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Pustular Psoriasis Feet
PLEASE HELP, i have pustular psoriasis on my feet dr wants me to try methotrexate or enbrel?
Ive tried creams and steriods nothing seems to work. what are the risk of these drugs and side effects thanks for all your help
Alright, Methotrexate is a pretty strong drug. It's used in psoriasis as well as in cancer treatments, arthritis, etc. It's use in psoriasis is warranted only when other treatments havent' worked, so I'm assuming that you've already been on other prescription strength meds. As I mentioned, this is a very strong drug. There is a long list of the possible complications and side effects with this drug. The most common side effects are ulcerative stomatitis (mouth sores), problems with blood cells (white blood cells = used to fight infection), nausea, abdominal distress, fatigue, fever, chills, dizziness, and malaise (which means feeling "sick"). If you're taking this drug for psoriasis, then once the beneficial effects are noted, the doctor should reduce the dose to the lowest possible level with long rest periods between doses (again, b/c it's very damaging). Take this medication at bedtime with an antacid (tums, rolaids, etc.) to minimize stomach discomfort. Do NOT take OTC vitamins! Avoid ASA and alcohol (this medication is hard on the liver and ASA and alcohol can cause damage and bleeding). Also avoid contact sports (increased risk of bleeding and increased risk of infection). If you notice any mouth sores report it immediately, b/c that is one of the first signs of toxicity! Keep in mind that some people experience hair loss, but it should regrow after the medication is discontinued. Also make sure to drink at least 2-3 liters of fluid a day to prevent kidney damage. This drug can cause the acid levels in the body to rise, so your urine should be checked for the pH. Because of the increased acid, you may be at risk for developing "gouty arthritis" so if you notice problems with your joints tell your doctor. And because I mentioned earlier that it decreased the white blood cell count, you should avoid crowds and those with infections, also do NOT get any vaccinations while you're taking this medication.
Etanercept (Enbrel) is commonly used in conjunction with methotrexate. Some of the more common side effects of etanercept are upper respiratory tract infection (URTI), injection site reaction (this is administered as a shot), headache, nausea, dizziness, infection, rash, abdominal pain, cough, swelling in the extremities. If you're going to be self-administering these injections, just remember to rotate your sites (you can use the thigh, stomach, or upper arm).
Your doctor or nurse SHOULD explain all of this and more to you when you receive the medication. Whatever you do, make sure that you don't leave that office without a firm understanding of exactly what you're supposed to do and who to call if you start experiencing adverse effects (especially with methotrexate). These drugs are used to control psoriasis, but just be careful. Methotrexate is a strong drug and can cause serious damage if taken incorrectly. Your doctor should be following you closely while taking these meds. I wish you the best! 
At one time described as a variety of leprosy, psoriasis is probably one of the longest known illnesses of humans and the least understood. While its confusion with leprosy may not have been all that surprising, considering its visual appearance on the skin, it was not until 1841 that the condition was finally given its own name by a Viennese dermatologist.
The non-contagious disease, which affects the skin and joints and commonly causes red scaly patches on the skin, are caused by psoriatic plaques, or areas of inflammation and excessive skin production. As the skin rapidly accumulates at these sites, it takes on a silvery-white appearance. It occurs most frequently on the elbows, knees, scalp, and genitals. Psoriasis is surmised to be activated by abnormal activity of the body's immune system. The chronic condition is recurring and varies in its severity. According to the National Institutes of Health, it is estimated that nearly 7.5 million American suffer from psoriasis.
Five types of psoriasis have been identified. The most common form, plaque, is the most preventable form of the disease and is characterized by raised, inflamed, red lesions covered by a silvery white scale. Guttate psoriasis is a form of psoriasis that often starts in childhood or young adulthood. This form resembles small, red, individual spots on the skin which most often appear on the trunk or limbs. Upper respiratory infections, Strep, tonsillitis, and certain drugs have been known to bring on a sudden case of guttate psoriasis.
A particularly inflammatory form of psoriasis, erythrodermic psoriasis is characterized by periodic and widespread redness of the skin. The reddening and shedding of the skin are often accompanied by severe itching and pain. Patients experiencing a erythrodermic flare should see a physician immediately, as the condition can cause protein and fluid loss.
Mostly seen in adults, pustular psoriasis produces white pustules surrounded by red skin. The pus consists of white blood cells. The consition is often localized to specific areas of the body, such as the hands and feet. Pustular posriasis can be triggered by internal medications, overexposure to UV light, pregnancy, systemic steroids, or infections, to name a few.
According to the National Psoriasis Foundation, psoriasis not only has a physical impact on its sufferer, it also has an emotional, psychological, and social impact. This visible disease can change how people view themselves and interact with others. Learning how to recognize and manage your emotions about psoriasis is just as important as treating the physical symptoms.
Stress is a proven trigger for some people who suffer from psoriasis. Psoriasis can erode a person's self esteem and low self esteem can lead to stress, and possibly the worsening of psoriasis. In addition to relaxation and stress reduction, it's important to understand why psoriasis occurs. There are a variety of stress reduction methods which may prove successful in helping to clear an outbreak.
Psoriasis may also appear in areas of the skin that have been injured or traumatized. Called the "Koebner phenomenon," vaccinations, sunburns, and scratches can all trigger this type of response.
Certain medications are also identified as triggers for a psoriasis outbreak. Used to treat psychiatric disorders, lithium aggravates psoriasis in about half of those with psoriasis who take it. Inderal, a high blood pressure medication worsens psoriasis in about a quarter of patients with psoriasis who take it. Indomethacin, used to treat arthritis, has been known to also worsen some cases of psoriasis. Other possible triggers include allergies, diet and weather.
Psoriasis has no known cure, but various therapies can reduce, or nearly stop, their symptoms. No single treatment works for everyone, but something is likely to work in most cases. Finding the right treatment may take some experimentation. Topicals are typically used as the first line of defense. Topicals slow down or normalize excessive cell reproduction and reduce inflammation. Steroids, ultra violet light treatments, or phototherapy, and systemic medications are also commonly used treatments.
Now available for home use to soothe the aches and pains associated with arthritis, psoriasis, tired joints and sore muscles from an active lifestyle. Thousands have benefited from the pain relieving power of these safe, natural, non-prescription treatments.
