Regular psoriasis on heel now pustular psoriasis?

** Originally posted by Mommyisme **

So, i have had psoriasis on my heels for over 2 years now, but it was just the skin peeling, very dry, itchy, and cracky type (not sure the type). Don't get me wrong, there were days when I could not even walk without limping, but now one of my heels has had two episodes of pustular type of symptoms. My foot is swollen and it is very hard to walk. In the last episode I picked them and it still hurt with even great intensity because ethe skin under was so raw. So I waited this time, until last night. The pain was unberible and my foot was so swollen. The bubbles had gotten bigger, it was horrible. The pain in still here today and still can't walk on my foot much.

So my questions are, for people who might have this or know some info:

Is it possible for the type of psoriasis to change in a particular location?

What are some treatments or suggestions for what I can do to help with the pain? I am currently nine months pregnant and can't really take much right now. But maybe for the future?

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** Originally posted by tessie10 **

i do have pustular psoriasis on both hands and my right foot. i have learned that picking the ares (no matter how bad they itch) only spreads it especially on my foot. you should see your derm or rheumy doc to confirm that this is pppp. hopefully they can give you something low dose due to your pregnancy to help:) as far as the question about if you can have two different types i would say yes but i am sure hoping that i only have this one to deal with good luck!

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** Originally posted by Mommyisme **

Thanks for the reply :). It sure does hurt either way if I pop them or not. They are just so full and big, it is like I have no choice.

Also, do you swell? I have no idea why I am swelling? My right foot is huge!

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** Originally posted by resycup27 **

Hey mommyisme, so sorry you are having difficulty!

I have pppp on my hands and feet and then after med rebound got scalp p and now have gutate all over entire body and whatever the type is you get in groin area too! So unfortunatly you can get more than one type.
As far as the foot pain....DO NOT POP THE BLISTERS!! it makes it spread, i know how horrible the pain is, trust me! I get my husband to do just about everything, stay off feet as much as possible...when i do i put mentholatum on them to help with the pain, it does not burn or sting me in the open cracks either....it just is a topical pain releiver and it helps me...
For the severe itch, i have been using a can of pop and putting a tail in between the can and my skin and it helps some....
Hope this helps you some...best regards

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** Originally posted by Mommyisme **

Thank you resycup :). I will try what you mentioned. It seems if I don't pop them, that they get deeper and spread just the same as if I did. Do you swell on your feet as well? Just want to see if this is normal.

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** Originally posted by SuzanneT **

Nope, I don't think popping them makes it any better or any worse. It has a mind of it's own. And popping them relieves the pressure and makes it easier to walk. I've had it for about 15 years, and popping blisters has never led to any infection or made it any worse. I have it on my heels as well. If you do search on my user name and PPPP, there are tons of pics and posts. Nothing has ever worked for me except Raptiva and now Stelara. I feel your pain - it's like walking on ground glass, isn't it?

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** Originally posted by hll222 **

http://www.bagbalm.com/

When I peel mine too soon after the blisters...I expose the raw skin too. I use bag balm. It heels fast. I put it on at night with socks (use a pair you don't love - it's petroleum based). I use it on my hands too and put socks over them too. Usually feels better by morning.

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** Originally posted by Mommyisme **

Thanks so much! Is it similar to vasaline, beacause that is what I am using now. I can't even walk on my heel, it is so painful. I am so pregnant and have 2 young children at home to carry around, so life really stinks right now :(. I juts wish these blisters would go away, they are so deep and the skin is so thick.

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** Originally posted by resycup27 **

yes i do have swelling in my hands and feet....but always assumed that is was part of the psa.....i am not sure though

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** Originally posted by DEBAK **

All the literature I have read states popping the pustules will not cause P to spread as there is nothing contagious about P. The stress and trauma of picking at it and creating an open area may make that area hurt more. I started out with pustular on hands and feet but all of the pustules were very tiny like the size of a blunt pencil point. From what you are describing they sound much larger and more like the size of blisters or hives. My hands are now clear thanks to 2 years of Remicade, but my feet continue with now severe plaque P and never clear, plus I have developed multiple allergies. I am allergic to any topical in a cream base...so those were making me worse. Has to be in ointment form for me. I am also allergic to chemicals used in the processing of leather and rubber so am allergic to most shoes. If you have not had the TRUE test skin patch allergy tests done I would highly recommend it to make sure there is not an allergy aggravating things for you. As my Rhuemy told me....once the immune system malfunctions as it does in P it leaves you susceptible for other allergies to start. I had none before the P.
One thing that you can try to give you some comfort is OCCLUSION. Put on your topical med, or vaseline or bag balm or even Vicks ( the menthol in vicks helps with the itching) then a thin pair of cotton socks, then put a small plastic bag over your foot and then a second pair of socks to hold it in place. The small bags you can buy on a roll that people carry to clean up after their dog is a good size bag. I do the same thing for my hands only use get a pair of cotton derm gloves at drug store and cover those with either the vinyl , nitrile or latex medical exam type gloves that you can get by the box at pharmacy as well. I DO feel your pain tho. It is like walking on crushed glass with bruised bones that have been sunburned. I lived the first 6 months with my hands and feet occluded at least 20 hours a day and crawled to get around in the house. Now I just occlude my feet in bed at night. My new Rhuemy is gonna try moving my Remicade to every 4 weeks instead of every 6 to see if we can break this awful 2.5 year flare of the feet and I go tomorrow for my first one at 4 weeks so cross your fingers for me. While I would NOT occlude Ben Gay...it is a good topical to apply for itching. Best of luck to you all

