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Why is it so difficult to get information about rashes?

By Anonymous October 15, 2015 - 12:36am
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Four years ago I developed a rash that seemed to constantly move to different parts of my body and eventually displayed as 5 distinctly different rashes. I recognized 3 types of psoriasis. I was put on steroids and told to use 3 different strengths of steroid cream. The skin on the palms of my hands and bottoms of my feet split and hurt so much I couldn't walk and my hands had to be wrapped most of the time. The oral steroids seemed to work - as long as the dose was kept at a certain level. I started breaking out about a month ago with another full body rash. This time I decided not to go to any of the doctors I went to before - no blood samples, no biopsies no allergy strips (all with no results!) This time I am thinking for myself what might be going on. Last time I was miserable for over a year and the rash started subsiding regardless of what I did. So far, this time, the rash covers more of my body and hurts more (I think) and it is all over my face, making my eyes swollen and miss-shaped and I am peeling or shedding too much to go to the grocery store. I am in pain, but not as frustrated as before.

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Hello Anonymous,

Welcome to the EmpowHER community. My heart goes out to us for the suffering you have endured for the last four years.

What sub- specialists have you consulted? A rheumatologist? A dermatologist? An allergist?

Psoriasis is a chronic, inflammatory, immune-mediated, multi-system disease with a prevalence of approximately 1% to 3% worldwide. Palmar-plantar psoriasis is a specific type which most often appears on the palms of the hands and soles of the feet.

Coal tar products, salicylic acid, and corticosteriods are commonly prescribed. Palmar-plantar psoriasis is relatively resistant to even the most potent topical therapies, likely due in part to the thickness of palmar and plantar skin.

Sometimes doctors suggest alternating topical corticosteroids with a type of vitamin D called calcipotriene. Wear cotton gloves when applying it to avoid getting it into sensitive spots, such as on your face.

Psoriasis is an immune system condition, so if skin treatments don’t work, your doctor may recommend drugs that affect the disease at a cellular level. These include:

Methotrexate, which slows an enzyme that causes the rapid growth of skin cells in psoriasis
Cyclosporine, to slow down your overactive immune system
Low-dose retinoids like acitretin (Soriatane), to reduce cell multiplication

Doctors often combine retinoids with light therapy for hands and feet psoriasis. You might have UVB or psoralen-UVA (PUVA) phototherapy or targeted phototherapy (laser treatment). PUVA involves taking the drug psoralen, either by mouth or applied like paint, along with the light therapy.

A rash is a symptom caused by a variety of conditions.

Pemphigus is a general term for a group of rare autoimmune blistering skin disorders. Autoimmune disorders occur when the body's own immune system mistakenly attacks healthy tissue. The symptoms and severity associated with the various forms of pemphigus vary. All forms of pemphigus are characterized by the development of blistering eruptions on the outer layer of the skin (epidermis).

Toxic epidermal necrolysis (TEN) is a rare, sometimes life-threatening unless properly treated, immunological disorder of the skin. It is characterized by blisters that meld into one another to cover a substantial portion of the body (30% and more), and extensive peeling or sloughing off of skin (exfoliation and denudation). The exposed under layer of skin (dermis) is red and suggests severe scalding. Often, the mucous membranes become involved, especially around the eyes (conjunctivitis), but also the mouth, throat, and bronchial tree.

In adults the disorder is usually caused by a reaction to taking a pharmaceutical drug, especially anticonvulsants, non-steroid anti-inflammatories, and/or some antibiotics.

Anonymous, I don't know if any of this information comes close to what you have been looking for. I can only suggest, if you are not satisfied with the level of care that you are currently receiving, look elsewhere, particularly at a hospital associated with a major medical school or in a major city.

Best regards,

October 15, 2015 - 8:31am
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