Pustular (pronounced Pus-tew-ler) psoriasis is an uncommon, but potentially very serious type of psoriasis. There are two main types of Pustular Psoriasis: Generalized and Localized. If it widespread over the body it is referred to as Generalized Pustular Psoriasis; if it is limited to just one part of the body, it is referred to as Localized Pustular Psoriasis. There are two types of Localized Pustular Psoriasis: Acropustulosis, which occurs only on the tips of the fingers, and Palmo-plantar pustulosis, which only occurs on the palms of hands and/or the soles of feet.
Palmo-Plantar Pustular Psoriasis
In general, Palmo-Plantar Pustulosis is localized to the palms of hands and/or soles of feet. It normally occurs in people between 20 and 60 years old, may be triggered by infection and/or stress. It has also been found to affect females more than males. As with Generalized Pustular Psoriasis, Palmo-Plantar Pustulosis occurs in a cyclical pattern, with new pustules occurring after a period of low-to-no activity.
How is Palmo-Plantar Pustulosis treated?
Palmo-Plantar Pustulosis often proves stubborn to treat. Topical treatments, such as corticosteroids, are usually prescribed first. PUVA, acitretin (Soriatane), methotrexate or cyclosporine (Neoral) sometimes must be used to clear this form. Combination treatment with PUVA and Soriatane (called RePUVA) may also be effective.
Notice that doesn't say "Cured". It only says "treated" because there is not yet a cure. I believe one day there WILL be a cure but until then, thousands of sufferers can only treat their psoriasis. Some will get their psoriasis to go into remission. Others like myself, battle it on a day by day basis.
My psoriasis story.
About 5 years ago I noticed that I had half a dozen small red spots and peeling skin on the soles of both feet. I thought it had something to do with my diabetes to be honest and since it didn't really give me any trouble I just kept putting moisturizer on my feet and ignored it. Not really a smart thing to do not just because I'm a diabetic but because when anything is going on with your body you should have it checked out by your physician.
So after moving with my husband to northern Michigan from Louisiana I came down with the flu, then I had bronchitis followed by the flu again and finally I ended up in the ER room with a case of strep throat. I had been running a fever of about 101 for 3 days at the time. The doctor gave me a shot of penicillin and although they couldn't get my fever to come down they sent me on my way. I ran that fever for another 2 days before it finally broke. That's when my PPPP went wild. At the time I had no idea what it was.
Well maybe 3 days later I start having little blisters pop up on the palms of my feet and hands. I'm like well this is weird and kind of painful. So everyone in my family says oh yea that's hoof n mouth, I'm like the COW disease? lol ok yes they're country folk. Anyway I end up going to the ER Room again where they tell me they think its Coxsackie Virus, (also called hoof and mouth which made me laugh) gives me an anti itch pill because at this point its really starting to itch, I go home, take the pill, fall asleep, wake up, OMG its worse. Like these blisters overnight completely covered the palms of my hands. There were blisters on top of blisters, skin is getting thick, old blisters turning dark red and I am freaking out.... FREAKING OUT! To make things really bad the anti itch pill which was Atarax. The only thing that pill did was make me sleep constantly.
So I go to the dr, my insurance doesn't cover a dermatologist, and he says, "I don't think its Coxsackie or it would be getting better not worse, I think its such and such Eczema (sp?) I'm like ok dry skin you're kidding right? So he gives me some steroid pills to take, alike a 5 day treatment to get the swelling down because my fingers looked like they were going to pop and a medium duty anti itch cream for the itching. Well the swelling came down dramatically, I only occasionally itch, but then my skin was thick like leather, my hands looked like they were rotting, literally, and new blisters coming up on top of the leathery skin which already still had blisters.
Anyway, I start talking to my brother after someone says something stupid to me "Oh that looks like Leprosy" lol Talk about freaking me out... he gets to looking on the web and finds pictures that look exactly like whats on my hands and they are pictures of palmo-plantar pustular psoriasis. NOW I'm freaking out. I frantically search the web, all I can find out? It cannot be cured. You get it you get stuck with it and your life is slowly taken over and ruined by it.... niceeeee! Just wonderful!
For 4 days I couldn't even pick up a glass to take a drink using my hands and now I'm thinking I have to live this way? So I finally find a wonderful website, The National Psoriasis Foundation. What did I find there? I found that no one there is freaking out as much as I am, so it cant be the end of the world if this is what I have.
So I go to the doctor again. He looks at it and says "No thats not PPPP that's coxsackie I'm positive." He gives me a script for some steroid cream and sends me on my way. At this point this had been going on for almost a month. I'm no fool, I knew there was something else going on and not what this doctor was suggesting.
I end up a week later at Urgent Care. The doctor looks and says he thinks that this is eczema and gives me Presidone 60mg a day for 7 days and a medium duty steroid cream to slather on twice a day. I clear up. Completely. But about 6 days later the blisters start coming back. So I go back to Urgent Care because at least that doctor made me feel he wanted to help. Well he is there but not working so he talked to the doctor who was on duty and she turned out to be very nice, very caring. She tells me that it 'could be Coxsackie' but she thought it looked like possible psoriasis. She gives me a super potent steroid topical. This worked great, although I havent been clear since I took the Presidone. She also went beyond what she needed to do and found a dermatologist who accepted my insurance.
Well I went to the dermatologist. I don't like her. But she diagnosed me right away with PPPP. She gives me a script for Halobetasol ointment which is a super potent steroid and sends me home.
I can only use steroids for 2 weeks at a time due to problems that can occur from it getting into the bloodstream and into my liver and kidneys. Occasionally you'll find me ranting and raving about how I'm feeling. That's part of why I decided to blog here. Although the National Psoriasis Foundation is a wonderful site for information and socializing, its a bit heavy with censorship. You'll know when I post things on my blog that I can't post on NPF's site lol Other than censorship, they're a great place and I recommend you checking them out if you have psoriasis.
That's all for now, sleep well!
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