Inverse Psoriasis

A Challenge

Inverse psoriasis appears like a tender red rash that can be found in the groin, armpits, under the breasts, under the genitals, and under the buttocks. Treatment of inverse psoriasis can be a challenge because most of the cases occur in the most sensitive areas of the body.

Treatment

For treatment of inverse psoriasis, medications may range from over-the-counter hydrocortisone to prescription-strength medications such as Elidel (pimecrolimus) and Protopic (tacrolimus). Because of skin sensitivity in flexure areas, Protopic and Elidel are medications usually preferred over cortisone-type treatments. Use of steroidal treatments such as hydrocortisone may cause skin thinning and other side effects.

Protopic and Elidel medications are given the strongest warning by the FDA by including black-box warnings for these treatments. Using the medication increases the risk of viral infections and a possibility, although rare, of developing lymphoma and skin cancer. Even if these medications are the preferred types, FDA recommends both medications to only be used as last resorts over a short period of time only.

The American Academy of Dermatology’s considers the appropriate use of these medications under the supervision of a dermatologist, despite the black-box warnings, to be safe and effective. Many dermatologists treat inverse psoriasis using these medicines first as they do not involve the risk of skin thinning.

Ultraviolet B (UVB) light is believed to slow the growth of psoriasis cells and its use as treatment for inverse psoriosis is helpful. For treatment to be received, the patient must undress and stand in a light box, usually at the doctor’s office.

A case study in 2002 reported that after 3 weeks of UVB light treatment, one patient received “complete clearance” from inverse psoriasis lesions. A larger study using UVB light among people with standard psoriasis says that about 66% were “90% clear after a maximum of 10 treatments.”

A product called Castellani’s Paint of Castederm is used by patients whose inverse psoriasis is usually worsened by moisture. It is a liquid medication that comes in both prescription and nonprescription strength and contains the active ingredient phenol. Available over the counter are Domeboro astringent soaks and this can also be helpful.

In cases were inverse psoriasis is particularly stubborn, treatment using biologics such as Enbrel (etanercept) and Remicade (infliximab) may be recommended by a doctor. These types of medications are injected.

A change in diet might also be a good treatment for inverse psoriasis. Eat whole grains, fruits, vegetables, and avoid some types of animal food such as meats, eggs, and shellfish.

Coping

A patient must follow their doctor’s recommendations by being active in their health care and track the triggers that cause flare-ups. Connecting with other patients in the same situation can provide emotional support as well as offer valuable information on how to cope up with inverse psoriosis.

Patients should be active participants in their health care, which means following doctors’ recommendations and tracking triggers that cause flare-ups. Ask about the latest treatments. And, as with any chronic condition, connecting with other patients can reap valuable information as well as emotional support.