Became a Flaker Late, Juggling Meds Since
from Patricia R.

Hi, Ed.  I have been perusing your website for about five years now — never got up the nerve to send an email.

I've had psoriasis now for about six years.  I'm 58 years old.  Guess you could say that I'm lucky since I didn't develop this disease until middle age.  It all started with a wart-like growth on my leg.  This fell off, then I developed several lesions on leg.  Went to the derm and they diagnosed it as psoriasis.

It was rather mild at first.  Then I had a small skin cancer removed from my chest (same derm).  I kept complaining that it was hurting even after it healed — they wouldn't listen.  I went to another derm as I was breaking out all over with plaque psoriasis.  The new derm found a stitch that hadn't been removed — the new doctor pulled it out and injected the site with a steroid.  From then on I have had severe plaque psoriasis.  I'm sure that stress has been a contributing culprit.  Been on Enbrel since then.  It has worked pretty well keeping it in check though not completely clear.

One thing I would like to mention is that quite a while ago I was diagnosed with Fibromyalgia.  Then when I developed Psoriasis (years later), the rheumatologist said I had Psoriatic Arthritis.  Was I developing Psoriatic Arthritis all along before the skin eruptions?   

In November of 2006 I had a colonoscopy.  I have had a flare since then.  Don't know if that was the trigger.  Last month my rheumatologist doubled the dose of Enbrel for 3 months.  (Yes, I have Psoriatic Arthritis as well.  Have bone spurs in my heels — so painful!)  The lesions started to clear, now I am breaking out again — fingers are so sore — can hardly bend them. I guess the Enbrel has stopped working.  He has talked about switching to Remicade.  I don't know.  Topicals don't seem to work very well.  I have tried them all.  Another thing I would like to mention is in December I started the Enbrel Sure Click.  I didn't like it.  I'm back to regular injections I give myself.  I was wondering if the delivery of the med from the Sure Click pen might have caused the flare?  It was a lot more painful that the regular injection.  So I don't know.

So tired of dealing with this.  Going to the derm tomorrow and will ask him about light therapy — a unit that I can use at home.  Never done this before.  My daughter suggested that I go to the tanning salon with her.  I asked the doctor and they don't recommend it.

Glad you are doing well after your heart surgery.  Keep doing what you are doing (so well at FlakeHQ!).

Regards, -Patricia

*****
Ed’s Response:  Thanks for writing, Patricia.  I'm hearing from more and more people that are finding the good results they've had from Enbrel wear out with time.  This has been true for virtually every medicine in our western arsenal for treating P, so I guess we should not be surprised that it's true for the biologics, too.

With P, PA, and Fibromyalgia you've got a lot to keep track of.  (I looked up Fibromyalgia on WebMD and was surprised at how little is really understood about the disease.  Inflammation — one of the biggest culprits in P and PA — does NOT seem to be a factor, nor was there any suggestion in the article I read that it could be an autoimmune disorder (like P and PA). 

If I were in your position, Patricia, I'd ask try other biologics.  Remicade seems to be preferred over Humira, though both are approved for the treatment of Psoriatic Arthritis and known to help skin P, too.  The in-office infusion protocol for Remicade makes it inconvenient for some people (like me) who opt, instead for the do-it-yourself subcutaneous injections of Humira.  Either of these are good candidates for an alternative to Enbrel. 

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