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Re: Psoriasis and CLL

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I used to have psoriasis of the scalp for several years,

even before I was diagnosed with CLL in 2005. I used a

variety of creams and lotions, settling eventually on

triamcinolone 0.025% and a tar shampoo called DHS. This

helped reduce itching, but did not cure the psoriasis.

However, after I started IVIG for my poor immune system, the

psoriasis vanished within a short time. I just suddenly

realized it was not there any more. I also stopped taking an

antibiotic, Ethambutol, at the same time. I started taking

it again about a month ago, however, and so far the

psoriasis has not come back.

I have asked several of my doctors what they would attribute

this sudden improvement to. None of them, even the

dermatologist, knows for sure. The dermatologist did agree,

however, that it might be due to the IVIG, since psoriasis

is an autoimmune disorder an I am getting infusions of

healthy immunoglobulin.

Bente

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I have been in W & W since 2005. I have had a scalp condition

that I can't seem to clear up. I have seen a dermatoligist

on a few occasions but nothing prescribed seems to

work.Basically I live with it....I was never told it could

be association with the CLL. Any suggestions would be

appreciated.

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Last year my dermatologist prescribed 2 creams, 1 for

morning and one for night. It seemed to clear somewhat, but

my derm told me it will NEVER be cured. Then in June 2010,

I went through 4 treatments of FCR. I no longer have any

psoriasis, but my onco at DFCI told me it will come back

after the FCR leaves my body, whenever that is.

I would not recommend FCR as a treatment for psoriasis.

On Fri, May 20, 2011 at 5:03 PM, Gail wrote:

> I have been in W & W since 2005. I have had a scalp condition

> that I can't seem to clear up. I have seen a dermatoligist

> on a few occasions but nothing prescribed seems to

> work.Basically I live with it....I was never told it could

> be association with the CLL. Any suggestions would be

> appreciated.

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I have had severe psoriasis for decades. Since being

diagnosed with CLL, I had been receiving narrow-band UV-B

treatments, which were working, in lieu of the drugs I was

taking previously. When I started FCR in December, I had

to discontinue the UV treatments However, I was told that

my skin should improve because FCR is such a potent

immunosuppresant and other immunosuppresant drugs like

cyclosporine are effective treatments for psoriasis. To

everyone's surprise, the FCR caused my psoriasis to flare.

About six weeks after my last FCR treatment, my psoriasis

seemed to subside a little, and I have now resumed UV

treatment to try to get my skin under control.

I researched my issue online and found a journal article

that reported a similar phenomenon. The title of the article

was " Paradoxical Exacerbation of Psoriasis During Treatment

With Fludarabine " -- so I'm not the only one who experienced

this counterintuitive reaction to FCR.

Mitch

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Mitch,

Like we've said before, EACH OF US IS DIFFERENT.

We can only relate our personal experiences.

On Sat, May 21, 2011 at 10:33 AM, wrote:

> I researched my issue online and found a journal article

> that reported a similar phenomenon. The title of the article

> was " Paradoxical Exacerbation of Psoriasis During Treatment

> With Fludarabine " -- so I'm not the only one who experienced

> this counterintuitive reaction to FCR.

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Psoriasis is believed to be a disease mediated by T cells.

As such, we would expect that it might improve with typical

treatments for CLL (fludarabine, pentostatin, bendamustine)

as these agents knock down T cells as well as B cells. In

my experience, I have not seen rituximab make any psoriasis

flare, but it is theoretically possible it might due to

" altering the T cell - B cell environment " . Rituximab might

also improve psoriasis just by bring the CLL under better

control.

With that being said, I have seen a patient, and there is a

report in the literature, of psoriasis worsening with

fludarabine treatment.

Rick Furman, MD

>

> What experiences, positive and negative, have folks had

> managing psoriasis and CLL at the same time? What steps led

> to improvement in the psoriasis?

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