1 00:00:03,080 --> 00:00:06,720 Speaker 1: Growing up, Janelle Rodriguez always felt a disconnect between the 2 00:00:06,760 --> 00:00:09,240 Speaker 1: life that she wanted and the life she was living, 3 00:00:09,520 --> 00:00:11,560 Speaker 1: all because of a chronic skin condition. 4 00:00:12,000 --> 00:00:13,880 Speaker 2: I would have played sports in high school, like I have, 5 00:00:14,040 --> 00:00:15,480 Speaker 2: like this competitive nature to me. 6 00:00:15,640 --> 00:00:16,920 Speaker 3: Probably would have joined a dance team. 7 00:00:16,960 --> 00:00:19,160 Speaker 2: I love to dance, but I wouldn't do these things 8 00:00:19,200 --> 00:00:22,040 Speaker 2: because I was so afraid of showing my skin having 9 00:00:22,079 --> 00:00:25,400 Speaker 2: to wear a certain uniform. And so as the years 10 00:00:25,400 --> 00:00:28,640 Speaker 2: were passing and I keep missing out on opportunities, missing 11 00:00:28,640 --> 00:00:31,400 Speaker 2: out on things. Eventually, when I finished high school, I 12 00:00:31,440 --> 00:00:33,560 Speaker 2: felt like those years kind of passed by and I 13 00:00:34,080 --> 00:00:36,040 Speaker 2: experienced a lot of the things I would have wanted to. 14 00:00:36,600 --> 00:00:40,000 Speaker 1: Plaque siasis is not just a skin condition. It's a 15 00:00:40,080 --> 00:00:42,879 Speaker 1: visible barrier that can hold you back from living your 16 00:00:42,920 --> 00:00:45,880 Speaker 1: life to the fullest. But as we'll hear from Janelle, 17 00:00:45,920 --> 00:00:49,839 Speaker 1: with the right mindset, treatments and lifestyle adjustments, it doesn't 18 00:00:49,840 --> 00:00:56,520 Speaker 1: have to Hi, guys, and welcome. I'm so glad you're here. 19 00:00:56,800 --> 00:00:59,880 Speaker 1: I'm Nicole Berry and this is Skin Queries, a show 20 00:01:00,040 --> 00:01:02,560 Speaker 1: all about our skin and its health as. 21 00:01:02,440 --> 00:01:03,160 Speaker 4: We grow in age. 22 00:01:03,160 --> 00:01:05,760 Speaker 1: Our skin is really a record of a life well lived, 23 00:01:06,000 --> 00:01:08,160 Speaker 1: because there isn't one body part that I could think 24 00:01:08,200 --> 00:01:11,240 Speaker 1: of that reflects our well being as clearly as our skin. 25 00:01:11,600 --> 00:01:14,440 Speaker 1: So let's go on this journey together to really understand 26 00:01:14,480 --> 00:01:17,319 Speaker 1: what's going on with our skin. Let's unravel the mysteries 27 00:01:17,319 --> 00:01:24,520 Speaker 1: happening inside and out. Today we're talking about an inflammatory condition, placksoriasis. 28 00:01:30,040 --> 00:01:32,440 Speaker 1: I can't believe this is the last episode of this 29 00:01:32,560 --> 00:01:36,080 Speaker 1: season of Skin Queries. We've talked so much about the skin, 30 00:01:36,319 --> 00:01:40,840 Speaker 1: whether it's nutrition, extreme temperatures, aging the sun, even my 31 00:01:40,880 --> 00:01:44,440 Speaker 1: own husband's story about how stress has affected him physically. 32 00:01:44,920 --> 00:01:47,840 Speaker 1: As you know, Nick has placksoriasis and it flares when 33 00:01:47,880 --> 00:01:50,240 Speaker 1: he gets stressed. And one of the biggest things I 34 00:01:50,360 --> 00:01:53,640 Speaker 1: learned about our journey together is that it's so important 35 00:01:53,680 --> 00:01:56,080 Speaker 1: to empathize, be present, and listen. 