Question:
>And compel >them to do more research for a more satisfying solution to the >disease.
Making demands of a derm who sees patients will rarely get beyond the derm. Most of them are not involved in research. – Dave W. http://psorsite.com/
Response:
>> >First, steroids do not tackle the root of the > >problem it only suppress symptoms, and while the immune system may be > >locally suppressed the human body through the HPA axis upregulates the > >immune system systemically which results in worse disease in other > >parts of the body. > If you know about the HPA axis stuff, you should know the fairly-strict > definition of "rebound" that Kim is referring to. >Just because I know about the HPA axis I should be able to read minds >as well? >I am waiting for Kim to define her definition of rebound.
Sorry I didn’t jump to heel fast enough. Guess I didn’t read minds fast enough either, as I only just checked back to see your call. It’s not my personal definition. although it is laid out pretty fully in the FAQ, which I did draft, had you looked (honestly, that’s a good idea with any newsgroup). While Psorsite provides a more technical explanation involving the HPA axis stuff, which is why Dave made the above comment http://psorsite.com/docs/stereffects.html My layman’s version is that a psoriasis rebound is when the treatment itself, once you stop using it or it becomes ineffective, causes the psoriais to abruptly worsen and spread beyond where it was prior to using the med. This is different from a regular flare occuring because the psoriasis isn’t being sufficiently controlled or is being otherwise triggered when you stop using a given treatment, which is the reality behind most of what people mistakenly call rebounds. Flares are a general part of the facts of psoriatic life for most people. Rebounds are a very specific subset of them. Kim The Psoriasis Newsgroup Resource FAQ can be found at http://www.psoriasisfaq.com but will also be coming soon (twice a month) to a newsgroup near you…
Response:
>If you are indeed an exception than great for you. Do you mean that >you can use steroids whenever you want and your psoriasis just gets >better with each use and now you are psoriasis free?
No, not at all. I used some steroids back in the early days of my psoriasis, the psoriasis went away a bunch, and when I stopped using the steroids it came back some – but not to its original levels. Fast forward two _years_, and I got some new patches on completely different limbs. >Maybe you can >share with others your personal experience with steroids, i.e. the >kinds of steroids you used and frequency and duration of use. Maybe >the vast numbers of people who have problems with steroids have been >using it wrong and can learn something from you.
Please provide evidence supporting your assertion that there are "vast numbers" of people who have problems with steroids. I can’t answer the implied question when the premise assumes facts not in evidence. >Would be interested to know your personal experience with psoriasis, >age of onset, type, triggers, response, treatment.
Age: 27 (now 36) Type: vulgaris Triggers: beats the heck out of me. Response: what do you mean, response? Treatment: Steroids, early on, coal tar keeps it in check enough for me now. >Exactly, steroids work by suppressing the immune system. However, >there is a distinction that must be made: Immune suppression on a >systemic level, i.e. HPA axis; but also on a local level where the HPA >axis is not involved. You assume that only large doses of strong >steroids suppress the immune system.
No, I assume that large doses of strong steroids (or lower dosages for long times) suppresses the HPA axis, which does not equal the immune system. In fact, when the HPA axis is suppressed, the immune system can run rampant if there’s nothing else going on (like big doses of topical or oral steroids). >Small amounts of nonpotent >steroids used for brief periods of time usually have no effect on the >HPA axis.
Right. >However, because they work as you yourself know, they must >have suppressed the immune system at a local level and it’s this >effect that is worrisome and causes psoriasis to return worse than >before regardless of rebound. Again, this is local upregulation of >cytokine production from T-cells and does not involve the HPA axis.
There you go again, using absolutes. Provide evidence that cytokine production is higher after low-dose steroid usage than it was before. >"A few people" hmmm, I wonder what "evidence" you have to support >your claim that only a few people have bad experience with steroids
You somehow think that every one of the millions of psoriatics in the world read this newsgroup? The experiences related here are from a very small minority of the people with this disease. >Conversely, what evidence do you have for saying that "millions of >psoriatics" don’t get worse with steroid use. If you have evidence, >please share it with me.
Actually, I’d much rather you support your claim first. Your assertion, that is, that anyone who uses steroids for psoriasis "invariably" gets a worse case of psoriasis afterwards. This is a statement which I’ve never encountered before, while I can say that I’ve read, from the NPF, about how the vast majority of psoriatics have only mild cases of the disease. You are claiming that all of those people will, indeed, get worse psoriasis after the steroids they tend to use do their nasty work. >I don’t think I have to provide any evidence.
