What is the treatment option to manage psoriasis?

Question

Hello doctor,

I am writing about my husband who is 39 years old whose psoriasis has exploded since his liver transplant two months ago. The doctor said this happened from the anti-rejection medicines, Tacrolimus and Prednisone. The incision site is surrounded by thick plaques that crack and bleed. His joint pain is so bad he cannot do his physio exercises. I missed three sessions already. My latest laboratory test shows elevated liver enzymes ALT 82, AST 78, and low WBC (2.1). The Tacrolimus level is high (16.8) but we are scared to reduce it. I want to know about the treatment options that would not mess with his transplant medicines.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Tacrolimus and Prednisone are effective post-liver transplantation immunosuppressants and can treat early acute rejection. On the other hand, it may cause liver injury. Its level in blood should be below 16 ng/ mL, an average of 6 to 10 ng/mL. When high, this means an increased risk of transplantation rejection or toxicity. Tacrolimus has proved to be effective in treating psoriasis, but in some cases, it causes skin problems. Tacrolimus is not used with Hydrocortisone as this will increase the blood level and effects of one or both medications. Contact your healthcare provider to shift to an alternative Tacrolimus (having good immunosuppressant effects and fewer side effects). Use an alternative to hydrocortisone as a vitamin D analog.

This information will help you.

Thanks.