good day all

richard

[dbhill]

Hello to all my friends on this message board!

Happy election day.

I just past the two year anniversary of discovering that I had Guttate Psoriasis. I self diagnosed myself after reading through this board. I can't tell you how grateful that I am that this site and the National Psoriasis Foundation exists.

After doing research on this site, I went to a dermatologist who specialized in psoriasis and I received UVB treatment for 12 weeks. It completely cleared my skin and I've been clear ever since.

I remember when I was first diagnosed, I was worried it was the start of a lifetime of battling psoriasis for me. I am grateful that I have been clear for this long but will never take having clear skin for grated again.

I plan to be a lifetime member of the NSF.

I still worry about being exposed to strep throat, but next time I'll know how to get the appropriate help more quickly. I'm still amazed at the lack of knowledge about psoriasis so many of the doctors that I went to had. Since my outbreak, I have been trying to let people know about the strep throat and GP connection.

Sending positive thoughts to everyone.

Warm Regards,

Daria

[RichJ]

hi daria,
this place is a wonderful place to learn about and every thing goes along with having it. congrats on your clear. i wish you the best

have a good day all

richard