Yes, you do. You made the claim, now back it up with data or appropriate citations… >Just think back on how your psoriasis first developed and spread.
…and not anecdotal evidence. Because you’ll be surprised by me, again. Those extra spots that popped up two years after my steroid use? They’re in places where it’s hard to get topicals to stay put, and so I haven’t been treating them, except for the occassional soak (twice a year, maybe). But guess what? They’re going away, anyway. >If psoriasis were a >self-limited disease, you probably wouldn’t have to use any steroids >and you wouldn’t be in a newsgroup trying to find solutions and argue >with me.
You’re making a ton of assumptions. How much coverage do you think I have? And why didn’t you ask for that piece of data above? >You have yet to provide any convincing arguments or evidence to >counter what I have said in the first post.
I thought it was pretty clear that you provided your own best argument against using absolute terms the way you do. You spoke of the massive variability of psoriasis. Claiming that steroids _always_ make the disease worse at some later time disagrees with what you said, and also isn’t discussed in any of the medical literature. You’re the one who’s making the big positive claims here, you need to back them up. >Which part of my post was >pseudo-medical nonsense, please be more specific.
Any place you used a term which signified certainty about these claims of yours which haven’t, apparently, been tested. >Experiential-I suggest that you look up the word experiential in a >dictionary and then reply.
I apologize. I mis-read your word. No need to get dictionary-snippy. >Again, I don’t think many people who are psoriasis sufferers would >agree with you.
Well, that’s one of the problems with your average person, now isn’t it? That’s why testimonials work so well in advertising. They are not evidence, but billions of people think they are. Facts, however, aren’t found by popularity contests, and some facts are downright unpopular. It saddens me that millions of psoriasis sufferers (and billions of others) believe that testimonials are good evidence for medical claims, and I do my best to spread the "testimonials are not evidence" word. – Dave W. http://psorsite.com/
Response:
- Hide quoted text — Show quoted text ->Also, what is your definition of a rebound and how do you distinguish >it from a worsening especially when the disease has been stable over >time and worsened after steriod use? > Steve, I haven’t had the (awful) experience myself, but from all > accounts the "rebound" effect is completely obvious, if someone with > psoriasis goes cold-turkey after getting some relief from steroids. > It gets a lot worse, really fast. > Also, there are lots of things >which may cause disease progression and steriod use is one of them, >regardless of duration and dosage of use. > That just isn’t clear. It may well be true, but as you said further > along in your message, there’s a lot of variability in psoriasis, so > it may be a lot more true for some people than for others. For people > with mild psoriasis, using modest amounts of steroids, there are > apparently a lot of people who manage to use them and get some relief > without major problems.
Steroids as a class of drugs is a double edged sword. It provides relief but at the real risk of making the disease worse. As many psoriasis sufferers know, the state of medical care for psoriasis is woefully inadequate. Granted, medical knowledge has come a long way from the times of blood-letting and leeching(there are actually some indications for leeches). It still has a long way to go. I imagine that physicians who will be trained 20 years from now will laugh at our "state of the art medicine". I urge people to be more sceptical of their M.D. and ask more questions. I think they will find that the derms just can’t answer many of the basic questions they have. – Hide quoted text — Show quoted text -> I gather you’re not one of them, and neither am I. In fact, I know > that I am, and perhaps you are, one of those from the other side, for > whom steroids quickly cause more problems than they fix. I am > completely with you on the anger and disgust at the first > dermatologist I went to who prescribed the stuff, and should have seen > quickly that it wasn’t doing much good and was in fact probably > causing things to worsen. However, I’m even angrier at the medical > profession as a whole, that has apparently not recognized that there > are people like me (and others who pop up on this newsgroup from time > to time) for whom even modest amounts of common steroid topicals are > downright hazardous. > That said, once I realized this, I found that with careful and > occassional use, I can get some temporary relief from steroids without > any apparent longer-term effects. I seldom bother, frankly, as it > interferes with other treatments. Only so much skin, so much time. > Also, Kim knows all this stuff, too, and her post was reasonable and > informative and I endorse it entirely, fwiw. If you want to rant at > some of us who’ve been here for a while, you can at least be sure > you’re preaching to the converted on pretty much all the facts that > you cite, and where you wander into some overstatements, as we all may > do when we get up a good head of steam, well, that usually gets > something of a sympathetic reading, plus or minus a little discussion > for any newbies who happen to wander in.
