Are biologic shots safe for itching and skin flaring?

Question

Hi doctor,

My plaques on my elbows and scalp are flaring up again, and it is worse than last year. The itching drives me crazy at night. I have been using steroid cream, but it stops being effective after a while.

Are there any new medications that work better for the long term?
I came across information about biologic shots. Are those safe?

I am also embarrassed at work because the flakes show up on my black shirts. I have tried reducing stress and changing shampoos, but it keeps coming back.

Please guide.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concerns.

I would like you to share pictures of the lesions so that I can confirm your diagnosis.

Additionally, please share the prescription from your treating doctor for a better understanding of the dosages and medications prescribed. If the condition is prurigo nodularis, I would like to provide you with some brief information about it.

Prurigo nodularis is a chronic allergic skin condition, and the exact cause and mechanism are unknown. It results in itchy rashes and nodules, which may sometimes be pus-filled, primarily located on the arms, legs, trunk, and other areas.

I understand that the itching can be very intense, to the point of disturbing your sleep. Generally, treatment involves the use of moisturizers and steroid creams. In severe cases, biological drugs are available for management.

Biologics are medications that do not suppress the immune system but work by inhibiting the source of inflammation. Dupilumab is a biological medication approved for prurigo nodularis, but its necessity depends on the severity of the condition.

This condition could also be psoriasis, which is an autoimmune disorder characterized by silvery plaques. Psoriasis is typically managed with immunosuppressants, and abrupt withdrawal of steroids in these cases can worsen the situation.

Alternatively, the condition could simply be eczema, another autoimmune disorder where fluid may ooze from the rashes after scratching. Therefore, please share images of the lesions for diagnosis confirmation. Be aware that flare-ups can occur due to stress, hormonal imbalances, and other factors.

It is essential to maintain a proper sleep schedule, exercise regularly, eat a healthy diet, stay hydrated, and engage in stress management. Additionally, your doctor may initially prescribe oral steroids as part of the treatment.

I hope this answers your query. Feel free to reach out anytime.

Thank you.