Receiving a diagnosis of psoriasis can feel like the start of a journey that no one ever prepares for. It’s a blend of relief in finally having an answer, coupled with the daunting realization of managing a lifelong condition. In sharing my diagnosis story, I hope to connect with others who may be starting down a similar path or seeking understanding of these challenges.

The Path to Diagnosis:

In retrospect, I now recognize that my journey toward a diagnosis began well before I ever sat in a doctor’s office. It was October 2021 when I noticed rashes under my breasts. The rashes were pink, looked like patches and itchy. I bought and applied an over-the-counter anti-itch cream (Cortizone) to relieve the itchiness. It did not go away though. January 2022 came, and there appeared dandruff-like patches on my scalp, hairline, the back of my neck and skin around my ears. At first, I thought they were just dandruff and I tried applying baby oil on the affected areas. However, after just less than 30 minutes, the patches appeared again! This went on until April 2022. I got worried so I contacted my primary doctor who prescribed Fluocininolone - a scalp oil and also Betamethasone Valerate for the rashes under my breasts.

I remember it was a grueling experience having to apply and reapply again and again the prescribed medications only to experience temporary relief; not to mention the extreme itchiness. I also started wearing wide headbands to hide the patches on my hairline.

In May 2022, pink to reddish patches with whitish buildup became visible at my back and on my tummy. It was not only itchy but also painful. I started having sleepless nights. It was very uncomfortable!

I was given a new set of medications on June 3, 2022 since the first prescriptions were not working and there were new skin conditions too. The doctor first diagnosed it as Eczema. He then prescribed Clobetasol spray for my scalp, Cetirizine (Zyrtec) for the itchiness and Tacrolimus ointment for the other affected areas.

Yes, like many, I went through a period of trial and error, with different doctors and tests. I remember the frustration of having symptoms but no clear answers. I will never forget also how one hospital staff cringed when she saw my skin and even predicted that I might have Mpox. That was both an embarrassing and frustrating moment!

Getting the Diagnosis:

The day I received my diagnosis was both a relief and a moment of fear. On one hand, I finally had a name for what I was experiencing: Psoriasis. On the other hand, I now faced an unfamiliar world of chronic illness.

According to the National Institute of Health website, Psoriasis is a chronic (long-lasting) disease in which the immune system becomes overactive, causing skin cells to multiply too quickly.

It was June 8, 2022 and it was also our 21st Wedding Anniversary. We went to another doctor because the new medications (from the week before) that I have been using seemed not to work and that the itchiness and pain were becoming so unbearable.

At this stage, I felt a flood of emotions, ranging from denial to acceptance. I was given the following: Apremilast/ Otezla (both the starter and the regular tablets) which I took twice a day; and also Clobetasol lotion for the rest of the affected areas of my body.

The Otezla proved to be damaging for me. I was having endless diarrhea, fatigue, extreme body pain and nausea. I was working full time and it was just so difficult! The side effects went on for 2 weeks.

We moved to Las Vegas in the middle of Summer. I got sick of Covid-19. I started a new job.

Then the ultimate psoriasis attack came - August 2022.

Psoriasis covered 95% of my body (except my face). I was not sleeping at all. My whole body was super itchy and painful. Nothing seemed to work - not the Otezla, not the Clobetasol lotion, not the Epsom salt bath, NOTHING.

Since we moved to another state, our new health insurance was not activated yet. But I found the courage to go to a dermatologist to seek help.

When the nurse and the doctor examined me, they were full of pity for me. The nurse was even teary-eyed looking at my psoriasis-ridden body. They cannot believe how I am surviving and keeping up with my condition.

The doctor said that I almost have all the kinds of psoriasis:

• Plaque psoriasis (on my arms, thighs, legs, scalp)

• Guttate psoriasis (on my tummy)

• Inverse psoriasis (under my breasts)

• Erythrodermic psoriasis (at my back)

Because of the severity of my psoriasis, the only medication that will work for me, according to the dermatologist, is Biologics. The National Psoriasis Foundation defines Biologics/ Biologic treatments as targeting specific parts of the immune system and are given by injection or IV infusion.

Because of how severe my psoriasis was, I need to stop working.

Unfortunately that time, since I don’t have my health insurance yet, I need to wait and be approved. To ease my flares, the dermatologist gave me free Otezla tablets and prescribed me with a new topical cream, Triamcinolone Acetonide and also a Clobetasol scalp solution.

The time came when my health insurance was activated and I was approved for Skyrizi. Skyrizi is given as an injection using a prefilled pen. It targets a specific protein in the immune system which is responsible for causing inflammation.

One dose of Skyrizi costs $21,017.36. I am fortunate that I have health insurance and a Skyrizi Complete Savings Card to help with the payment.

I am now injecting myself with Skyrizi every 12 weeks. So far, so good.

I began to research and learn more about what was happening inside my body. I learned that inflammation caused by psoriasis can impact other organs in the body. Scientists do not know what exactly causes psoriasis. The immune system and genetics play major roles in its development. Triggers include stress, injury to skin, any illness, weather, certain foods, alcohol and environmental factors.

With psoriasis, I am at a higher risk for cardiovascular disease, depression and Type 2 diabetes (which I was diagnosed with in September 2023).

But, Psoriasis is not contagious.

I also learned that one in three people with psoriasis may also develop psoriatic arthritis.

And yes, in September 2023, I was diagnosed with Psoriatic Arthritis - a chronic, inflammatory disease of the joints. I experience joint swelling, joint pain, morning tiredness and eye inflammation. Supposedly, my Skyrizi can also treat Psoriatic Arthritis. It was working for a while but right now I might need a new medication for Psoriatic Arthritis.

Coming to Terms with My New Reality:

Adjusting to life with psoriasis and psoriatic arthritis meant rethinking many aspects of my day-to-day life. I have been making lifestyle changes - I started small. I enjoy doing Zumba in the morning. I spend a portion of my day in prayer. Gluten-free and Mediterranean diets prove to be helping too.

The virtual tutoring small business I started when I left my full-time job also needed to take a backseat now because of new symptoms of possible autoimmune conditions.

Living with a chronic condition isn’t easy, and it’s okay to acknowledge that. For me, understanding that I was not alone in this struggle was crucial. Some friends who also have psoriasis reached out and shared treatments that work for them. Pharmacies who fill my prescription are very helpful and approachable. Skyrizi nurse ambassadors constantly check on me.

Lessons Learned Along the Way:

In navigating this journey, I’ve learned a few things about resilience, patience, and self-compassion. I have always been a positive person. But these conditions tested me big time. I then allow myself to feel the despair, feel all the feels and slowly start anew again. I am trying to be kinder to myself - do the things I enjoy and love. Being able to sleep well and waking up pain-free are huge wins for me. Taking a break from even my own small business is necessary to attend to myself more.

Looking Ahead:

Though my journey with psoriasis and psoriatic arthritis continues, I feel more equipped to face the challenges ahead. By sharing my story, I hope to shed light on the realities of these conditions and support others who are walking a similar path. Remember, while each journey is unique, none of us are truly alone.

Thank you for reading my story. If you’re going through a similar journey, I’d love to hear your thoughts or experiences in the comments below. Together, we can create a space of encouragement, strength, and understanding. Stay tuned for more posts where I’ll dive into practical tips, insights, and resources for managing life with psoriasis and psoriatic arthritis.