The statement that "steroids make psoriasis worse" can seem plain wrong at first glance. However, as you know from experience, it is more true than not. All I am trying to convey across is that psoriasis sufferers need to demand from their derms alternatives, even if there are none. By demanding for medicines that actually help rather than harm the disease you are simply exercising your right as a patient. And compel them to do more research for a more satisfying solution to the disease. Or you can simply let the derms know that the frontline drug they offer will work in the short term but eventually will make things worse. – Hide quoted text — Show quoted text -> On the Elidel (pimecrolimus) cream, I haven’t tried it (probably > should), but, well, as Kim said, there are some vague reports of at > least quick worsening after Raptiva (nee Xanelim) usage, but certainly > not from Amevive, another biologic, with Enbrel sort of in-between > (and Remicade seems to have reports of longer-lasting relief). So, > for the biologics overall, it seems the likelihood of actual rebound, > where things quickly get worse than before, is rather small. At > least, I don’t recall any reports of it on this newsgroup. > On the positive side, there have been several reports on this group of > people using Elidel on psoriasis and getting good response, where the > psoriasis is on thin skin or is otherwise thin and accessible to > topicals. I’ve seen no reports of it working on thick plaque > psoriasis. However, I did see one report of trials of elidel as some > kind of systemic treatment, but never saw any trial results. > J.
Response:
Novartis says no rebound (for eczema anyway) http://www.elidel.com/hcp/mechanism.jsp J.
Response:
> I used elidel for gential inverse P, and it worked initially fairly well >for about a week or so, now I don’t use it, it burns more than protopic, and >doesn’t work at all it seems anymore.. I do use Protopic with quite a bit of >success now, i use the .03% instead of 10% to minimize stinging etc.. I >much prefer the action and application of the Protopic over the Elidel for >The inverse on the Genitals, for those who need to know.
Appreciate the info from someone who’s tried both! Also, Protopic has a more informative and amusing web site, great slide shows and animations (scratch, scratch): http://www.protopic.com/professional/science/moa.php?page=science&sub… J.
Response:
> >Again, I must say that I believe any use of a steroid results in worse >disease than before starting steroids. > If testimonials are accepted as evidence, as you appear to indicate, then I am > the exception to that belief.
If you are indeed an exception than great for you. Do you mean that you can use steroids whenever you want and your psoriasis just gets better with each use and now you are psoriasis free? Maybe you can share with others your personal experience with steroids, i.e. the kinds of steroids you used and frequency and duration of use. Maybe the vast numbers of people who have problems with steroids have been using it wrong and can learn something from you. >It’s just a matter of degree of how much worse. > "Negatively worse" is the answer in my case.
Would be interested to know your personal experience with psoriasis, age of onset, type, triggers, response, treatment. >First, steroids do not tackle the root of the >problem it only suppress symptoms, and while the immune system may be >locally suppressed the human body through the HPA axis upregulates the >immune system systemically which results in worse disease in other >parts of the body. > If you know about the HPA axis stuff, you should know the fairly-strict > definition of "rebound" that Kim is referring to.
Just because I know about the HPA axis I should be able to read minds as well? I am waiting for Kim to define her definition of rebound. > On the other hand, when a person uses lots of steroids, the HPA axis actually > _down_ regulates the body’s own production of steroids. Stop applying the > steroids, and the body has a massive debt of them, since it takes several days > for the HPA axis to ramp production of them back up. During that time, > inflammation can run rampant, and _pow_, a rebound!
Exactly, steroids work by suppressing the immune system. However, there is a distinction that must be made: Immune suppression on a systemic level, i.e. HPA axis; but also on a local level where the HPA axis is not involved. You assume that only large doses of strong steroids suppress the immune system. Small amounts of nonpotent steroids used for brief periods of time usually have no effect on the HPA axis. However, because they work as you yourself know, they must have suppressed the immune system at a local level and it’s this effect that is worrisome and causes psoriasis to return worse than before regardless of rebound. Again, this is local upregulation of cytokine production from T-cells and does not involve the HPA axis. >Even if the steroid is tapered slowly and symptoms >seem stable or even improved, the next time psoriasis is triggered >through whatever mechanism it is invariably worse than if no steroids >were used. The experience of yourself and many others in this group >is ample evidence of my supposition. > A few peoples’ experiences from a newsgroup is no evidence at all. There are
"A few people" hmmm, I wonder what "evidence" you have to support your claim that only a few people have bad experience with steroids > millions of psoriatics who use steroids who do _not_ "invariably" get worse > psoriasis symptoms.
