psoriasis and steroid dose

[Crochetgirl65_]

Over the years my consultant has always asked me if I had any signs of psoriasis and pain and swelling in finger joints. This has never been the case until now. I am down to 1mg of pred a day (after a few months of 0.5 and zero) and I have patches of what appears to be psoriasis on one hand. I had these skin problems as a child and intermittently as an adult but not for years. Is this something else associated with steroid withdrawal? Still no swelling of joints.

[PMRpro Ambassador]

Did he not ask if you had a HISTORY of psoriasis? There is a type of arthritis associated with psoriasis which can have a polymyalgic onset. The rheumy I saw was adamant that was what I had despite having never really had any joint problems.

[Crochetgirl65_ in reply to PMRpro]

Well he has checked every single time but not said why. I have never had any swelling joints and up until now no psoriasis? I did tell him I had it as a child but he made no comment 🤷‍♂️. I always had an outbreak when I was stressed and ‘cold sores’. I still get a lot of cold sores if I am tired/run down / stressed maybe that’s why this is back? I am on very low dose of pred and I’ve had a few issues with (we think) cortisol levels.

[Miacaro45]

I have had Psoriasis since age 10. Throughout my life the Psoriasis has come and gone. Since 2020 I have been on a major amount of Prednisone and my Psoriasis all but disappeared. Now that I am taking 11 mg. I have noticed that the Psoriasis is slowly “ rearing it’s ugly head” .I have never had swelling of the joints.

[Crochetgirl65_ in reply to Miacaro45]

It’s odd isn’t it? I’ll see what the consultant had to say on Friday 👍

[jarn]

Having had "occasional" psoriasis events on my scalp, it did disappeara when I started on Pred. However, when I stopped taking Pred, the scalp patch re-appeared! So I renewed Rx for a steroid gel which have only used a few times, which controls it. So, yes, think steroids to halt the psoriasis.

[Crochetgirl65_ in reply to jarn]

Thanks for the info, very interesting!

[Lizzery]

Umm that question has never been raised when I’ve seen a rheumatologist, and now I find myself with Palmoplantar psoriasis on my foot, and now patches on my hands, together with nail,psoriasis. I have read somewhere lately, that on reducing steroids this can happen. If I’d known that, I may not have reduced much below 5mg pred, and tapered done the leflunomide instead. It’s a learning curve all the way!

[PMRpro Ambassador in reply to Lizzery]

I'm sure there was a case of that on The Bad Skin Clinic recently - and treated successfully by Dr Emma!

[softekcom]

Interesting. I've had a patch on my scalp since 2013 when the pain and exhaustion began. It was diagnosed as dandruff. And then as a fungal infection after tests (prescribed Terbinafine). Then as dermatitis. It has returned since i began tapering. I am back on that cycle again. Tests last month say no fungus. GP says it's some sort of dermatitis.Could this be auto immune related?

[PMRpro Ambassador in reply to softekcom]

Very possibly. Are all these non-diagnoses from a GP rather than a skin specialist? I've been watching the series with Dr Emma, a dermatologist with an NHS post at St Thomas's as well as her private work and have been taken aback at the things patients have appeared with that GPs have obviously dismissed.