Psoriasis- Desperate!

caroledge: psoriasis is a negative in my life. I’m hoping you have a solution or suggestions how to live with it. I have taken Otezla 2x day for 4 years plus clobetatol .05% applied 2x day to assorted psoriasis areas of skin. No matter the psoriasis flares for no known reason to: Large areas as well as small areas appearing on arms, legs, torso, back. Huge plaques as well as smaller ones grow abundantly; then they seem to reduce in size for unknown cause.
I will appreciate all help you can suggest. My internal med doc does not seem to know what else I can do.
Help! dbamos1945

caroledge: psoriasis is a negative in my life. I’m hoping you have a solution or suggestions how to live with it. I have taken Otezla 2x day for 4 years plus clobetatol .05% applied 2x day to assorted psoriasis areas of skin. No matter the psoriasis flares for no known reason to: Large areas as well as small areas appearing on arms, legs, torso, back. Huge plaques as well as smaller ones grow abundantly; then they seem to reduce in size for unknown cause.
I will appreciate all help you can suggest. My internal med doc does not seem to know what else I can do.
Help! dbamos1945

@dbamos1945 I took Methotrexate and it cleared my psoriasis. Unfortunately I had to stop it because it is not good for my liver, long term.

Then I was on Stelara which wasn’t as effective, and neither was Skyrizi. Now I am taking Bimzelx injections every eight weeks and that has cleared my skin. Of course, psoriasis is an auto immune condition that cannot be cured, but with the right medication for you (each person reacts differently to any one given treatment) it can be controlled.

I have psoriatic arthritis, so I have both the arthritis and rash. I think I had it most of my lift and didn't know it because it was very mild when I was young. Once it hit menopause, my psoriasis exploded.

I tried all the usual things, UVB light treatments, clobetasol (which wasn't enough for almost my entire body), changing diet, and nothing was helping, so I started Humira. It took quite a while to work, but after about a year and 1/2 or so, I was about 75 to 80% clear. I did have many problems with my pharmacy, though, and ended up getting late doses and missed doses. At one point, I had nothing for about 2 months, so my Doctor at the time suggested I try Consentyx. Well, my pharmacy and insurer denied me for Cosentyx and said I had to try Skyrizi, so I tried that. Apparently, Skyrizi is very successful for many people, but not me, unfortunately. Both my skin and joints went completely downhill while taking it.

Then I had go back to a Rheumatologist because my knee got so inflamed, and had me go back on Humira while adding methotrexate. That worked a bit better, but at one point, she had me take the Humira every 10 days rather than every 14 days. I did that for quite a few months until my pharmacy suddenly made me stop. It figured because the combo of Humira every 10 days along with methotrexate (even though I had awful side effects from the methotrexate) worked the best. I was almost completely clear of my rash once my pharmacy stopped me from taking it every 10 days. Back to every 14 days wasn't working as well, and my side effects from methotrexate were getting unbearable, so I stopped it for about 6 months.

Then at one point, my pharmacy stopped providing Humira all together, so I had to switch again. My Doc and I chose a biosimilar, but it didn't work nearly as well for me.

I have also since completely stopped methotrexate, again due to the side effects. At one point I tried the injectable format instead of the pills because my Doc said some people do better on the injections. It didn't seem to matter for me, though.'

Now, as of 4 or 5 months ago, I've been taking Cosentyx. My pharmacy allowed it this time, I guess because of the failure of Skyrizi and the Humira biosimilar. It has not been working yet and my skin has been getting worse again. The itching had come back full force, though my joints aren't too bad. Maybe it works better for my joints than my skin. At last month's office visit, my Doc and I decided to try the higher dose of Cosentyx (300mg instead of 150mg per month), so I will see how that goes. I am due to my first dose of the 300 mg in about 2 weeks.

There are many biologic options available that target different proteins in the body, so if one doesn't work, there are others to try. It can be frustrating, though, because the results usually don't happen right away. Taking methotrexate along with biologics can help alot if you can tolerate the side effects. Not everyone gets side effects, either.

Anti-inflammatory foods are generally whole, nutrient-dense foods that help reduce chronic inflammation in the body.
Here’s a clear list by category:

Vegetables
Especially colorful, leafy, and cruciferous vegetables.
* Spinach
* Kale
* Swiss chard
* Broccoli
* Brussels sprouts
* Cauliflower
* Cabbage
* Beets
* Carrots
* Sweet potatoes
* Bell peppers
Fruits
Rich in antioxidants and polyphenols.
* Blueberries
* Strawberries
* Raspberries
* Blackberries
* Cherries
* Oranges
* Grapefruit
* Apples
* Pomegranates
* Avocados
* Pineapple

Fatty Fish (high in omega-3s)
Omega-3 fatty acids strongly reduce inflammation.
* Salmon
* Sardines
* Mackerel
* Herring
* Anchovies
* Tuna

Nuts & Seeds
Contain healthy fats and antioxidants.
* Walnuts
* Almonds
* Pistachios
* Chia seeds
* Flaxseeds
* Hemp seeds
* Pumpkin seeds

Whole Grains
Provide fiber that supports gut health and lowers inflammation.
* Oats
* Quinoa
* Brown rice
* Barley
* Farro
* Whole wheat

Legumes
Great source of fiber and plant protein.
* Lentils
* Chickpeas
* Black beans
* Kidney beans
* Cannellini beans
Healthy Fats

Key for anti-inflammatory eating.
* Extra-Virgin olive oil
* Avocados
* Olives

Herbs & Spices
Some of the most powerful natural anti-inflammatories.
* Turmeric
* Ginger
* Garlic
* Cinnamon
* Rosemary
* Thyme
* Basil

Turmeric’s anti-inflammatory compound is called Curcumin.

Drinks
* Green tea
* Black tea
* Matcha
* Water with lemon
Green tea contains the anti-inflammatory antioxidant Epigallocatechin gallate (EGCG).

Other Helpful Foods
* Dark chocolate (70%+ cacao)
* Fermented foods (yogurt, kefir, kimchi, sauerkraut)

Common inflammatory foods to limit:**
* Refined sugar
* Ultra-processed foods
* Refined carbs (white bread, pastries)
* Processed meats
* Excess alcohol
* Trans fats

@njbay how are you doing on the increased dosage of Cosentyx?

@rashida It wasn't working and I have since switched to Bimzelx, but that hasn't been working yet either. I think Bimzelx is causing me some additional issues with my eyes and mouth as well. I keep getting blepharitis as well as psoriasis in and around my eyes and now I have a white tongue, too. I still have to get my tongue checked out but I've already had several treatments for the blepharitis and it goes away but then comes back a while after stopping treatment. I never had this on the other biologics. Actually, while taking Humira, I never had any of these issues, but I can't take that anymore unless I want to pay full price for it. I have to bring all this up with my rheumatologist at my next visit. The last time, she mentioned if Bimzelx didn't work, I could try Tremfya, however, I am skeptical of that working either. It targets the same protein as Skyrizi, which reversed all the clearing I had with Humira, plus my knee blew up while on it.