TCZ and Psoriasis

[jarn]

Historically, have had a small spot of Psoriasis on nape of neck. After a year of Prednisone, it did disappear. Yippeee I thought. Now, after being off Pred, the wee spot is back. Is it possible or coincidence, that the Actemra/TCZ injections are causing the psoriasis to make its reappearance? I have reported to the company that over the 2yrs of using TCZ, have noticed a few skin blotches. Just curious if anyone has noticed similar? My Rheumy has no thoughts on that reaction but just figures my immune system is "back at it"! It seems that some things just don't change unless on drugs.............and obviously TCZ doesn't prevent the recurrence. Thanks for your comments,

[HeronNS]

Maybe because TCZ only targets interleukin-6 (IL-6)?

[PMRpro Ambassador in reply to HeronNS]

Apparently high levels of IL-6 have been found in psoriasis - I found that quite easily but am still cogitating on the question!

[HeronNS in reply to PMRpro]

Interesting. Following your lead had a quick look, and there are other cytokines involved also. The things you learn from this forum!

[PMRpro Ambassador in reply to HeronNS]

I'll have a look tomorrow ...

[jarn in reply to PMRpro]

Many thanks for your making the time; has been puzzling!! well, much like everything

[jarn in reply to HeronNS]

Isn't that just the truth and always grateful to the folks onboard.

[SheffieldJane]

I had reoccurring, pretty severe ear infections, swollen closed with dry peeling skin and no production of ear wax. This cleared up completely over the years of Pred treatment but as I reduce Pred below 6 mgs, I notice itching. I sincerely hope that won’t return.

[jarn]

You always have such informed answers and I do appreciate it. Thanks for replying and do think with all the shared replies, there will be many kernels of truth.

[jarn]

Also, thanks for the referencce to the psoriasis site

[Grammy80]

Wow, you go my attention. I'm down to 5 mg of pred and on Actemra. I noticed, or felt a patch by my hair line that is slightly itchy and 'feels' like there is a weeping or blistering spot. I've just had it a few months. At the moment it is going to have to take a back seat to a few other issues.💞

Neither my husband or myself can see it ~ 👵🏻👴🏻👀

[jarn in reply to Grammy80]

Well, am glad on one hand that it isn't only me experiencing this, but sorry if it happens to you as well. However, Grammy80, it certainly is not the worst that could happen. Psoriasis does itch and can feel like scalp is tightening, but not the worst of ill effects. Just strange how one drug can upset the body's rhythms. Initially, it did feel a bit "weepy" before it dried out. As long as we keep shampooing/washing the area, it does control it somewhat. But just strange that a drug can do all this!! Thanks for sharing

[Grammy80 in reply to jarn]

I was actually pleased to see your post. Immediately I thought--"that's what it is" -- I had wondered. I don't mind a side-effect here on there when the drugs have done so many wonderful things!! Right? Do you put anything on it?💞

[Pollyanna16]

Good morning, Psoriasis came first for me, in my case inherited & started in my teens. Generally it eased as I got older & on Pred it almost disappeared. I remember my GP making the comment that she wasn’t surprised it was reappearing as I dropped down the dose. She also happened to have Psoriasis. Now on 3.5mg it really only appears on my upper arms, annoyingly, & I keep an eye on my scalp which can get sore & itchy. So, yes, another autoimmune disorder I’ve learnt to live with 🙄

[jarn in reply to Pollyanna16]

It is interesting and it seems genetic as my mother had the psoriasis of the scalp in her later years. Comforting (??) that we can share this info thanks to this website. Have never found a remedy for it. Was interesting that the Pred did suppress it. Thanks again

[Hidden]

my GP said the Lichen Sclerosis and Interstitial Cystitis I suffer from are both AI diseases and likely due to having Still’s which is too. I think drs like to say that as it lets them off the hook a bit - “well you already have an AI”

[Plantingwithfaith]

Hi Jarn, yes Acterma seems to have given me some strange patches of skin I’ve never had before on my forearms. I’m on prednisone and Acterma infusions for 7 months now (GCA) I think I remember readings it can give you areas of skin roughness but mine doesn’t itch.

[jarn in reply to Plantingwithfaith]

Thank you for commenting as it now confirms what I had been trying to figure out; the TCZ did motivate the psoriasis cells!! Have been applying some Tea Tree to it but don't think it helps much

[jarn]

You are a fountain of info. Thank you. At the moment have applied Tea Tree Oil for its cooling effect more than anything; don't think there is much to control the plaque except shampooing. As long as I can control it in a single area, will be content.

[Elephants2019]

interesting reading your question, as prior to Gca days, I had a very itchy, flaky scalp which dermatologist thought was psoriasis, and prescribed a topical steroid solution, to help control the symptoms. Fast forward to GCA and high dose of prednisone, and my scalp too cleared up. But as I reduce, the flaky, itching seems to increase. I had read about a patient that had extracranial GCA and psoriasis and had a good outcome being treated with a biological(can’t recall name), that blocks the IL17. Today I asked doctor if they couldn’t run a cytokine panel test to find out what was causing the inflammation, as possibly I should be on a different biologic than Actemra. She did not think we would get good test results, since currently on prednisone and Actemra. But does make one wonder!

[jarn in reply to Elephants2019]

Hmmmm. Really appreciating everyone's input. So am thinking that TCZ is truly the cause for the psoriasis to return. If you discover which biologique is the good guy.......would love to check with my rheumy. I honestly don't feel that any topical ointment does the job. Shampooing regularly (3x a week) does keep the itch in check. Thank you for responding.

[PMRpro Ambassador in reply to Elephants2019]

Well she'll get a panel of the other cytokines! Actemra only stops IL-6. All biologics are very specific - and Actemra works for the IL-6 that is the main cause of GCA inflammation.

[jarn in reply to PMRpro]

Yes indeed. You were right on the spot in your first response and now, am just curious which biologic could possibly do the trick. In the meantime, just a relief to know that the Pred did the trick initially; now, guess just live with it. Many thanks for the research.