First time post & Request for advice!

[Kris88]

Hi everyone,

Firstly id like to say this board is a great idea, and i wish i had found it sooner than now. I was diagnosed with Psoriasis around four years ago, and has gotten progressively worse since, affecting my hands, arms, knees, lower back and sometimes face. I'm 23 and I own a busy restaurant, the psoriasis on my hands has destroyed my confidence and ability to work front of house, before i was able to cover one or two plaques with a plaster and pass it off as a kitchen mishap, but now thats not possible. I'm constantly stressed that relying on other members of staff to run front of house will have a negative effect on the business, which is a vicious cycle, as you all know.

The way i have been controlling it is spending as much time in the sun as possible, and having regular sun beds - this method would clear it almost completely but with the risk of increasing the chance of skin cancer.

I recently changed my GP, and he has prescribed me dononex and dovobet to use together, dovobet once a day for up to 4 weeks and dovonex twice a day. He recommended this as using the dovonex cream will help prevent the skin from relapsing from the withdrawal of the steroid. I just wondered if anyone else has tried this method or if anyone has any view on it. (I realise this is maybe the wrong section in the forum for this post and I'm sorry!)

I've read a couple of dovobet related horror stories and its put me off using, i just want to be sure before i enter a treatment plan for it as I could not manage if the condition was to worsen.

Thanks for your time

Kris

[MULLINDE]

Hi Chris,

I really can't understand why you GP would prescribe you with Dovonex and Dovobet.

The active ingredient in Dovonex is Calcipotriol which is a derivative of Vitamin D.

Dovobet contains two active ingredients: Calcipotriol and also  Betamethasone which is regarded as a "potent" steroid.

I used Dovobet many years ago and it didn't lead to any significant improvement of my P. But I do think that it contributed to the thinning of my skin, which my Derm describes as being like "tissue paper".

From what you say about the coverage of P that you have, I wouldn't have though that a topical application is appropriate. Have you spoken to your GP about being referred to a Derm?

Regards,

Daryl

[MULLINDE]

Hi Kris,

Sorry about miss-spelling your name!

Daryl

[arizona]

The way Dovonex/Dovobet use has been described by your doc is the way it should be used. Dovonex is non steroid and it is good to see a doc actually advise the correct way of use for a change. Yes dovobet has to be used cautiously as it can cause a rebound flare so be sure not to get it on any unaffected skin and gradually lessen the use towards the end of the month (every other day and so on).
The next step should be to be referred to a derm as the coverage you have is really too much (unless it is very small patches) for topical ointments like dovobet. I believe its max is 30% coverage of p from what i remember.

You really need to be referred so you can get onto the treatment ladder at the hospital. Will start with uvb or puva i would imagine, then onto ciclosporin or methotrexate and so on
There are many treatments now that will put it into remission, though the p will sometimes become resistant and hence will need something else to be tried
Having had this four years , i would say you are 3 1/2 years overdue to be referred and its time you were insisting on this with your doc

[Kris88]

I think maybe that the idea was to ween away from dovobet with dovonex and trick the skin into thinking its the same cream but without the steroid maybe?

I've been to two derms in the past, who have prescribed me eumovate and synylar creams, but didn't really make a noticeable difference. I've been using dovobet for two days already and it has already made a noticeable difference, but i am terrified of a relapse.

My coverage isn't extremely bad at the moment, but its more than i would like, especially on the hands area. The problem is my job is so stressful, and I always have my hands in cleaning substances which probably doesn't help. Ive tried wrapping them during the nights in emollient and a light hydrocortisone cream but it didn't really help, apart from softening the plaques.

I will upload a few pictures later on which might help to get a better idea.

Thanks for the replies!

Kris

[MULLINDE]

Hi Arizona,

Thanks for putting me straight on that one, and apologies to Kris if what I said was incorrect.

Regards,

Daryl

[Kris88]

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[arizona]

Hi Arizona,

Thanks for putting me straight on that one, and apologies to Kris if what I said was incorrect.

Regards,

Daryl

Thanks Daryl, there's an awful lot i dont know but that one came from my doc who is very up on it all due to her niece having p

[arizona]

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One thing that certainly isnt helping your hands is the constantly in and out of chemicals and water, delegate  or use these underneath washing up gloves with moisturiser on your hands
You are not allowed to view links. Register or Login*I8&GUID=cb1573041320a47a2676e736fd9d6159&agid=1177881191&tm_kw=cotton+pimple+riding+gloves&siteid=3&MT_ID=11&tt_encode=raw&keyword=cotton+pimple+riding+gloves&geo_id=21&ff4=228459_228459

they are stretchy close fitting and cotton, cheap and magic for those with p
yes i know they are riding gloves, i used to be in the equestrian trade 

[MULLINDE]

Hi Kris,

From what I can see from the photos that you posted, it doesn't look to me like plague P. More like guttate. And I am not sure that a Derm would recommend UV treatment for the  amount of coverage that you have unless it would be just for the hands. But it would be worth getting a referral to find out.

I totally agree with using gloves (no matter where they come from). The riding gloves that Arizona recommends sound good to me, but if you don't have a local equestrian outlet, then "Boots" do fairly cheap cotton ones, then there are tubifast  and skinnies (which can be bought on line) - and skinnies are available on the NHS with a prescription - Tubifast are not!

Any suitable gloves are good to use at night with a hefty whack of moisturiser underneath.

Any questions - just ask and I am sure that someone here will try to help.

Regards,

Daryl