'They Might Amputate My Legs': 29-Year-Old Fights Psoriatic Arthritis - Warning Signs To Watch For

From ndtv.com

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects the joints and can develop in people with psoriasis. It is an autoimmune disease, which means the immune system mistakenly attacks healthy tissues, causing inflammation.

Phoebe Phillips, a 29-year-old, says that she is facing the possibility of a double leg amputation after years of severe inflammatory arthritis damaged both her knees. The woman was diagnosed with psoriatic seronegative inflammatory oligoarthritis in March 2019, after her right knee suddenly became severely swollen and painful in late 2018. Over the years, she says she tried several medicines, including methotrexate, sulfasalazine, JAK inhibitors and biologic drugs, but her disease continued to progress. By April 2026, an X-ray showed that she had no cartilage remaining in her knees, which has made walking incredibly difficult.

"I've missed out on my entire adulthood so far," said Phoebe, according to a report in Mirror. "It's really the small things that are so much more important to me. Just to be able to go up and down a couple of stairs like a normal person.. Standing in the shower and not having to sit down - all the small stuff.

"I can't even sleep in a normal bed, I have a rail next to the toilet, and all those kinds of things that I just shouldn't have to be dealing with, if I'd have been taken more seriously sooner or listened to."

Phoebe says she needed to repeatedly advocate for herself and feels her concerns were not taken seriously early enough. She now has severely restricted movement, permanently bent legs and difficulty carrying out everyday activities such as climbing stairs, sleeping comfortably and standing in the shower. Doctors have advised that double knee replacement may be necessary and the procedure might have to be repeated every 10 years. She says she has also been warned that repeated replacement surgeries and bone loss could eventually make above-knee amputation necessary. However, Phoebe said that it is a risk she is willing to take.

What Is Psoriatic Arthritis?

Psoriatic arthritis (PsA) is a chronic inflammatory condition that affects the joints and can develop in people with psoriasis. It is an autoimmune disease, which means the immune system mistakenly attacks healthy tissues, causing inflammation.

Psoriatic arthritis may lead to cartilage loss, bone damage, deformity, stiffness, and other problems   Unsplash

Although psoriasis often appears as red, scaly skin patches, PsA can affect the joints even when skin symptoms are mild or absent. It may affect the knees, fingers, toes, ankles, elbows, spine and the joints connecting the spine to the pelvis. Unlike ordinary wear-and-tear arthritis, PsA can cause inflammation that progressively damages cartilage, bone and other structures around the joints if it is not adequately controlled.

Types Of Psoriatic Arthritis

Psoriatic arthritis can appear in different patterns. The main types include:

• Asymmetric oligoarthritis: Affects a small number of joints, often on one side of the body
• Symmetric polyarthritis: Affects several joints on both sides of the body and can resemble rheumatoid arthritis
• Distal arthritis: Mainly affects the joints closest to the fingertips and toenails
• Spondylitis: Causes inflammation and stiffness in the spine and sacroiliac joints
• Arthritis mutilans: A rare but severe form that can cause major destruction of the joints and bones in the hands and feet

Warning Signs To Watch For

Symptoms can vary considerably, but common warning signs include:

• Persistent joint pain, swelling or stiffness
• Stiffness that is worse in the morning or after periods of inactivity
• Swollen fingers or toes, sometimes described as "sausage digits"
• Pain around the heels or where tendons attach to bones
• Lower back or buttock pain linked to inflammation
• Nail changes such as pitting, ridges or separation from the nail bed
• Psoriasis or a history of psoriasis
• Reduced movement or difficulty using an affected joint
• Fatigue

What Causes Psoriatic Arthritis?

There is no single known cause. PsA develops through a combination of genetic, immune-system and environmental factors.

Genes can increase susceptibility, which is why having a close relative with psoriasis or PsA can raise the risk. The immune system then becomes abnormally activated and triggers inflammation in the joints, tendons and other tissues.

Certain environmental factors may also contribute, including infections, physical trauma and other immune triggers. However, having psoriasis does not mean a person will definitely develop PsA.

Who Is At Higher Risk?

People with psoriasis are at increased risk of developing PsA, particularly those with extensive skin disease or certain nail changes. A family history of psoriasis or PsA can also increase susceptibility.

PsA can develop at any age, although it commonly begins in adulthood. Other factors, including obesity, smoking and some environmental triggers, may also be associated with a higher risk. It is important to note that the condition can also occur in people who have not previously been diagnosed with psoriasis.

What Happens If Psoriatic Arthritis Is Not Controlled?

Persistent inflammation can gradually damage joints. Over time, this may lead to cartilage loss, bone damage, deformity, stiffness and significant loss of mobility.

