Psoriasis on both arm and leg

[a_random_guy]

Hi, I am a 19 year old male, and for the last 2 months, I have had many small red spots that are different sizes, mostly round shaped, raised, and had scales over it on both my arms and legs. The red spots on my leg are more severe than my arms. I went to the doctor to have him have a look at it and he suspect it to be psoriasis. He did a skin biopsy on my leg, and I am currently still waiting for results. In the meantime, he gave a Elcom (Mometasone Furoate 0.1%) Cream to put arms and legs, once daily.

I have been using this cream for about a month now. I noticed that some of the spots on my arms are getting better, but as for my legs, there is little improvement. Also, I have noticed that the skin around the spots have become whiter and they seem to be different.

What I want to know is:
1) Why the spots on my leg are not getting better?
2) What should I do to improve my condition
3) What can I do to prevent flare ups
4) Is there a better treatment option other than using a corticosteroid that is damaging my skin?
5) Potential complications of psoriasis?

I am very stressed about my condition, and feel embarrassed to wearing t-shirts because of the red spots. Any help would be appreciated.

[Bhupinder Kaur, MD]

Hello,
It is true that long term use of steroids is not without side effects and the side effects include skin thinning, atrophy, telangiectasia and steroid induced rosacea. To tackle these side effects it is advisable to taper the dose of steroids under your dermatologist’s guidance and then start again after a few days. Also treatment can be changed after a period of time and a combination of treatments is used.

I hope it helps. Take care and regards.

[a_random_guy]

I got my biopsy results yesterday and it was indeed psoriasis. My family doctor prescribed me with another cream to use (Amcinonide 0.1%) and he told me to use it 1-2 times a week.

I am just wondering, it's the chronic use of tropical steroid creams have any side effects on one's general health? I noticed that the skin surrounding my effected area are different and drier.

Thank You

[Bhupinder Kaur, MD]

Hello,
It is better to wait for the biopsy results because it can be psoriasis. Psoriasis is a long-term (chronic) skin problem that causes skin cells to grow too quickly, resulting in thick, white, silvery, or red patches of skin. It is thought that psoriasis occurs when the immune system overreacts, causing inflammation and flaking of skin.

It commonly causes red scaly patches to appear on the skin. It can be treated but it commonly has recurrences also. So a regular treatment is required for this. Treatment options include Ointment and creams containing coal tar, dithranol (anthralin), corticosteroids like desoximetasone (Topicort), vitamin D3 analogues (for example, calcipotriol), and retinoids, Psoralen+UVA and PUVB therapy. Over time, psoriasis can become resistant to a specific therapy. Treatments may be periodically changed to prevent resistance developing (tachyphylaxis) and to reduce the chance of adverse reactions occurring.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.