36 00:01:56,360 --> 00:01:57,920 Speaker 4: So that's what we're going to do today. 37 00:01:58,360 --> 00:02:01,600 Speaker 1: Listen because Janelle read Vegas has a story to tell. 38 00:02:01,920 --> 00:02:04,400 Speaker 1: It's about what it was like growing up with severe 39 00:02:04,400 --> 00:02:08,280 Speaker 1: psoriasis and how she learned to cope through acceptance and 40 00:02:08,440 --> 00:02:11,720 Speaker 1: community building. We're also going to hear from doctor Memina 41 00:02:11,760 --> 00:02:15,640 Speaker 1: to Regano about placksoriasis and how to treat it. According 42 00:02:15,680 --> 00:02:20,280 Speaker 1: to the National Psoriasis Foundation, placsoriasis affects about eight million 43 00:02:20,320 --> 00:02:23,440 Speaker 1: people in the United States alone. It's one of the 44 00:02:23,560 --> 00:02:28,200 Speaker 1: most common autoimmune diseases out there. First, here's Janelle. She 45 00:02:28,360 --> 00:02:31,200 Speaker 1: was diagnosed with psoriasis at just four years old. 46 00:02:32,400 --> 00:02:35,120 Speaker 2: I think the first place was my cheek, and I 47 00:02:35,240 --> 00:02:38,440 Speaker 2: don't have too much of a memory of what that 48 00:02:38,639 --> 00:02:42,040 Speaker 2: was like. Once it started to surface on my skin. 49 00:02:42,240 --> 00:02:44,560 Speaker 2: I think my mother had to take action very quickly 50 00:02:44,680 --> 00:02:48,000 Speaker 2: to meet with a dermatologist, especially because it surfaced around 51 00:02:48,000 --> 00:02:51,320 Speaker 2: the time that I was starting school and with it 52 00:02:51,480 --> 00:02:54,240 Speaker 2: kind of looking like chicken pox, for example, because of 53 00:02:54,280 --> 00:02:57,480 Speaker 2: all the spots, there was always a concern even if 54 00:02:57,520 --> 00:03:00,440 Speaker 2: they would say, like, it's not contagious, but they needed 55 00:03:00,440 --> 00:03:03,079 Speaker 2: like some sort of medical record to prove. 56 00:03:02,880 --> 00:03:07,280 Speaker 1: That, and so were they able to diagnose you with plaxorisis. 57 00:03:07,600 --> 00:03:10,239 Speaker 2: I know at some point they did have to get 58 00:03:10,480 --> 00:03:13,520 Speaker 2: like a piece of my skin, and I can't forget 59 00:03:13,520 --> 00:03:16,280 Speaker 2: that because it was so painful when they removed like 60 00:03:16,480 --> 00:03:17,040 Speaker 2: a chunk of it. 61 00:03:17,080 --> 00:03:18,600 Speaker 3: I still have like the scar on my leg. 62 00:03:18,800 --> 00:03:19,040 Speaker 5: Wow. 63 00:03:19,960 --> 00:03:22,040 Speaker 2: And I think from there it was like a for 64 00:03:22,080 --> 00:03:28,200 Speaker 2: sure it's placorisis. And with plaxorisis, it surfaces kind of everywhere, 65 00:03:28,240 --> 00:03:31,680 Speaker 2: at least for me, like I got it on my elbows, knees, 66 00:03:32,120 --> 00:03:34,680 Speaker 2: and the spots they appeared very small, but they started 67 00:03:34,720 --> 00:03:36,840 Speaker 2: to kind of grow in time, and you know, they 68 00:03:36,880 --> 00:03:39,600 Speaker 2: get very flaky. So I think with just seeing it visibly, 69 00:03:39,800 --> 00:03:42,000 Speaker 2: you can tell what it is, but then having that 70 00:03:42,120 --> 00:03:44,640 Speaker 2: biopsy was kind of like confirming its psoriasis. 