(February, 1999)

Lesion Starts and Auto-immune Associations
from Judy C.

Hi all! Wow, I just stumbled on to this website and I love it! It seems to me 'flakers' must all have the best senses of humor! I am a 45 yr old woman. I have had P since I was 9 yrs old. What a life: teasing, torture, agony, itching, pain—but you know .

My coverage ranges from 5% up to 75% with at least 3 types of P from head to toe—and in the nooks and crannies. Have you ever noticed how, when you find a med that works somewhat, the P just breaks out in other areas? That's what happens to me, so I often just give up and let it run its course. The strange thing is that every couple of years it'll just improve on its own. Even though it only lasts a few months, generally my P gets better when I let it have its own way.

I have not found sea water helps much. I lived on the east coast most of my life, and now on the west.

One thing I do find helps wonderfully is chlorinated pool water. I've asked the docs but they have no clue.

Oh yeah, I also have the P arthritis and lovely bent fingers as a result.

I am curious as to how many psoriatic's might have Fibromyalgia, Chronic Fatigue Syndrome, Myofascial Pain, or other overlapping conditions. I am a fibromyalgic (severe muscle pain) and the nature of the disorder is anti-immune-related like P, so I wonder if there is a connection?

Hope I didn't take up too much space. -Judy C.

*****

Ed's Response: The space is here for the taking, Judy—so welcome aboard! You bring up an interesting aspect of P that we haven't commented on much: i.e., new lesions starting. I've heard from others who report a consequence of getting lesions under control is sometimes the start up of new lesions. My P steadily grew from onset to about 65-70% total skin involvement at its worst, but now seems to be roosting. I haven't discovered a "new" lesion in probably well over a year. (What I notice is some lesions disappear entirely for weeks or months; others may quiet down but never disappear entirely. The lesions I got from Koebner Phenomenon on my ‘92 appendectomy scar finally faded in ‘97 but re-emerged slightly in ‘98.) I don't think anybody really knows why lesions start where they do, but some people believe they occur at points where the skin is stressed the most. The Koebner Phenomenon is the most obvious suggestion of this. This phenomenon—named after the fellow who first described it—suggests skin trauma through wounds will become psoriasis lesions. It's one reason why P-savvy derms are sometimes reluctant to do optional surgeries. Removing a benign mole on a psoriatic, for instance, may stimulate a new P lesion.

But less dramatic lesion activity can also be stress-suggested. For example, lesions on elbows, knees and knuckles are common, and all these are areas where flexing stresses the skin. Forearms, shins and thighs get rubbed and scratched more than other areas. Genital areas ... well, stressed more for some than others.... Anyway, you get my drift. It's a comfortable notion until you run into those cases where there is major lesion activity and minimal apparent skin stress. Like I suggested, we hypothesize but facts are few and far between.

I thought for awhile I, too, was aggravating more lesion growth by treating the already blossomed ones. But this was during my early P years. I look back on it now and wonder if I wasn't just experiencing a steady spread of the disease that would have occurred whether or not I treated the lesions? Since I can't repeat the process, I'll probably never know.... Comments, anyone?

And your observation about chlorinated pool water is interesting. For about a year—my first year as a P, I realize now—I had it only on my head, in my scalp. This was also the last year I owned a hot tub, which I used several times a week. That was a lot of chlorine-rich soaking. As soon as I stopped hot tubbing, the P started to spread to other areas of my body. Is it coincidence that I usually did not get my head wet in the hot tub? We can but conjecture....

It will be interesting to hear from other Flakers who may share your litany of auto-immune-related conditions. The more I learn about the auto-immune system, the more I think it is an awfully delicate process, easily knocked off kilter.

Thanks for some stimulating inquiries, Judy! -Ed

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