Conversely, what evidence do you have for saying that "millions of psoriatics" don’t get worse with steroid use. If you have evidence, please share it with me. >Steroids only acclerates what >time does to psoriasis-makes it worse faster even if it may offer some >temporary relief. > You’ve got funny ideas about psoriasis. Where is there evidence that psoriasis > gets worse over time, even if untreated?
I don’t think I have to provide any evidence. Just think back on how your psoriasis first developed and spread. If psoriasis were a self-limited disease, you probably wouldn’t have to use any steroids and you wouldn’t be in a newsgroup trying to find solutions and argue with me. >Yes, long term use will certainly result in more noticeable harm but >short term use will also result in rebound albeit they may not be >recognized immediately. No, these are not potential risks, they are >real but may not be as noticeable. > Your use of absolutes turns what you write into pseudo-medical nonsense, as you
You have yet to provide any convincing arguments or evidence to counter what I have said in the first post. Which part of my post was pseudo-medical nonsense, please be more specific. > probably know since you also wrote, "The variability of psoriasis is > tremendous, from genetics to disease severity, from disease triggers to > response to treatment." >However, my >belief that steroids will cause disease progression is combined a >priori and experiential. > What? How can your belief be based on experiments when you go on to _propose_ > an experiment which hasn’t yet been done to test your belief?
Experiential-I suggest that you look up the word experiential in a dictionary and then reply. >The experience of many psoriasis sufferers as posted on this group >will testify to my claim. > Testimonials are worthless as evidence for your claim.
Again, I don’t think many people who are psoriasis sufferers would agree with you. – Hide quoted text — Show quoted text -> – Dave W. > http://psorsite.com/
Response:
> First, have you used Elidel yourself? if not, how do you know that > there is no rebound? I have done some search on this topic and it > seems that Elidel does not improve psoriasis dramatically and of those > who addressed the use of Elidel they did not mention any rebound but I > would like to hear from people who have experience using Elidel. > Also, what is your definition of a rebound and how do you distinguish > it from a worsening especially when the disease has been stable over > time and worsened after steriod use? Also, there are lots of things > which may cause disease progression and steriod use is one of them, > regardless of duration and dosage of use.
I used elidel for gential inverse P, and it worked initially fairly well for about a week or so, now I don’t use it, it burns more than protopic, and doesn’t work at all it seems anymore.. I do use Protopic with quite a bit of success now, i use the .03% instead of 10% to minimize stinging etc.. I much prefer the action and application of the Protopic over the Elidel for The inverse on the Genitals, for those who need to know. Dan
Response:
>Again, I must say that I believe any use of a steroid results in worse >disease than before starting steroids.
If testimonials are accepted as evidence, as you appear to indicate, then I am the exception to that belief. >It’s just a matter of degree of how much worse.
"Negatively worse" is the answer in my case. >First, steroids do not tackle the root of the >problem it only suppress symptoms, and while the immune system may be >locally suppressed the human body through the HPA axis upregulates the >immune system systemically which results in worse disease in other >parts of the body.
If you know about the HPA axis stuff, you should know the fairly-strict definition of "rebound" that Kim is referring to. On the other hand, when a person uses lots of steroids, the HPA axis actually _down_ regulates the body’s own production of steroids. Stop applying the steroids, and the body has a massive debt of them, since it takes several days for the HPA axis to ramp production of them back up. During that time, inflammation can run rampant, and _pow_, a rebound! >Even if the steroid is tapered slowly and symptoms >seem stable or even improved, the next time psoriasis is triggered >through whatever mechanism it is invariably worse than if no steroids >were used. The experience of yourself and many others in this group >is ample evidence of my supposition.
A few peoples’ experiences from a newsgroup is no evidence at all. There are millions of psoriatics who use steroids who do _not_ "invariably" get worse psoriasis symptoms. >Steroids only acclerates what >time does to psoriasis-makes it worse faster even if it may offer some >temporary relief.
You’ve got funny ideas about psoriasis. Where is there evidence that psoriasis gets worse over time, even if untreated? >Yes, long term use will certainly result in more noticeable harm but >short term use will also result in rebound albeit they may not be >recognized immediately. No, these are not potential risks, they are >real but may not be as noticeable.
Your use of absolutes turns what you write into pseudo-medical nonsense, as you probably know since you also wrote, "The variability of psoriasis is tremendous, from genetics to disease severity, from disease triggers to response to treatment." >However, my >belief that steroids will cause disease progression is combined a >priori and experiential.