71 00:03:45,480 --> 00:03:48,760 Speaker 1: Janelle was given a prescription, but having a visible condition 72 00:03:48,960 --> 00:03:51,520 Speaker 1: put her in a lot of uncomfortable situations. 73 00:03:51,920 --> 00:03:55,600 Speaker 2: I got a lot of attention in elementary school where 74 00:03:56,240 --> 00:03:59,760 Speaker 2: my pleasorisis it's also on my scalp as well, so 75 00:04:00,040 --> 00:04:03,839 Speaker 2: I had some experiences where a teacher would like pull 76 00:04:03,880 --> 00:04:05,720 Speaker 2: me out of class so that I could see the nurse, 77 00:04:06,120 --> 00:04:09,240 Speaker 2: and if they didn't have like a letter from the doctor, 78 00:04:09,280 --> 00:04:11,400 Speaker 2: they would send me home. So very early on, I 79 00:04:11,440 --> 00:04:14,720 Speaker 2: started to have experiences where I just noticed it brought 80 00:04:14,760 --> 00:04:17,040 Speaker 2: some sort of attention to me. It wasn't always positive, 81 00:04:17,440 --> 00:04:20,160 Speaker 2: and little by little I started to take it very 82 00:04:20,160 --> 00:04:23,560 Speaker 2: personally as I started getting older, and you know, growing 83 00:04:23,640 --> 00:04:25,400 Speaker 2: up in New York, a lot of times like we 84 00:04:25,440 --> 00:04:28,440 Speaker 2: would go to public pools and I was getting ready 85 00:04:28,440 --> 00:04:30,440 Speaker 2: to go to a pool. Then when they saw me, 86 00:04:30,640 --> 00:04:34,080 Speaker 2: they kind of started to question, you know, was this contagious. 87 00:04:34,080 --> 00:04:36,440 Speaker 2: Can she come into the pool and swim with other people? 88 00:04:36,880 --> 00:04:39,279 Speaker 2: And I remember my oldest sister getting like upset, and 89 00:04:39,680 --> 00:04:41,560 Speaker 2: my sisters would always come to my defense of this 90 00:04:41,600 --> 00:04:44,839 Speaker 2: would happen, So I kind of always felt very protected. 91 00:04:45,720 --> 00:04:48,200 Speaker 1: According to a study in the Journal of the American 92 00:04:48,240 --> 00:04:52,080 Speaker 1: Academy of Dermatology, sarria sis carries such a huge amount 93 00:04:52,080 --> 00:04:55,080 Speaker 1: of stigma, and many people have the misconception that it's 94 00:04:55,120 --> 00:04:59,240 Speaker 1: contagious and infectious, which of course it is not. Thankfully, 95 00:04:59,320 --> 00:05:01,960 Speaker 1: Janelle had her older sisters to protect her and look 96 00:05:01,960 --> 00:05:04,640 Speaker 1: out for her, but that didn't last long. When she 97 00:05:04,680 --> 00:05:07,000 Speaker 1: started in middle school, Janelle was left to face that 98 00:05:07,120 --> 00:05:09,000 Speaker 1: judgment and stigma on her own. 99 00:05:10,760 --> 00:05:13,279 Speaker 2: So I moved to Florida when I was about almost 100 00:05:13,279 --> 00:05:15,640 Speaker 2: twelve years old. And I'm living in a state now 101 00:05:15,640 --> 00:05:17,679 Speaker 2: where it's hot every day. 102 00:05:17,960 --> 00:05:19,279 Speaker 3: Right, But now I'm. 103 00:05:19,120 --> 00:05:22,800 Speaker 2: Going to school wearing like short sleeves, capris, maybe a skirt. 