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Suffering from eczema. Using propysalic nf ointment. Radiation therapy done. How to get rid of this?

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I am a 37 yr old male. I work as a software developer. My weight is 70 kg and height 160cms. I live in India, Kolkata. I am pure vegetatian.I have been suffering from ezima since 1998. I had gall undergone bladder stone operation in 2001. I have been using propysalic NF ointment since 2008. Ezima/psoriasis had affected me on both the legs till knees, elbows and scalp and both the palms. I had undergone treatment in Year 2004 for UV beta rays for 7 days with one day gap(each time 5 to 7 minutes), and I was using coltar cream, which gave good relief for 6 months almost no sign of ezima/psoriasis. From yr 2008 I have been using Propysalic NF ointment. This ointment works for the day and keeps my skin soft.
Now I found that ezima has affected in my nose.How to get rid of this skin desease. Kindly help me.
Posted Tue, 12 Feb 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 1 hour later
Thanks for writing to us.
Firstly I would like to mention that eczema and psoriasis are two different skin disorders.
The site and type of lesions probably point more towards psoriasis. In cases of confusion, skin biopsy is confirmatory.
Psoriasis is a skin disorder where you get red elevated skin lesions covered by thick silvery white scales. Lesions are usually present over legs, forearms, lower back, abdomen chest, knee, elbows, palms, soles, nails and scalp.

In your case to treat the same you might go with these treatment options-
1) use a mild soap like dove, venusia bar, elovera bar, cetaphil
2) use an intensively moisturising cream like cotaryl or moisturex immediately after bath.
3) you may also add bathing oils to water while bathing
3) to treat scalp lesions use a salicylic acid or tar based shampoo along with application of topical steroid and salicylic acid based lotion.
4)you have been using propysalic NF since last four or five years, its regular use for such long time can induce irreversible skin thinning. Prolonged use of a potent steroid is not advocated. You may switch to milder steroids like mometasone or beclomethasone and apply them after diluting in coconut oil.

5) your lesions are extensive and are now developing on face too, you might need oral therapy in form of methotrexate or acitretin.
6) sometimes instead of oral therapy, we put the patient on phototherapy( narrow band ultraviolet b) therapy for three non consecutive days in a week. It yields great results. Once the lesions clear off, we maintain the patient on maintenance sessions of phototherapy.
As you had good results in a week. I would advise you can try phototherapy again with topical therapy. It is a good treatment option with minimal and no serious side effects..
The only precaution with phototherapy is to avoid sun exposure as much as possible and use a good sunscreen.
All these treatment options are prescription based and treatment for psoriasis should always be taken under a dermatologist's supervision. I would highly recommend that you consult a dermatologist nearby to discuss the treatment according to your disease progression.
Psoriasis is a remitting and relapsing disease and treatment is basically offered to keep the disease in remission for the longest period possible.
Hope that answers your query. Should there be more, I would be happy to help you further.
Above answer was peer-reviewed by
Follow-up: Suffering from eczema. Using propysalic nf ointment. Radiation therapy done. How to get rid of this? 40 hours later
1)Pls prescribe me ointment to apply on body and scalp, I am going to quit propysalic cream. I don't use any soap, I don't use coconut oil or any oil.
you have mentioned these mometasone or beclomethasone. any other?
2)Is there any harm on phototherapy related to fertility. How frequent can I take this.
3)Is this curable , if yes how long it will take.
4) What food I should avoid. (I am pure vegetarian. I dont take milk. I don't smoke , i don't drink alchohol etc)
5) In winter how can I take care of my body as it becomes severe in winters.what moisteriser cream is good for face.
6) I dont have any kids now. Is this heredetary desease. Thanks
Answered by Dr. Kalpana Pathak 4 hours later
Thanks for writing back.
Psoriasis has a genetic component and roughly in 20 percent of cases it may pass on to next generation but that should not be a deterrent to get married or have kids.

Psoriasis is not completely curable, treatment is offered to induce remission for prolonged period( this remission could run from months to years). Once the remission is induced, keeping your skin well moisturised and immediately treating the lesions that recur is advised.

No particular food induces psoriasis. However some suggest taking diet XXXXXXX in omega 3 fatty acids like fish and antioxidants like fruits, nuts, vegetables etc helps in psoriasis. It is better to abstain from alcohol and smoking as it can flare up psoriasis

I would advise you to undergo sessions of phototherapy. Narrowband UVB is very safe and no effects on fertility are seen. However during the sessions eyes and genitalia are advised to be shielded. It can be taken three days in a week on non consecutive days.

To keep your skin hydrated in summers and winters
Use XXXXXXX warm water to bathe as hot water decreases moisture
Use mild soap bar cetaphil or venusia
Use cotaryl cream or moisturex cream to hydrate skin immediately after bath as these creams contain urea and lactic Acid which not only keep the skin hydrated but are also keratolytic hence improve psoriasis lesions too.

As you have propisalic ointmentfor long, it is better to switch over to mild steroid like beclomethasone lotion. Later on you can dilute it further in coconut oil. This will prevent side effects of steroids.

Use a tar and salicylic acid based shampoo like salisia kt to reduce scalp scaling. You may apply beclomethasone lotion over scalp also.

I would advise you to visit a dermatologist nearby to discuss these options as treatment of psoriasis depends upon the severity and extent of lesion which can only be ascertained by skin examination.

Hope that answers your query. Take care.
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