May, '01 | briefing | mail | don't say this | flakers' jargon | articles | other places | archives | send mail | ed dewke | legal stuff | order | search | PsorHeads | 2001 Ed Dewke

How Will My Lesions Clear?
from Ryan H.

Hi Ed and Greetings from Iowa:  My name is Ryan, and I am writing you from West  Des Moines, IA.  I really enjoy your insight on P and your responses to others.  I thought I would pick your brain on my situation.  Here it goes...

I have had P for close to a year and a half.  I will, thankfully, admit mine is a fairly mild, but stubborn case.  I have finally been prescribed Soriatane, and have taken 50mg for 5 weeks.  The side effects are nasty, but bearable with the hopes of clearance.  I have a real stubborn area on my legs and this is what is confusing.

My lesions are very flat, do not protrude off the skin much at all.  They flake often and look like they are starting to clear in the middle of the lesion.  How does Soriatane eat away at the lesion and what should I expect to see in the clearing?  Will a brown spot or mark remain after clearing?  I haven't got a lot of feedback from my doctor and I am curious.  Any insight you could provide would be great!

Have a terrific day! -Ryan H.


Ed’s Response:  I think you may not have gotten much response from you derm on these questions, Ryan, because there may not be any pat answers.  While it doesn’t get talked about much, the few exchanges I’ve had in which the process of clearing has been discussed suggest to me that lesions go away about as variably as they appear.

Soriatane is the one popular systemic I’ve not yet tried, so I can’t even talk about myself in this case.  Perhaps some other readers who have cleared on Soriatane will share their experience with us.

I can say  that my lesions clear similarly both with systemics (methotrexate and cyclosporine) and with topical corticosteroids.  First their redness diminishes, then — if the plaques were thick to begin with, and they aren’t always — the plaques will flatten, then the flaking gradually stops and sometimes no sign of the lesion remains while it is hibernating.  (I always say hibernating because I know they are still there and bound to become active again.)  Sometimes a salmon coloring remains and this I tolerate without further application of topicals.  Very rarely, I’ve had lesions clear by small spots of good skin appearing inside the lesion and then growing.  At some point I have an atoll-like lesion and the last remaining “edge of inflammation” usually doesn’t flake but persists in looking weird for quite awhile. (At one time I told gullible people those were the remnants of giant squid sucker marks from my last and nearly tragic deep sea diving adventure.)

Other correspondents have reported lingering skin discoloration and my derm says this, too, will go away if the lesion remains inactive.  Will that happen to you?  I guess the only way to know is to wait and see.

While we await more authoritative observations from other readers, do keep us apprized of your progress.  -Ed

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