104 00:05:22,960 --> 00:05:25,800 Speaker 2: And now I'm realizing I'm more conscious, like I'm more 105 00:05:25,839 --> 00:05:29,120 Speaker 2: aware of my surroundings. And I would notice how kids 106 00:05:29,120 --> 00:05:30,919 Speaker 2: would look at me. I would get a lot of 107 00:05:30,920 --> 00:05:34,120 Speaker 2: comments about what is that, or it would be compared 108 00:05:34,160 --> 00:05:38,440 Speaker 2: to something, and little by little I started to get 109 00:05:38,560 --> 00:05:40,000 Speaker 2: very insecure about my skin. 110 00:05:40,360 --> 00:05:43,680 Speaker 1: I think we're so self consciousnessed teeths regardless of what's 111 00:05:43,720 --> 00:05:45,760 Speaker 1: going on, you know. And to add that on top 112 00:05:45,800 --> 00:05:48,240 Speaker 1: of it, how did that affect your confidence? 113 00:05:48,640 --> 00:05:52,279 Speaker 2: I just remember I wanted to the best way I 114 00:05:52,279 --> 00:05:53,880 Speaker 2: can explain it is like I want to blend in. 115 00:05:54,520 --> 00:05:57,479 Speaker 2: I don't want to draw too much attention to me 116 00:05:57,640 --> 00:06:00,280 Speaker 2: where people can see my skin and ask me questions. 117 00:06:00,080 --> 00:06:04,640 Speaker 2: And here in Florida, when we experienced a cold front 118 00:06:04,880 --> 00:06:07,719 Speaker 2: and I wore like a sweater to school and long pants, 119 00:06:08,200 --> 00:06:11,440 Speaker 2: I remember how safe I felt. And that's like the 120 00:06:11,480 --> 00:06:14,479 Speaker 2: best way that I can describe how I started to 121 00:06:14,600 --> 00:06:17,520 Speaker 2: kind of isolate and hide my skin. It was because 122 00:06:17,560 --> 00:06:19,120 Speaker 2: for the first time, like I could sit on my 123 00:06:19,200 --> 00:06:22,560 Speaker 2: desk and not not be afraid to show my arms 124 00:06:22,640 --> 00:06:25,360 Speaker 2: and things like that. And over the years that affected 125 00:06:25,360 --> 00:06:28,400 Speaker 2: my confidence because I started to really hide myself and 126 00:06:29,040 --> 00:06:33,120 Speaker 2: isolate and I was hiding something that's a big part 127 00:06:33,160 --> 00:06:34,200 Speaker 2: of who I am. 128 00:06:34,360 --> 00:06:38,800 Speaker 4: And this insecurity made her miss out on a lot. 129 00:06:38,080 --> 00:06:40,440 Speaker 2: Like I would have been someone that I would have 130 00:06:40,440 --> 00:06:42,279 Speaker 2: played sports in high school, like I have like this 131 00:06:42,360 --> 00:06:44,920 Speaker 2: competitive nature to me, probably would have joined a dance 132 00:06:44,960 --> 00:06:46,960 Speaker 2: team I love to dance, but I wouldn't do these 133 00:06:47,000 --> 00:06:49,680 Speaker 2: things because I was so afraid of showing my skin 134 00:06:49,880 --> 00:06:53,080 Speaker 2: having to wear a certain uniform. And so as the 135 00:06:53,160 --> 00:06:56,440 Speaker 2: years were passing and I keep missing out on opportunities, 136 00:06:56,480 --> 00:06:59,559 Speaker 2: missing out on things. Eventually, when I finished high school, 137 00:06:59,560 --> 00:07:02,560 Speaker 2: I felt like those years kind of passed by and 138 00:07:02,640 --> 00:07:03,320 Speaker 2: I didn't. 139 00:07:03,240 --> 00:07:05,360 Speaker 3: Experience a lot of the things I would have wanted. 