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Recent Graduate from Colitis to Psoriasis
from Michael

I'm new to this psoriasis thing, been on the learning curve for only a couple of months. I have had ulcerative colitis for about 5 years now, but I had no inkling of any connection ‘til I saw a couple of posts about it on newsgroups. As I read it, unfortunately it made complete sense. And now I am, frankly, getting worried.

I am currently using a topical steroid for my P and am obtaining some relief. At first the symptoms cleared completely—or was it that I just THOUGHT they did? I don't know now. Right now I'm only having outbreaks on the soles of my feet and palms of my hands. It does make it awkward walking or doing almost anything.

I am so new to this, I have only been to the doctor once during which the P was diagnosed. But now, after reading those posts, I am getting worried. It isn't going to go away. Is it? Criminey. I'm scared. -Michael

*****

Ed's Response: I know how you feel, Michael, but reserve your fear. You just fell into the hole and have just barely begun to explore ways to get out of it.

My understanding, based on what I've learned from others like you (see "Ulcerative Colitis" in the Archives) is that UC is related to P in being an immunological disorder for which we either are or aren't genetically predisposed. One correspondent called his outbreak of P a "cutaneous manifestation of my ulcerative colitis" which suggests to me the genes involved may be close kin.

You are a good candidate for "a healthcare team," which is the current medical establishment's way of saying several expensive doctors treating you, presumably cooperatively. You didn't mention if the doctor you saw is a dermatologist. If not, I recommend you see one. Email the National Psoriasis Foundation for a referral. If another doctor recommends a dermatologist to you, you should ask that derm if s/he is a member of the NPF. Lots of dermatologists aren't effective P therapists.

There are dozens of topical steroids in varying strengths. If you are currently using a topical corticosteroid for the first time, don't dismay if the results are unsatisfactory. Docs often start low on the potency scale and work up to something that works for you. Plus there are other therapies to consider—a number of light therapies (ultraviolet-B and ultraviolet-A), a number of systemics (drugs taken internally). And the combinations of therapies can keep you busy for a lifetime!

With lots of diligence and some luck you may be able to contain the P, even drive it into remission. So don't get too frightened quite yet, Michael. Consider your glass half full, not half empty! -Ed

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