Hi doctor, I am suffering from severe psoriasis. I also have something else going on along with the psoriasis. My skin is red, swollen, pus filled and large yellow scales of skin are coming off. I cannot touch anything on my skin as it causes extreme pain. It is also hot to touch. I picked all the scales off. As soon as I apply lotion the scales will be back within one hour or so. I can hardly touch my skin to apply the lotion. About 60 % of my body covered with these scales now. It just started a little less than two weeks ago. I was completely covered in sheets of psoriasis within a week or so. When I visited my dermatologist he said there is nothing much more that he can do for me. I am on Remicaid every six weeks infusion. I have tried Humira, Enbrel, Methotrexate, steroids and topical creams. I would like to get a second option as I feel I should be hospitalized. Thank you.
Hi. I have read your query in detail, saw the pictures (attachment removed to protect patient identity) and do understand your concern. This pus filled lesions is a form of psoriasis called pustular psoriasis. Also you seem to be going into psoriatic erythroderma that is involvement of more than 90 % body surface area, which is an indication of hospitalization. For pustular psoriasis, Acitretin is the preferred form of treatment. Cyclosporine can also be started and gives good results. As you know, psoriasis is a chronic disorder for which medicines are prescribed whenever condition worsens. These listed treatment options will depend on any associated disease, hepatic and renal profile, dose of drugs already taken, etc.  You can discuss about these treatment options with your dermatologist who is the best judge since you are suffering from this problem since a long time. Avoid stress and alcohol. For further information consult a dermatologist online -->