Jan-Feb '09 | briefing | mail | interviews | articlespsorchat |  don't say this | flaker creativity | flakers' jargon | spouses corner | other places | archives | send mail | ed dewkesearch | acknowledgments | legal stuff | Flake: Confessions of a Psoriatic  | 2009 FlakeHQ, Inc.

Derm Not Willing to Prescribe Systemics
from Mike R.

Ed: All I’ve used to treat my P for 25+ years is prescription topical ointments, mostly steroids, but I have tried Tazorac and Dovonex. My derm says my psoriasis at its worst is moderate. Is that why he doesn’t want to prescribe pills or biologics?  -Mike R.

*****

Ed’s Response:  Who knows what goes through the minds of these deeply specialized medical professionals?  Ooooooooooooo.

Seriously, though, if by “moderate” your derm means between 3% and 10% of your skin is affected by psoriasis, he may be unwilling to risk the side effects of the systemic medicines that are better options for more severe cases.  It’s impractical and unwise to use strong topical corticosteroids on large areas of skin. Possible skin damage occurs slowly and may be harder or impossible to correct after the fact. Though the systemics can cause dangerous side effects, the most common are easily detectable through blood tests and other symptoms and correct naturally after systemic treatment is stopped.

I’m hoping your derm also has you on some kind of rotating regimen of topicals — using different strengths and different bases — so the effectiveness of any one topical doesn’t wear off. -Ed

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