Hi Lee Anne, there are a lot of topics to hit on in your post a few of which
I felt I might offer instructive comments on. First off as you already know
there is some genetic predisposition for psoriasis and having multiple recent
ancestors who have shown symptoms increases the likelyhood of developing it.
The skeletal symptoms very well might be psoriatic arthritis, PA. One
indication that may help to define PA is changes to the fingernails such as
detatchment from the skin beneath the nail, changes in the shape of the nail,
pitting on
the surface etc. A Rheumatologist is best equipped to diagnose PA, make sure
to point out the psoriatic lesions of the skin and mention the family history
of psoriasis.

You mention digestive problems along with osteoporosis, if her stomach doesnt
produce sufficient acid then her body wont take up calcium well which could
contribute to the osteoporosis. Symptoms of hypo/achlohydria include
indigestion and heartburn especially after meals containing a large amount of
protein.


The spots that came up on her ankles; Psoriasis does not leave scars. If
she were excoriating the spots, agressively digging at them, that could cause
scars from what was a psoriatic lesion. It is a bad thing to dig, pick, scrub,
scratch or any other activity to forcefully remove scales. A 20 minute soak
in water or liberal use of skin lotion can soften the scales to be removed more
gently.

Eczema behind the ears. That's the first place I really noticed psoriasis
that stayed more than a week or two. Around the mouth 2 winters in a row.
That could be confused with herpes simplex, a cold sore/fever blister.

Scalp psoriasis should not bleed unless the scales are forcefully removed.
If the psoriasis is limited to her scalp you may get her a shower cap so that
she can wet her hair and let it soak for 20 minutes or more as she goes about
her business at home followed by shampooing to gently remove the scales. You
might also try a coal tar based shampoo such as Neutrogena T-gel. Wal-mart and
Wallgreens have store brands of coal tar shampoo which are much cheaper and I
find to be just as effective. I prefer the Wallgreen's brand for the
fragrance. The coal tar shampoo may be a bit more effective if after shampooing
and
rinsing the affected area is immediately exposed to a few minutes of sunshine.
Coal tar will make her more sensitive to sunlight so take it easy with the
sun exposure while using it.

I had a lot of what was defined as "growing pains" and have at times
experienced significant joint problems but thankfully that has improved and I
experience no visible joint damage. I havent ever been to a Rheumy or had any
kind of
imaging of the joints so who knows. Hopefully the Rheumatologist can answer
some of the questions on her joint pains and come up with something to improve
that situation.
She is at that sensitive age where a visible flaw can be that much more
devastating socially so dont overlook her feelings. It may be very valuable to
her
emotionally if you do the shampooing for her the first couple of times to
show her that you arent afraid to touch the psoriasis, that it is not something
contagious to be avoided. This small gesture wont do anything to educate the
kids around her but it may be very comforting to her to know that you
understand. Orin


In a message dated 9/17/05 11:32:25 AM Central Daylight Time,
AllenLeeAnneBye@... writes:
Hi my name is LeeAnne and I have four wonderful kids all with complex
health issues. I am posting to this group for some insight into
diagnosis and treatment. My father and my husband both have psoriasis
and psoriatic arthritis, not a very good gene pool I am afraid but
lots of other attributes! Anyway our daughter Amanda shares with her
younger bother and sister some health issues believed genetic that
have caused orthopedic problems, osteoporosis, overly loose joints,
back problems with spondylolisthesis(a slightly dislocated L5
vertebrae), she also has gastroesophageal reflux an autoimmune GI
problem and mild asthma(they all have some GI issues and asthma).
Several years ago she began to have severe back pain in her upper
back, a lot of studies were done, bone scan, MRI etc and all that we
found was the displaced L5 much lower then where her horrible pain
was and the osteoporosis and joint hyper mobility. She was put in PT,
water therapy a back brace, elavil, motirn around the clock and given
an IV medication to increase her bone density(pamidronate) all to
improve her back pain which it did
over months. At the same time she developed about 7 or 8 very small
red raised scaly lesions on her torso and a few on the outsides of
her
ankles which looked very similar to my dads psoriais except they were
few and small, Dad's are very large (my hubbys is
very mild in scalp,dads is all over and more severe). Flash forward
several years, the lesions scarred over and aside from the scars no
new lesions, one really bad case of eczema behind her ears did come
up as well, which derm called ezcema, as a few ezcema like dry scaly
patches by her mouth two winters in a row. Her
back pain was OK, a few mild flares but none so severe but she began
to complain alot of right ankle, feet and
left knee pains as well as occasional right hip pain over the last
year. This week I realized
she has been scratching her head alot, and I investigated. Her scalp
is pretty much covered in large pale pink very dense thick scaly in
area
plaques. It looks very much to me like numerous rather large
psoriatic lesions, with pinkish edges, some slightly bleeding. I have
an almost
immediate appointment to see derm at Children's in Phila on Monday.
BUT my big question and concern is , we have blamed the joint and
feet pains on her overly loose ligaments and joints I seriously
wonder if in fact it is psoriatic arthtitis. I have a call in to see
a ped rheumatologist as soon as we can get in. Her pain complaints
have been much worse the past month or so but I was blaming it on
walking more and back to school. I do think the scalp lesions have
appeared in the past month to two and interestingly she just hit
puberty in July too. My poor kid is upset and I am wondering how best
to get a good evaluation and diagnosis if it is and what is
appropriate treatment for a 12 y/o girl?
I'd truely appreciate any feedback, info or resources.
Thanks,
Lee Anne


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