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** Originally posted by Mommyisme **

Thank you so much DEBAK, your advice is wonderful. I think I will see the derm soon before the baby is born to do a patch test. I am a pretty strong person when it comes to pain, but carrying all this extra weight right now and tending to the children is so difficult right now. I have never really been so down in the dumps before. I am also contemplating on whether or not I should breastfeed, and try meds right after the baby so it doesn't get worse. My FIL ( a dermatologist) suggested biologics (sp?), but I am also afraid of the side effects. I don;t want to develop any cancers as I need to be there for my family.

Again thank you so much, just your time to share means the world to me.

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** Originally posted by DEBAK **

Another thing you can try which my derm also said can be done is to use superglue to seal those deep cracks/fissures closed. I would be allergic to the resin in it so have not tried it myself. I would be totally chairbound if not for the biologics (Remicade) I started out on Enbrel and had no response, then tried Humira which made me worse and have been On Rem. since Oct. 07. Light therapy helps a lot of people...does your FIL have it in his office? Insurance will sometimes pay for a home unit. I can do it on my legs but my feet burn in less than 6 seconds. While the cancer risk is there is really is rare when you look at the total number of people who are on them and have no problem....but it is a scary decision to make no doubt.

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** Originally posted by Mommyisme **

You are right, the number is low. I think I will bring it up to my derm when I see her next as well. I think superglue might also cause some sensitive reaction, I do have pretty sensitive skin. Is Remicade something that you take everyday? My FIL has his practice in Alaska and I am in Cali, but I do keep contact with him through the phone and pictures by email. I did the light treatment, the narrowband and also the foot and hand booth three times a week for 5 months. For me, there was not much difference. I am also out in the sun a lot. I think my only option would be the biologics. I spoke with my husband last night and think that it would be best that I do not breastfeed due to the pain it my cause on the P on my nipple area. So I think that the patch test and the biologics would be my next step. I can't go on with three young children and the pain on my feet to where I cannot walk, it is horrible. My spores are very large and spread throughout the heel area very deep.

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** Originally posted by hll222 **

mommyisme

You could always try to breastfeed...get in a week or so which would be good for the baby (they say the 1st two weeks are the most important) and then take it from there. The pregnancy could be causing the flare and you might calm down after baby comes.

Bag balm is like vaseline but with an antiseptic in it so it heals fast. Overnight relief.

I took Humira and I am about to go back on it. I understand your fear. I have two small children. I actually broke down in tears discussing while expressing my fears to my rheumatologist. They said there is no definitive connection between the biologics and the cancers...we may all be at higher risk for the cancers just because of the autoimmune disorders themselves. And the "increased risk of serious infections" technically means you must be at risk for a serious infection in the first instance to have an increased risk. So if you are a cleanly person and don't live in a high risk area you really don't have much to be afraid of there.

Good luck with the coming baby!

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** Originally posted by Mommyisme **

Thanks so much for the advice hll222. I guess I could try to BF for a couple weeks then slowely wean. Might be easier on me too :). I BF both my children until they were 14 months old, so will feel so bad not doing so with this little guy. It is so good for them. I will look up Bag Balm (is there a specific store that I can find this at?). I think that pregnancy/ hormone change IS what cause my P in my case. Just my feeling though. Maybe after a few years I will get back to normal when the hormones settle.

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** Originally posted by hll222 **

Bag balm can be found right at Walmart and alot of the pharmacy type stores. Last resort would be an Agway. Don't be scared off by the fact that it is made for cow udders. My family has been using it for over 50 years for skin healing. There are actually other posts here on the forums about it. I could tell you felt bad about not BF that's why I suggested giving it a try.

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** Originally posted by Mommyisme **

Thankyou :).

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** Originally posted by DEBAK **

I am a nurse and years ago we used bag balm for early stage bedsores until newer things became available...so yes it is safe to try. Most women Ive read on here have had the opposite effect with pregnancy in that they cleared up while they were pregnant....so maybe for you when your hormones change upon delivery you will get some clearing. Not that hormones are the cause of P but they do seem to have impact on it. Maybe now you could start putting pure lanolin or what ever your OB has BFing new moms use for nipple cracking on and putting a piece of saran wrap over it ...under your bra to see if you can get some clearing before delivery

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** Originally posted by Mommyisme **

Thanks, yes I will be getting the bag balm asap. FIL says it is fine to BF with P, but to use cortisone ointment and it is safe. I am using a light steroid topical right now to get them healed before delivery. Hopefully things will get better for me after this baby is born, I feel like this pain on my heel is horrendous to say the least.

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