What? How can your belief be based on experiments when you go on to _propose_ an experiment which hasn’t yet been done to test your belief? >The experience of many psoriasis sufferers as posted on this group >will testify to my claim.
Testimonials are worthless as evidence for your claim. – Dave W. http://psorsite.com/
Response:
>Also, what is your definition of a rebound and how do you distinguish >it from a worsening especially when the disease has been stable over >time and worsened after steriod use?
Steve, I haven’t had the (awful) experience myself, but from all accounts the "rebound" effect is completely obvious, if someone with psoriasis goes cold-turkey after getting some relief from steroids. It gets a lot worse, really fast. > Also, there are lots of things >which may cause disease progression and steriod use is one of them, >regardless of duration and dosage of use.
That just isn’t clear. It may well be true, but as you said further along in your message, there’s a lot of variability in psoriasis, so it may be a lot more true for some people than for others. For people with mild psoriasis, using modest amounts of steroids, there are apparently a lot of people who manage to use them and get some relief without major problems. I gather you’re not one of them, and neither am I. In fact, I know that I am, and perhaps you are, one of those from the other side, for whom steroids quickly cause more problems than they fix. I am completely with you on the anger and disgust at the first dermatologist I went to who prescribed the stuff, and should have seen quickly that it wasn’t doing much good and was in fact probably causing things to worsen. However, I’m even angrier at the medical profession as a whole, that has apparently not recognized that there are people like me (and others who pop up on this newsgroup from time to time) for whom even modest amounts of common steroid topicals are downright hazardous. That said, once I realized this, I found that with careful and occassional use, I can get some temporary relief from steroids without any apparent longer-term effects. I seldom bother, frankly, as it interferes with other treatments. Only so much skin, so much time. Also, Kim knows all this stuff, too, and her post was reasonable and informative and I endorse it entirely, fwiw. If you want to rant at some of us who’ve been here for a while, you can at least be sure you’re preaching to the converted on pretty much all the facts that you cite, and where you wander into some overstatements, as we all may do when we get up a good head of steam, well, that usually gets something of a sympathetic reading, plus or minus a little discussion for any newbies who happen to wander in. On the Elidel (pimecrolimus) cream, I haven’t tried it (probably should), but, well, as Kim said, there are some vague reports of at least quick worsening after Raptiva (nee Xanelim) usage, but certainly not from Amevive, another biologic, with Enbrel sort of in-between (and Remicade seems to have reports of longer-lasting relief). So, for the biologics overall, it seems the likelihood of actual rebound, where things quickly get worse than before, is rather small. At least, I don’t recall any reports of it on this newsgroup. On the positive side, there have been several reports on this group of people using Elidel on psoriasis and getting good response, where the psoriasis is on thin skin or is otherwise thin and accessible to topicals. I’ve seen no reports of it working on thick plaque psoriasis. However, I did see one report of trials of elidel as some kind of systemic treatment, but never saw any trial results. J.
Response:
> Not at all. The only meds that cause an actual rebound are steroids > and methotrexate (and I believe Xanelim may as well, among the new > biologics being tested, although not sure it that’s official). It’s a > common error – calling any worsening a rebound, when rebound means > something very sepcific and of limited application.
First, have you used Elidel yourself? if not, how do you know that there is no rebound? I have done some search on this topic and it seems that Elidel does not improve psoriasis dramatically and of those who addressed the use of Elidel they did not mention any rebound but I would like to hear from people who have experience using Elidel. Also, what is your definition of a rebound and how do you distinguish it from a worsening especially when the disease has been stable over time and worsened after steriod use? Also, there are lots of things which may cause disease progression and steriod use is one of them, regardless of duration and dosage of use. >Also, I would like to urge all readers to avoid the use of steriod >creams whenever possible. > I understand the sentiment behind this, and don’t use them myself, but > you are unnecessarily scaring people with this warning based upon a > mistaken assumption that the results of mis-use/abuse of steroids are > inherent in any use of them.
Again, I must say that I believe any use of a steroid results in worse disease than before starting steroids. It’s just a matter of degree of how much worse. First, steroids do not tackle the root of the problem it only suppress symptoms, and while the immune system may be locally suppressed the human body through the HPA axis upregulates the immune system systemically which results in worse disease in other parts of the body. Even if the steroid is tapered slowly and symptoms seem stable or even improved, the next time psoriasis is triggered through whatever mechanism it is invariably worse than if no steroids were used. The experience of yourself and many others in this group is ample evidence of my supposition. Steroids only acclerates what time does to psoriasis-makes it worse faster even if it may offer some temporary relief. > Many derms *are* too quick to prescribe them and keep prescribing them > for too long with insufficient supervision about the results. But > that’s misuse of them.