140 00:07:05,160 --> 00:07:08,360 Speaker 1: To got to today. And Janelle is so much more 141 00:07:08,400 --> 00:07:11,080 Speaker 1: comfortable in her skin. But funny enough, that did not 142 00:07:11,120 --> 00:07:13,800 Speaker 1: come from any improvement to her skin. It was the 143 00:07:13,880 --> 00:07:16,080 Speaker 1: determination to change her mindset. 144 00:07:17,560 --> 00:07:20,720 Speaker 2: So when I was twenty and I remember I was 145 00:07:20,760 --> 00:07:23,200 Speaker 2: getting ready to move. I was moving to New York, 146 00:07:23,360 --> 00:07:25,800 Speaker 2: and I was like really looking forward to the summer, 147 00:07:25,880 --> 00:07:28,120 Speaker 2: like my skin was clearing up. I was thinking about 148 00:07:28,120 --> 00:07:29,640 Speaker 2: all the things I was going to wear, and I 149 00:07:29,680 --> 00:07:31,400 Speaker 2: was so excited for that. I was waiting for like 150 00:07:31,440 --> 00:07:34,560 Speaker 2: that clear skin moment to like finally show up in 151 00:07:34,560 --> 00:07:35,640 Speaker 2: the world as I wanted to. 152 00:07:36,360 --> 00:07:39,120 Speaker 3: And right before I moved, I went through one of. 153 00:07:39,120 --> 00:07:42,000 Speaker 2: The worst flares that I've ever had, and it was 154 00:07:42,080 --> 00:07:44,160 Speaker 2: just like such a letdown for me, and I felt 155 00:07:44,160 --> 00:07:46,640 Speaker 2: like defeated in a way, like I was really looking 156 00:07:46,680 --> 00:07:49,760 Speaker 2: forward to that, and I remember that's kind of when 157 00:07:49,800 --> 00:07:52,160 Speaker 2: I had my AHA moment, was because I was just 158 00:07:52,240 --> 00:07:56,360 Speaker 2: so devastated by that and I felt defeated and that 159 00:07:56,440 --> 00:07:59,000 Speaker 2: I kind of questioned myself, like I reflected on like 160 00:07:59,080 --> 00:08:02,000 Speaker 2: the past six years and how I've lived, and I 161 00:08:02,120 --> 00:08:04,120 Speaker 2: kind of asked myself, like do I want to continue 162 00:08:04,160 --> 00:08:04,800 Speaker 2: living this way? 163 00:08:05,040 --> 00:08:06,760 Speaker 3: And I kind of made myself a promise. 164 00:08:06,800 --> 00:08:08,400 Speaker 2: I'm like, I can't keep living like this, Like I 165 00:08:08,400 --> 00:08:11,440 Speaker 2: can't keep hiding and waiting for the perfect moment to 166 00:08:11,560 --> 00:08:13,280 Speaker 2: dress the way that I want to do the things 167 00:08:13,280 --> 00:08:16,480 Speaker 2: that I want. So when I moved I started to 168 00:08:16,560 --> 00:08:19,120 Speaker 2: kind of challenge myself then to really just take it 169 00:08:19,160 --> 00:08:22,200 Speaker 2: as a fresh start and to wear the things that 170 00:08:22,240 --> 00:08:22,640 Speaker 2: I want. 171 00:08:22,840 --> 00:08:23,840 Speaker 3: And it was hard. 172 00:08:24,040 --> 00:08:26,200 Speaker 2: I had so many triggers, as you can imagine, like 173 00:08:26,280 --> 00:08:28,760 Speaker 2: sitting in a train and you know, my legs are 174 00:08:28,800 --> 00:08:31,400 Speaker 2: covered in it, my face and people could just stare 175 00:08:31,440 --> 00:08:31,840 Speaker 2: at you. 176 00:08:31,880 --> 00:08:33,160 Speaker 3: But it was like the. 177 00:08:33,080 --> 00:08:35,679 Speaker 2: Best decision because that kind of helped me to then 178 00:08:35,760 --> 00:08:37,720 Speaker 2: kind of move forward to where I am today. 