Hand, foot and mouth plus psoriasis

[RKP1234]

Hi all, about 3 weeks ago we all came down with hands, foot and mouth. I had secondary tonsillitis and ended up on antibiotics. Plus I have psoriasis, an auto immune disease and it resulted in the worst flare up of my life. My skin went black in places and flaked off.
my husband had a sore throat for a while, my oldest son had blisters, temp, sore throat etc and our baby had a sore throat.
my eldest feet are peeling and I'm covered in a different rash. I'm wondering if this still an affect of hfm.
I've been to GP who say it's psoriasis which I'm not convinced yet, I've had it my whole life and never looked like this. Steroids doing nothing.
I just wondered if any adults had caught hand, foot and mouth, and how long it took to recover. doctor did say three weeks for me but this was before this new rash appeared. Any insight would be interesting.

For someone with psoriasis, an autoimmune condition, you've had one hell of an assault lately on your body, both viral and bacterial by the sound of it.

Sometimes during a mega flare-up, psoriasis can present in additional and unexpected ways. But you'd still expect it to respond to treatments like Enstilar and emollients. What has your GP prescribed for you?

It's a crap condition to have, I know. Have you ever seen a dermatologist?

Thank you for your reply.
I have enstillar and dovobet. GP is now trying eumovate/mometasone in the morning and calcipotriol evening. My actual psoriasis has improved but this new rash isn't budging.
I have a dermatologist appointment in two weeks.

Is it guttate? I have plaque psoriasis normally but have got flares of guttate before and it can be linked to other infections.

Ah yes, the GP called it that.
I think I normally have plaque too.
Jeez I'm struggling to look after two kids with all this. Thank you again for replying.

Does guttate come and go? I'm worried this is another rash I'm now stuck with.

Last time I had it was in the middle of a major flare just before a started a biologic. My understanding is that it is more likely to go to of its own accord than plaque although it's not always the case. Have you explored other options than creams? That's the only way I've got any relief. Creams etc never did anything.

Ah yikes, nightmare with DC in the mix to look after, isn't it?

Can you describe this new rash, OP? Is this what your GP is saying is guttate psoriasis? (Hope I've understood.) Mine definitely flares up with a throat or viral infection, then goes after a short course of Enstilar treatment. (I also have plaque and flexural psoriasis.)

Good luck with your dermatology appointment. They will be able to talk you through a diagnosis and next steps (DMARDS, either conventional or biologic).

I'm going to have to see what the dermatologist suggests then. I found creams have never done anything either. The next sad decision I've got to make is to then stop breast feeding my baby I guess.
I've had ciclosporin in the past and UV light treatment in the past.

This is the guttate psoriasis

My usual psoriasis, plaque? But this is after and healing from hfm.

I've only ever had my usual psoriasis, it's never gone except with ciclosporin and sun.
This guttate one is new to me, I'm hoping it goes but I know how my luck runs.

Is your new rash warm? Could be erythrodermic psoriasis which I've had and is nothing like any other kinds.

Oh, thats's like tiny pustules.

OP, on a slightly brighter note - there are many medications for psoriasis in the DMARD categories that are compatible with breastfeeding if taken moderately. Also prednisolone, a corticosteroid, is considered compatible. So there's hope.

I can post a link if you'd like?

That looks like the guttate I get on my feet. It's really irritating isn't it?! And yes, classic plaque psoriasis too. Definitely worth asking about meds; I'm sure some are compatible with BF.

Oh yes please!

I was wondering if I could take steroids, I hate all these creams.
I'm terrified about having two types of psoriasis that won't go now 😔.
Thank you so much for replying!

Oh it's horrible, I wish I could go back to just my plaque psoriasis 🤣😭

Would that come on from hand, foot and mouth? It feels dry, does feel warm I think.
My plaque psoriasis went black almost and peeled off, but I assume that was hfm that I caught from my son.

Hi again, @RKP1234

This is a link to a recent (2022/2023) article to drugs you may be able to be prescribed while breastfeeding. Don't worry about the source being from British Society of Rheumatology - they use the same corticosteroid and DMARD drugs as dermatologists.

Scroll down to 'Table 1.Summary of drug compatibility in pregnancy and breastmilk exposure' - it's relatively near the top. (If you are on a laptop or PC use the CTRL F search and type 'adalimumab' and you'll be taken to it straight away.)

https://academic.oup.com/rheumatology/article/62/4/e48/6783012

Thank you, that's really helpful and interesting.

End of September/ October I had a really bad chest infection that triggered a flare up of G psoriasis (on top of my usual). I always have a flare of it after an illness. It has gone now and back to my usual flakey skin!
I find that tar based creams work well for me (exorex)... always worth a try if you haven't found something yet.
Also a side note, I was meant to be doing a medical trial for psoriasis but wasn't allowed to continue due to the flare up of G psoriasis. The whole premise of it was daily fish oil and so maybe try cod liver oil!
I hope you feel better soon.

You're welcome. I'm glad it was of help

(You need to tweak your use name back to its original form, btw!)

Oh I don't know why that's changed. Thank you

Thank you for your message. Fingers crossed this goes too then.
I do take omega as needed a hip replacement at 33! ( I can't believe my luck).
I'll look into exorex, thanks again.

Oh bless you OP. I had the worst flare up of my life after a throat infection and was covered with guttate head to toe. It was horrendous. Over time it spread out and morphed into plaque psoriasis, which was rubbish but at least I was familiar with that. I hope it calms.down soon. Guttate definitely didn't hang around as long in my experience. I am very careful about throat infections now as I worry about a recurrence.