These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.
Psoriasis [posted 11/5/98]
Question: My 9 year old sister and I have psorasis very bad to our scalp. Her’s is
going so far as going down on to her face. Others have said cod liver oil really help is
this true and is it safe for my little sister to take. Thanks for you help.
Answer: Not a great effect, but there are other drugs like methotrexate that may
need to be considered in severe psoriasis.
Psoriasis / Melatonin
Question: I had a first outbreak of a severe skin rash on my leg and stomach about
9 months ago. The first doctor I saw diagnosed it as an allergic reaction. The next doctor
did tests for fungal and bacterial causes, but determined that it was neither of those. A
doctor at my HMO determined that it was probably Psoriasis, but said it looked like there
were hives on top of it. It finally spread all over my body and I was given a variety of
creams including Seldane, Cyclocort, and Hydroxyzine, at various times. Prior to the first
outbreak, I had been taking Melatonin at night to help me sleep. I stopped taking
Melatonin shortly after the skin rash outbreak. As of a few weeks ago, the skin rash was
completely gone. I started taking 1500 mcg of Melatonin about a week ago to help me sleep.
A few days later, the same skin rash that was diagnosed as probably being Psoriasis broke
out on my stomach. I am wondering if the rash might be a reaction to the Melatonin? I
stopped taking it and the rash is currently contained to my stomach. Is there a source of
information on possible reactions to taking Melatonin?
Answer: Mellatonin is usually side effect free. However, the binders and dyes
can cause reactions. I would expect this is the cause. I would avoid melatonin after your
experience. Unfortunately, there is no data bank available other than the FDA. I would
have your doctor file an adverse reaction report to the FDA. They may contact you for
follow up in certain cases.
Psoriasis
Question: I have recently developed several red spotted areas on my legs and arms.
I also have developed a very itchy red rash on my back where I was sunburned mildly. The
spots on my legs seemed to be like pimples, but they never went away. The
“pustules” would go away, but the red spots would continue, and then some would
progress to larger red, scaly areas. I also received minor cuts on my upper leg from a cat
scratch. After what is now two or three months, the bruising has gone, but the red, scaly
patches are continuing to spread. The spots itch slightly, and then appear to
“peel”, but they don’t go away. I’m not sure that I have psoriasis, but
information I have found on the internet seems to point in that direction. Is there
anything I can do to slow down the spot development? I have also received information that
“strep” throat infections can trigger aggressive T-call development which can
lead to some form of psoriasis. I have had multiple strep infections in my life and two
bouts in the last year? Is this the cause? The progression of this skin disorder is quite
depressing, and unsightly to say the least. For your information, I am a 34 y/o, obese,
white female.
Answer: Psoriasis appears to be an inherited disorder. Actually, we really don’t
know what causes it. It can be activated by any infection, stress, etc. It usually
improves with sun light, coal tar applications and topical steroids. Severe cases will
require methotrexate. Topical vitamin A has also been used. The patches are always
symmetrical, although not identical. They usually appear on the elbows and knees but can
appear anywhere. Until you see your dermatologist, you can try topical steroids(available
as hydrocortisone cream over the counter). The other possibility is that these are a mild
form of fungal infection. These would require antifungals(usually not available OTC).
Psoriasis
Question: Is ultra-violet treatment really helpful and is it worth the additional
risk of cancer?
Answer: There are several tried and true treatments for psoriasis. These include
local coal tar(or equivalent), sunlight(or UV light) and topical steroids. Severe cases
necessitate use of methotrexate– usually once a week. For some reason, the risk of UV
doesn’t seem as high in psoriasis patients as patients without psoriasis. I’d use UV
versus a drug like methotrexate.
Psoriasis
Question: I have psoriasis on my scalp and patches on the back, buttocks, legs and,
sometimes, the hands and arms. I am using “Capitrol” shampoo. However, it has
not been very effective. Is there a better alternative? I am using Fluocinonide gel on the
spots. Is this the best treatment? Some of the spots are very persistent.
Answer: Psoriasis has several treatment options. First is local coal tar. This
is messy, but it generally helps. Second is sun or UV light. This long term treatment may
increase the risk of skin cancer, but it helps. Third is local steroid. This is effective,
but can produce systemic problems if used in large doses for long periods of time. Fourth
is methotrexate and other systemic drugs. These are reserved for severe cases or with
systemic organ involvement (arthritis, etc.).
Psoriasis
Question: For a flare-up of psoriasis, I was prescribed Deltasone in a quantity of
8 tablets (5 mg each) the first day, decreased by one each day. Could there be any side
effects for taking such a large dose?
Answer: For a short period of time the side effects are minimal. Taking large
doses over long periods of time will produce side effects. About the only problem for
short term use is that some patients experience difficulty sleeping and there is a
possibility of high sugars if you are diabetic.
Vitamin D3 Therapy
Question: Are there any serious side effects when using Vitamin D3 therapy to treat
psoriasis. I have tried every thing from coal tar to ultra violet light therapy but the
psoriasis keeps returning.
Answer: Actually very few. Your calcium level will need to be checked
occasionally and occasionally liver function tests; but, I haven’t seen any problems.