People with severe disease may struggle with walking, working, exercising or performing routine activities. Chronic pain and fatigue can also affect sleep, mental wellbeing and quality of life. PsA is not limited to the joints. It is also linked with an increased risk of other health problems, including cardiovascular disease, obesity, diabetes, inflammatory bowel disease and eye inflammation. Therefore, regular medical monitoring is important.

Can Joint Damage Be Prevented?

There is currently no cure for PsA, but treatments can control inflammation and reduce the risk of permanent joint damage. Treatment may include conventional disease-modifying antirheumatic drugs, biologic medicines and targeted therapies, depending on the individual's symptoms and disease pattern.

Painkillers and physical therapy may help manage symptoms, but they do not necessarily control the underlying inflammation. Treatment therefore needs to focus on suppressing disease activity as well as improving movement.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

https://www.ndtv.com/health/they-might-amputate-my-legs-29-year-old-fights-psoriatic-arthritis-warning-signs-to-watch-for-11900593  

Are Bleach Baths Helpful for Psoriasis?

From everydayhealth.com

By Carmen Chai

While it sounds counterintuitive at first, a bleach bath is a common non-prescription option for treating eczema. (If it sounds scary, too, you might think of it as comparable to a soak in a chlorinated swimming pool.) But does this at-home remedy work for psoriasis as well?

While eczema and psoriasis are both chronic skin conditions, psoriasis isn’t driven by the same skin-barrier and bacterial colonization problems that often come up in eczema, meaning bleach baths may not have the same therapeutic effect.

Eczema is often worsened by a bacterial infection, and a bleach bath helps reduce bacteria on the skin, alleviating itching, rash, and scaling. A bleach bath involves filling a standard tub with water and half a cup of household bleach and soaking for 10 minutes before getting out and patting dry.

Though a bleach bath may not be as effective for psoriasis, that doesn’t mean it's not worth discussing with your dermatologist. But bleach baths aren't a standard psoriasis treatment backed by research, and they shouldn’t replace treatments prescribed by your doctor.

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Potential Benefits of Bleach Baths for Psoriasis

The key potential benefit of a bleach bath for psoriasis is its antimicrobial effect — but this possible link is based on research in eczema, says Marisa Garshick, MD, a dermatologist in New York and New Jersey and a clinical assistant professor of dermatology at NewYork-Presbyterian Weill Cornell Medicine.

Specifically, bleach baths may decrease Staphylococcus aureus, a strain of bacteria that’s commonly found on eczema-prone skin, according to research — and research suggests bleach baths may have an anti-inflammatory effect on eczema-prone skin, too. 

Psoriatic skin is 4.5 times more likely to be colonized by Staphylococcus aureus than skin not affected by this condition, and the bacteria may be present in psoriasis lesions in 60 percent of patients.

Bleach baths may be helpful for this subset of psoriasis patients, Dr. Garshick says. “For someone with psoriasis who experiences frequent bacterial skin infections or has . . . skin that is prone to infection, a dermatologist may consider a bleach bath as part of an individualized treatment plan,” she says. “However, it’s not considered a standard psoriasis treatment.”

Don’t expect it to help with treating psoriasis plaques or inflammation, she says. “For psoriasis, they are not routinely recommended because there is limited evidence showing they improve psoriasis itself,” she says.

There are also instances in which patients have both psoriasis and eczema — this is another group who may benefit from bleach baths, according to Deirdre Hooper, MD, a board-certified dermatologist in New Orleans.

Research suggests they can be helpful in relieving itch in moderate to severe atopic dermatitis.

“If you have pure psoriasis, no itch, and no bacterial infection, bleach baths are probably not going to be helpful for you,” Dr. Hooper says. “But a lot of people have some overlap.”

Aside from bacteria and itch, research has also suggested bleach baths work in eczema by calming inflammatory pathways, specifically NF-κB, but again, this hasn’t been established in psoriasis, says Joseph Lam, MD, a paediatric dermatologist at the BC Children’s Hospital in Vancouver, British Columbia, who is a spokesperson for the Society for Paediatric Dermatology.

“The thick plaques of psoriasis are very different from the disrupted skin barrier in patients with eczema,” Dr. Lam says. “Currently, there is no good evidence for the use of bleach baths in patients with psoriasis.”

Important Safety Caveats

A properly diluted bleach bath is generally considered safe for many people to try when used following medical guidance. But people living with psoriasis need to tread carefully, Garshick says.

“The biggest concerns are skin irritation, dryness, and burning, all of which can worsen an already compromised skin barrier,” she warns.

