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Her 2 Pregnancies Affected Her P Differently
from MD

Dear Ed:  First, thanks for the website. I go here when I need to be cheered up about this whole thing. I'm a 36-year old female.  Psoriasis first showed up in my senior year of high school.  I have moderate guttate form; also my scalp and one big toenail are affected.   Mainly on my torso/back but arms and legs get involved sometimes.  Same old story:  worse in winter (I live in New England ), worse with stress, blah, blah.

I thought the following might be of some interest to readers of your website. I wanted to wait and see the results myself. I have two children, one of each (26 months and 4 months old currently). I had two completely different experiences during these two pregnancies. So what does this say about the hormonal influence on psoriasis?

My first child is a girl. My psoriasis (except the toenail) cleared COMPLETELY during the second half of the pregnancy. Nothing, no lesions, clear scalp. I could wear whatever I wanted (tank tops in public for the first time since I was 18, wow!), went to the beach often since she was born at the end of August. Within six weeks after her birth, it all came back, probably more lesions than before. "Crept" out to upper arms, where it had never been before, making it tough to wear short sleeves and not feel self-conscious. At least I could pretend it was mosquito bites (yeah, I don't have the courage to explain to everyone who asks) in the summer.

My second child is a boy. Reverse experience this time. My toenail cleared completely but my body lesions and scalp only lessened somewhat. A lot of the plaques flattened out and became more silverish-red. Enough that I stopped using topical prescriptions and just used a good moisturizer. But I never went back to tank tops or a bathing suit. After the second birth (in July this time), my psoriasis came back quicker — about 3-4 weeks afterward. Seems about the same, maybe a little less than when this all started around 2 years ago. A footnote to the whole thing is that I needed emergency gallbladder surgery 7 weeks after he was born. I had to explain to every single nurse, doctor, surgical staff that it was psoriasis and not a rash or reaction to IV painkillers. A rather humiliating experience.

So this ended up to be a longer letter than I expected, but I wanted to add my experience to the website. I would be interested in hearing form others; also in hearing about the pregnancy/psoriasis study that took place at UC-Irvine. Didn't see (or didn't search well enough?) results here. -MD

*****

Ed’s Response:  Thanks for sharing your experience with us, MD.  Preliminary results from the UC-Irvine study can be found imbedded in my response to this correspondence:  Interested In Pregnancy and P Connection.  I’ve been unable to lay my hands on a copy of the post-study documentation — but will see what I can find after this update to FlakeHQ is posted. 

Another correspondent — this one an inflammation specialist/researcher — shared with me recently a notion that our immune systems might contain their own back-up plans.  That is to say, those same immune response functions that have been associated with P at the protein level may be only one immune response that can trigger P lesions.  This would explain why sometimes the new, narrowly targeted biologics don’t work for people.  (In my case, it could explain why Enbrel didn’t work for me in 2003.  The drug was probably doing exactly what it was intended to do, but my immune system found a work-around, or called up its back-up plan to keep my psoriasis flourishing.)  The same thing may be what makes the pregnancy/psoriasis connection less than 100% certain. 

Furthermore, our immune response back-up plans may not all be hardwired.  That is to say, experience and a sort of biological trial-and-error may make our back-up plans evolve over time and with age.  We know we are not “ready made” to fight off many infections.  We know that our immune system “trains” its fighter cells to identify and thwart certain kinds of malicious invader-organisms.  (This is what vaccinations do — they “train” our immune system to fight certain infections with safe dosages or simulacrums of the bad guys.)  Perhaps your flaking response “learned something” as a result of your first pregnancy and was, therefore, better able to maintain your flaking when you got pregnant the second time.  All of this is theory, so far as I know.

When I can learn more about the UC-Irvine study, I’ll post it at FlakeHQ — even if it’s between updates.  Thanks again for sharing, MD.  -Ed

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