vs. Light Therapy
from Shaida W.
Your website was brought to my attention by the folks at Genetech after
attending a seminar on Raptiva.
thanks to you and all those who have shared their humor, solutions, and
most of all their pain. It takes guts to be vulnerable.
My P problem started a year ago following a course of antibiotics and a
year after my menopause. I turn 50 next December. I do have other
problems — high cholesterol, the onset of osteo, and seasonal asthma.
My P is mainly concentrated on my hands and feet with small patches on
knees and elbows. I am alarmed at its rapid progession and on my last
visit to the doctor insisted on phototherapy. I have an appointment for
Sept 18, but at this point weighing two options: Biologics or
phototherapy? Any advice? I should point out that money is not an
issue. My insurance would cover both. I am concerned about the time
involved for phototherapy. I work full time, have a demanding job and
an equally demanding 4-year old daughter. I am also thinking that if my
problem is systemic, then phototherapy would not guard against further
spreading, but the biologics will. Am I right? On the other hand, the
biologics are so new and therefore a bit scary.
By the way, one thing I find that keeps my P under control is my asthma
meds. I think if I hadn't gotten off them during the summer, as I
usually do, my skin would probably have been in better condition. As
for bathing in the ocean, it didn't work for me. Then again, I binged
heavily on junk foods and wine as always on those vacations.
Would very much appreciate your thoughts.. And once again, thank you for
providing this site. -Shaida W.
Response: Hello Shaida, thanks for writing and your kind words about
our web site.
I heard the other day that researchers are discovering so-called "adult
onset psoriasis" may be subtly different than the life-long version of
the disease. I, like you, fall into the "adult onset" category. Now
researchers are doubting whether or not our form of the disease has an
inherited component. Anyway, I'm trying to find more information on
Meanwhile, regarding your choice between phototherapy and trying a
biologic: The various versions of phototherapy are "tried and true" and
have helped many hundreds of thousands of flakers over several decades.
Biologics are a few years old and, for the treatment of psoriasis, are
still somewhat experimental. Given those distinctions, a lot of people
would encourage you to try phototherapy first. If it works, and you can
accommodate the inconvenience of the regimen, GREAT. These folks would
tell you to consider biologics a "second choice" if and when
phototherapy loses its advantage.
As my tryst with phototherapy was unusually brief — after a handful of
visits it became obvious to all concerned that I was NOT a good
candidate — I don't have a good handle on the true costs involved.
Obviously you have to factor in more than the fee for use of the
machinery and clinic time (e.g., gas to get there and back, your
time...). The costs of biologics, on the other hand, is pretty well
established for the moment — and it's HIGH, at about $12,000-$15,000 per
year. You say cost isn't a factor because you know your insurance will
cover either regimen. That would point my consideration back to safety
and convenience. Both phototherapy AND biologics are supposed to be
"safe," but phototherapy has the "experience edge." Biologics, though,
win hands down on convenience — especially if you use a biologic that is
self-administered by subcutaneous injection (Enbrel, Raptiva, Humira),
as opposed to in-office IV infusion (Remicade) or in-office
intra-muscular injection (Amevive). If you are suffering from both skin
P and P-arthritis, you best bets among the current crop of biologics are
probably Enbrel or Humira, both of which are conveniently
Let us know what you decide and how it work! -Ed
Thank you for
your kind reply, Ed. That's interesting about the "adult onset"
version. However, if I were to consider my family history that in
itself could be hereditary. Both my sister and father were afflicted in
I had my
consultation for Phototherapy yesterday. You're right, the schedule is
pretty daunting. I'm going to try it for a couple of months — at the
risk of losing my job and being divorced!
mention that since I last wrote to you, I bought a copy of Dr. Pagano's
book [Healing Psoriasis: The Natural Alternative]. I haven't
gone full steam on the diet and detox. (Maybe next year I'll take some
vacation time and do so.) However, I've been avoiding some
suspicious foods — cheese, the nightshades, and sugary stuff. The
result has been very impressive. Itching far less. Cracks have healed
and no new ones for more than a week! Small victory, I know. Also I'm
still on Flovent (Asthma med) and scared to get off, in fear the wrath
of P might descend once again.
fingers crossed and thumping wood! -Shaida
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