Bleach baths can be drying, and excessive dryness is a known trigger of psoriasis, Lam warns. Bleach can also be irritating to psoriatic skin, especially if you have raw, open lesions during a flare-up.

That matters because irritation or trauma to the skin can trigger the Koebner phenomenon, where skin trauma can cause plaques to spread to unaffected areas, Lam says.

If you have irritated, inflamed, or widespread unstable psoriasis, avoid bleach baths unless they’re specifically advised by your dermatologist, Garshick says.

Hooper’s practical rule is simple: If it stings or burns, stop. “The big warning I would call out is if you try it and it stings or irritates your skin in the bath, get out of the bath,” Hooper says. “You’re using too strong of a concentration.”

This is also why bleach should never be applied directly to psoriasis plaques. It should only be used in a very diluted bath, and only if your healthcare provider says it is appropriate for you, she says.

Talk to Your Doctor About Bleach Baths

If you are curious about bleach baths for psoriasis, have a conversation with your dermatologist before trying them out, Hooper says. This is especially important if your plaques are cracked, bleeding, crusted, painful, widespread, or showing possible signs of infection, such as warmth, swelling, pus, or increasing tenderness.

And if you’ve tried bleach baths and noticed improvement, that’s useful information to relay to your dermatologist, too, she says. It may suggest bacterial colonization, folliculitis (infection of the hair follicles), or some eczema overlap rather than bleach baths treating psoriasis directly.

“It’s complicated but important to tease out,” she says.

If a dermatologist approves a bleach bath, ask for specific instructions. Garshick says the dilution typically used for eczema is about ¼ to ½ cup of regular household bleach in a full standard bathtub, with a soak of about 10 minutes, no more than two to three times per week, and only under dermatologist guidance.

After bathing, she recommends rinsing, gently patting the skin dry, applying any topical medications as prescribed, and moisturizing immediately while the skin is still slightly damp.

Bleach baths are inexpensive, easy to set up at home, and safe if your doctor gives you the green light, Hooper says. They just may not be as effective for psoriasis. “There's nothing wrong with trying it. Just don't be frustrated if it doesn't work for you,” she says.

You can also ask your dermatologist about other options, especially if your current treatment plan isn’t working. Prescription topical therapies like corticosteroids or non-steroid treatments, biologic medications, and phototherapy when appropriate are some of the more evidence-backed options, Garshick says.

The Takeaway

• Research suggests bleach baths can reduce bacteria and ease symptoms like itch, rash, and scaling in eczema, but there’s little evidence showing they improve psoriasis plaques, inflammation, or flares.
• Avoid using bleach baths on cracked, bleeding, raw, or very inflamed plaques; burning, dryness, and irritation may worsen psoriasis or trigger new plaques on injured skin.
• Talk to your dermatologist before you try a bleach bath. Ask exactly how much bleach to use, how long to soak, and how often to do it.
• Keep in mind that better-supported psoriasis treatments are available, including prescription topical therapies, biologic medications, phototherapy, and other options your dermatologist may recommend if your current plan isn’t working.

https://www.everydayhealth.com/psoriasis/are-bleach-baths-helpful-for-psoriasis/

Have Psoriasis? Here’s What You Need to Know Before Your Next Cosmetic Treatment

From newbeauty.com

What to consider before your next injectable or laser appointment 

Psoriasis can be a very frustrating skin condition. With severity varying from person to person—from plaque location and medications used to flare frequency—these factors can influence how you approach in-office skin treatments. While patients with psoriasis can safely undergo aesthetic procedures, dermatologists say that timing, treatment selection and inflammation control are essential when it comes to choosing the right approach for you.

                                                                                                                              Photo by Fleur Kaan on Unsplash

Skin treatments to avoid if you have psoriasis

“Psoriasis doesn’t automatically mean you can’t have cosmetic procedures, but it does mean you need to be more selective and strategic,” explains New York dermatologist Jody A. Levine, MD. The biggest concern, says West Palm Beach, FL dermatologist Jacob Beer, MD, is patients experiencing “a clinical phenomenon called the Koebner phenomenon, which means that when someone experiences some form of injury, like microneedling, psoriasis plaques can appear in those areas.” Essentially, trauma to the skin can trigger new psoriasis plaques in previously unaffected places.

Because of this phenomenon, Dr. Levine generally advises patients to avoid skin treatments that can create significant or unnecessary injury to the skin during an active psoriasis flare. “This includes avoiding procedures such as microneedling, deep chemical peels, aggressive ablative laser resurfacing or other treatments that intentionally wound the skin,” she says.