There is an active search for other meds which may be able to offer relief like steroids but avoid the rebound/suppression effect. However, meds that suppress the immune system as indiscriminately as many if not all steroids do will invariably result in worse disease. The human body is clever and stubborn and doesn’t like to be told what to do certainly not by steroids. Again, the fact that you avoid steroids supports my claim if only anecdotally. > The risks of using them come primarily with long term continual use > (with some variation by person on how long qualifies as long term > continual) of higher strengths, and are still only potential risks
Yes, long term use will certainly result in more noticeable harm but short term use will also result in rebound albeit they may not be recognized immediately. No, these are not potential risks, they are real but may not be as noticeable. > NOTguaranteed problems. They can also be reduced significantly by > using steroids sparingly as part of a combination therapy rather than > over using the streoids alone. > While most people with psoriasis have very mild, stable cases where > proper occasional use of fairly mild steroids is pretty appropriate > and safe, except for individual idiosyncratic reactions.
The variability of psoriasis is tremendous, from genetics to disease severity, from disease triggers to response to treatment. However, my belief that steroids will cause disease progression is combined a priori and experiential. The experience of many psoriasis sufferers as posted on this group will testify to my claim. I think that if you add up all the miles that P. sufferers travel back to derms for ever stronger steroid creams you can get enough frequent flier miles to go to the moon. I think that our disagreement can be settled simply with experiments with mice. Apply steroids to mice with psoriasis for varying amount of times and have control mice who are left alone. Withdraw the steroid cream from the 1st set of mice however you like provided that they are given ample time for the washout of the steroid from the mice’s system. I believe that in the end, the mice who are left alone will have less psoriasis. steve
Response:
>I know that there is a nonsteroidal cream out on the market for >eczema. Have any of the people on this board tried using this cream >for psoriasis or seb. derm. What results have you obtain using this >cream. If you have used this cream, Elidel, have you experienced any >rebound effect with Elidel that is certain to happen with steriod >creams.
Check the ng archives, where it has certianly been discussed before: http://pinch.com/skinny?skin=psoriasis+elidel >I suppose that theoretically the dreaded rebound effect is just as >likely with Elidel as with steroid creams.
Not at all. The only meds that cause an actual rebound are steroids and methotrexate (and I believe Xanelim may as well, among the new biologics being tested, although not sure it that’s official). It’s a common error – calling any worsening a rebound, when rebound means something very sepcific and of limited application. >Also, I would like to urge all readers to avoid the use of steriod >creams whenever possible.
I understand the sentiment behind this, and don’t use them myself, but you are unnecessarily scaring people with this warning based upon a mistaken assumption that the results of mis-use/abuse of steroids are inherent in any use of them. Many derms *are* too quick to prescribe them and keep prescribing them for too long with insufficient supervision about the results. But that’s misuse of them. The risks of using them come primarily with long term continual use (with some variation by person on how long qualifies as long term continual) of higher strengths, and are still only potential risks NOTguaranteed problems. They can also be reduced significantly by using steroids sparingly as part of a combination therapy rather than over using the streoids alone. While most people with psoriasis have very mild, stable cases where proper occasional use of fairly mild steroids is pretty appropriate and safe, except for individual idiosyncratic reactions. Kim The Psoriasis Newsgroup Resource FAQ can be found at http://www.psoriasisfaq.com but will also be coming soon (twice a month) to a newsgroup near you…
Response:
I know that there is a nonsteroidal cream out on the market for eczema. Have any of the people on this board tried using this cream for psoriasis or seb. derm. What results have you obtain using this cream. If you have used this cream, Elidel, have you experienced any rebound effect with Elidel that is certain to happen with steriod creams. I suppose that theoretically the dreaded rebound effect is just as likely with Elidel as with steroid creams. However, since Elidel works in a entirely different manner to all steriod creams it may be able to avoid the rebound effect which results in worse psoriasis than before initiating steriod creams. Also, I would like to urge all readers to avoid the use of steriod creams whenever possible. Dermatologists tend to prescribe steriod creams in increasing strengths to control psoriasis, however, it results in a vicious cycle as I am sure many people have experienced first hand. Despite the temporary relief that steriod creams are able to offer, it invariably results in worse psoriasis. However, I realize that until scientists and clinicians are able to come up with a solution that begins to target the root of the problem, p. sufferers are left with drugs that do more harm to good.
Response: