Remicade and skin problems (psoriasis)

[mclavin]

I've been on Remicade for 8 months now. Two months after I started treatment I started developing skin lesions on my abdomen. Now they are everywhere and a biopsy came back as psoriasis. There is evidence that this is secondary to the Remicade. Anyone out there have this experience and if so what are they doing for it? My GI wants me to switch to Cimzia now.:ack:

 

[Catherine]

crohnsinct has daughter with this.

 

[AlliRuns]

I met a lady at the Remicade clinic who has psoriasis and Crohn's, she said the Remicade helped clear it up. I'm surprised that something that is also used to heal psoriasis can also cause it. Guess our bodies can react weirdly to it.

Hope it clears up for you, my grandmother, mother, and brother all have it, it's not very fun.

 

[Grumbletum]

I had three infusions then it was stopped as they thought I'd gone into remission. Three months after the last one, I developed pretty severe psoriasis lesions on my feet and lower legs.
The thing is, I think I'd started to have small patches before I first got abdominal symptoms, but when they put me on Prednisolone they cleared up. I was tapering off the Pred when I started on the Remicade/Infliximab.
My GP - who's a skin specialist - emailed my GI and he replied that they had had several cases where people had had incidences of psoriasis flares, mainly on the feet and ankles, while on Infliximab and advised the usual treatment i.e. with Betnovate ( steroid ) ointment which did help clear it up for me.
That was January last year, but strangely enough, it's started flaring up in the same places again, although not as badly as it did while I was on the Remi.

 

[mclavin]

Thanks everyone.... Yes, its completely paradoxical that this drug is used to treat psoriasis and yet causes it in others! It is very difficult and frustrating to live with esp. on top of the Crohn's. Grumbletum, I will talk to my doctor about the Betnovate ointment. Thanks so much guys.

 

[sickofcrohns]

I developed psoriasis while on Remicade, after 8 years on Remicade, but with 6 months of twice-weekly phototherapy and lots of topical steroids (Dovobet, which contains betnovate), the psoriasis went away.

It would be a shame to go off Remicade if it is working for you otherwise, especially if it's not clear that the Remicade makes the psoriasis worse. See if you can get a second opinion from a dermatologist about the psoriasis before deciding to go off Remicade. Generally, once you go off it, you can't get back on it.

 

[crohnsinct]

Hey there, I responded to your pm but for the benefit of those reading...my daughter got this paradoxical response. Phototherapy now is not an option as in all the Remicade literature there are warnings not to do it while on Remi. Our derm says the only way to clear it is to stop Remi and that only works 50-60% of the time. GI says it is only a matter of time before Remi stops working or a new and better drug is developed so mine as well stay on Remi.

My daughter has a really bad case. It is plaque psoriasis all over her face, all over her scalp, neck, chest, back, underarms and genital area. I would post a pic but she doesn't want me to.

Best thing for us has been cycling on and off steroid creams. But when they are stopped she gets a rebound reaction in that it comes back worse. So now we are trying 3 days a week and trying to wean down to 1 day a week.

Issues to watch for are: 1) psoriasis is broken skin and Remicade suppresses the immune system so risk of infection, 2) psoriasis increases risk of skin cancer and so does Remicade so be careful in the sun which is too bad because sun exposure is known to help clear psorisis up 3) psoriatic arthritis which my daughter is showing early signs of in her hands.

Natural things that have helped us: Oolong tea. Lots of it. She has about 3 cups a a day. Hot in the a.m. iced with lunch and dinner. Coconut oil. The plain old lard looking stuff you cook with. I read it is anti inflammatory and added it to her diet for Crohns but it is also excellent for skin issues. We apply it right onto the scales and it helps loosen the ones in her scalp and helps calm her face.

It totally stinks and is a bear, especially for a thirteen year old girl:voodoo:

 

[crohnsinct]

Hey guys. I posted on my daughters thread in the parents section but thought I would post here as well.

Her derm wants her off Remicade. GI doesn't.

Her sed rate was elevated at last infusion and they are thinking that is from the psoriasis. She also has added joint pain in her knees (psoriatic arthritis or CD related?).

GI is now suggesting we try a low dose (10mg) of Methotrexate weekly as mtx is sometimes used to treat psoriasis. If it works we will pull Remi levels in a few months to see if we could move out her infusion schedule (currently at 5 weeks) as mtx also slows the rate that you metabolize Remi.

I will keep you posted.