Injectable fillers and neurotoxins should also be used with caution. “While not absolutely contraindicated, they should be avoided in areas of active inflammation or plaques,” says Dr. Levine. Additionally, intense pulsed light (IPL) and photodynamic therapy are also not recommended for psoriasis treatment. “The 2019 AAD/NPF guidelines specifically recommend against topical 5-ALA-photodynamic therapy or methyl ALA-photodynamic therapy for localized psoriasis,” she adds.

What to consider before going for a cosmetic treatment

Active vs. inactive psoriasis

Whether psoriasis is active or well controlled makes a significant difference in treatment planning. “Active psoriasis generally indicates a more acute or subacute disease process,” says Dr. Beer. Active psoriasis is characterized by inflamed, scaly or expanded plaques, which is when the skin is at its most vulnerable and at risk of triggering additional lesions as a result of skin trauma. During this time, dermatologists recommend postponing elective cosmetic procedures until the flare is adequately treated.

However, “when psoriasis is inactive or well controlled, patients often become candidates for a much broader range of aesthetic treatments. Even then, I still recommend proceeding cautiously, choosing less aggressive options or spacing treatments farther apart to minimize the risk of irritation,” says Dr. Levine. In fact, certain vascular laser treatments can actually help treat persistent redness associated with psoriasis, but again it depends on how well a patient’s psoriasis is controlled.

Seasonal timing

Timing of cosmetic treatments can also make a difference. “Many people notice their psoriasis naturally improves during the warmer months because moderate sunlight and higher humidity can be beneficial for the skin,” explains Dr. Levine. Conversely, she says that winter can be even more challenging, especially with cold temperatures, low humidity and indoor heating, which dries skin and can often contribute to flares even though there’s a lower risk of post-inflammatory pigmentation.

This doesn’t necessarily mean that cosmetic procedures should only be performed in the summer. “Seasonality matters less than if the psoriasis is well-controlled. If the patient is on a biologic or treatment that controls the psoriasis well, then many treatments can still be done, albeit cautiously,” says Dr. Beer.

Featured experts

• Jody A. Levine, MD is a board-certified dermatologist in New York
• Jacob Beer, MD is a board-certified dermatologist in West Palm Beach, FL

https://www.newbeauty.com/view/psoriasis-treatments-what-to-know

How to Recognize and Treat Psoriasis on the Face

From verywellhealth.com

What you can do about plaques on this delicate skin 

Key Takeaways

• Psoriasis on the face can cause red or pink sores with silvery-white plaques.
• Treatments for facial psoriasis include creams, oral medicine, and light therapy.
• A dermatologist can help you figure out the best way to treat psoriasis.
• Facial psoriasis can cause red, itchy patches around your eyebrows, ears, and mouth. Learn how to recognize and treat this condition effectively.

What Does Psoriasis on the Face Look Like?

                                                 Reproduced with permission from © DermNet dermnetnz.org 2023.

Psoriasis on the face starts as small, red bumps that develop into red or pink sores, often topped with silvery-white plaques that can flake. The look of facial psoriasis varies by type:

• Plaque psoriasis looks like dry, discoloured, scaly skin on your face.
• Guttate psoriasis appears as small, scaly patches that show up on your skin after you’ve had a strep infection.
• Pustular psoriasis displays as pus-filled bumps on top of dry skin on your face.
• Scalp psoriasis looks like dry patches of skin on top of your head that can hurt.

Types of Facial Psoriasis

True Facial Psoriasis

True facial psoriasis looks like classic psoriasis plaques on the face. The red, scaly plaques are usually the same on both sides (symmetrical) and also appear on other areas of the body. The affected skin is often painful and itchy.

Hairline Psoriasis

Around half of people with psoriasis have scalp psoriasis, which can include the upper forehead.

Scalp and hairline psoriasis can be mild and may look like fine flakes of dandruff. Some people get severe psoriasis with thick plaques covering the hairline and behind the ears. The plaques can be greasy and yellow-coloured. 

Sebo-Psoriasis

Sebo-psoriasis is a combination of facial psoriasis and seborrheic dermatitis.

Sebo-psoriasis causes thin, pink plaques on the face that can be covered in greasy, yellow scales. They can show up on the hairline, eyelids, eyebrows, sides of the nose, and beard area. While the eyebrows, forehead, hairline, and the skin above the lip are the most common places affected by facial psoriasis, the condition can also spread to other parts of the face.  

worklater1 / Getty Images

Symptoms and Complications 

Facial psoriasis that spreads can cause symptoms specific to where on the face it is—for example, near the eyes and the mouth. 

Vision Issues

Psoriasis around the eyes is rare. It may cause dry, red patches of skin. Facial psoriasis that’s too close to the eyes can cause pain or impaired vision.

If you have psoriasis near your eyes, it’s important to work with your dermatologist to find a safe treatment that will not affect your vision. 

Nose Discomfort

Nasal psoriasis can look like peeling, cracked, sore, or scaly skin on your nose or nostrils. It’s very rare to get psoriasis inside your nose, but it can happen.

If you think you have psoriasis near your nose, see a dermatologist to make sure it’s not another more common condition like an infection. 

Hearing Trouble

Facial psoriasis can affect the inner and outer ears. The symptoms include redness, itching, and patches of scaly skin on the ears. The patches may show up on the skin behind the ears, around the ears, or inside the ear canal.

When scales build up inside the ear, it can lead to temporary hearing loss. However, never try to push or remove the scales from your ears yourself. Only your provider should treat psoriasis plaques in your ears. 

Mouth Pain and Bleeding

In rare cases, people with facial psoriasis have psoriasis symptoms in their mouths. You may have redness, burning pain, and bleeding along the gums, tongue, or inner cheeks. The symptoms can make it hard to eat and drink. Mouth psoriasis usually needs to be treated by both your dermatologist and your dentist.

Conditions With Similar Symptoms

There are some skin conditions that can look and feel similar to psoriasis on the face. Certain conditions can cause redness, rashes, and other symptoms that could be confused for psoriasis, such as:

• Eczema (atopic dermatitis)
• Seborrheic dermatitis
• Pityriasis rosea
• Lupus rash
• Rosacea
• Lichen planus
• Shingles (herpes zoster)
• Dermatomyositis
• Ringworm (tinea capitis)
• Intertrigo
• Skin cancer

What Causes Face Psoriasis?

Psoriasis is a chronic autoimmune condition that causes inflammation. With psoriasis, the skin cells grow too fast and pile up. The dead skin cells do not slough off like they’re supposed to, leading to silvery-white skin plaques building up on the skin’s surface.

It’s not totally understood why some people get psoriasis. There is a genetic component and psoriasis tends to run in families. If someone in your family has facial psoriasis or psoriasis elsewhere on their body, you might be more likely to have it, too.

Face Psoriasis Triggers

Certain things can cause a facial psoriasis flare-up including:

• Emotional stress
• Skin injury
• Infections (especially on the skin) 
• Cold, dry weather
• Prescription medications

Spending too much time in the sun and smoking can also worsen facial psoriasis symptoms.

How to Treat Psoriasis on the Face

Psoriasis cannot be cured but there are treatments. Since the skin on and around the face is sensitive, finding the best treatment for facial psoriasis can be challenging. Your provider may suggest several treatments, including topical medications, oral prescriptions, phototherapy, and immune therapies.

Medications and Procedures

The treatment you need will depend on the severity of your symptoms and which parts of your face are affected. Your dermatologist may recommend one or more treatments for facial psoriasis:

• Topical treatments include medicated creams, ointments, and shampoos that treat psoriasis symptoms. First-line treatment often includes a steroid cream. Hairline psoriasis may need to be treated with a medicated shampoo.
• Systemic medications are usually considered when you have psoriasis symptoms all over your body. Medications can include methotrexate, cyclosporine, retinoids, biologics, and others.
• Phototherapy uses ultraviolet light (UV) treatments to help slow skin cell growth and reduce inflammation. This can improve facial psoriasis symptoms over time.

How Can I Treat Facial Psoriasis at Home?

It’s not always possible to prevent psoriasis symptoms, but there are steps you can take to avoid triggers and take care of your skin. 

Skincare

Your skincare routine will be an important part of managing facial psoriasis.

• Choose skincare products carefully and avoid any harsh ingredients. Check the labels to make sure the products do not contain irritating ingredients (e.g., they should say “hypoallergenic,” “fragrance-free,” “for sensitive skin,” “alcohol-free,” and/or “dye free”).
• Use a gentle daily moisturizer, especially after washing your face.
• Do not over-wash your face, even if it feels greasy.

Lifestyle Changes

There are methods you can use to treat facial psoriasis at home:

• Learn your triggers for a psoriasis flare-up and work with your dermatologist to figure out how to avoid them. 
• Find techniques for managing stress, such as mindfulness and physical activity. 
• Avoid smoking and being around those who do.
• Wear quality sunscreen any time you’re in the sun.

Using Medicated Shampoos

If you have psoriasis on your scalp or hairline, talk to your dermatologist about using a medicated shampoo at home. You can also look for an OTC product that contains both salicylic acid and tar. Salicylic acid softens and removes the thick plaques, while tar helps slow skin growth and reduce inflammation.

https://www.verywellhealth.com/psoriasis-on-face-5180877