179 00:08:38,400 --> 00:08:42,120 Speaker 1: It's so inspiring to hear this revelation because Janelle made 180 00:08:42,120 --> 00:08:44,960 Speaker 1: the decision to not let her skin hold her back. 181 00:08:45,000 --> 00:08:47,880 Speaker 4: Anymore. And what's even more, she now helps. 182 00:08:47,559 --> 00:08:50,080 Speaker 1: Others who are going through the same thing by sharing 183 00:08:50,120 --> 00:08:54,320 Speaker 1: her experience with psoriasis online. In fact, Janelle has cultivated 184 00:08:54,360 --> 00:08:57,439 Speaker 1: a whole community, which, as my next guest will tell you, 185 00:08:57,720 --> 00:09:00,000 Speaker 1: is so important when it comes to feeling better. 186 00:09:00,520 --> 00:09:01,960 Speaker 4: I can't wait for you to hear. 187 00:09:01,840 --> 00:09:13,720 Speaker 1: What she has to say right after this break, Welcome 188 00:09:13,760 --> 00:09:16,840 Speaker 1: back to skin Qureise. Earlier, Janelle shared her journey with 189 00:09:16,880 --> 00:09:20,120 Speaker 1: plaxoriasis and how she learned to feel comfortable within her 190 00:09:20,120 --> 00:09:23,160 Speaker 1: own skin even when she's going through a flara. Now 191 00:09:23,200 --> 00:09:26,880 Speaker 1: let's get into the science behind soriasis treatments and therapies. 192 00:09:27,160 --> 00:09:29,880 Speaker 1: I'd like to introduce doctor Mamina to Regano. 193 00:09:30,600 --> 00:09:30,720 Speaker 6: Hi. 194 00:09:30,880 --> 00:09:32,079 Speaker 5: They're nice to meet you. 195 00:09:32,640 --> 00:09:35,400 Speaker 4: Thank you for taking the time to chat with us. 196 00:09:35,559 --> 00:09:37,280 Speaker 1: I would love for you to kick it off and 197 00:09:37,360 --> 00:09:41,479 Speaker 1: introduce yourself and tell us a little bit about your practice. 198 00:09:41,720 --> 00:09:46,079 Speaker 6: I am a triple board certified dermatologist, internist, and dermatic pathologist. 199 00:09:46,720 --> 00:09:49,400 Speaker 5: I am based in New Orleans, Louisiana. 200 00:09:49,800 --> 00:09:54,560 Speaker 6: I see the full gamut, including medical dermatology and some 201 00:09:54,600 --> 00:09:56,040 Speaker 6: cosmetic dermatology as well. 202 00:09:56,400 --> 00:09:59,640 Speaker 4: So let's start with plaquorisis. 203 00:10:00,200 --> 00:10:04,200 Speaker 1: Can you explain what that is, and how does that 204 00:10:04,280 --> 00:10:06,360 Speaker 1: differ from other types of psoriasis. 205 00:10:06,760 --> 00:10:11,920 Speaker 6: Yes, well, placksoriasis is probably what we traditionally know as psoriasis, 206 00:10:12,600 --> 00:10:16,679 Speaker 6: and it shows up on the skin as these usually 207 00:10:16,720 --> 00:10:21,800 Speaker 6: like thick, scaly, pinkish red plaques. They love the elbows 208 00:10:21,840 --> 00:10:26,079 Speaker 6: and knees, but they also can certainly occur everywhere on 209 00:10:26,120 --> 00:10:29,200 Speaker 6: the body. The scalp is another common area I see 210 00:10:29,200 --> 00:10:31,880 Speaker 6: off it on the back, like lower back, like above 211 00:10:31,920 --> 00:10:34,839 Speaker 6: the buttock area. It can be pretty debilitating for a 212 00:10:34,880 --> 00:10:37,400 Speaker 6: lot of people in terms of its appearance. It can 213 00:10:37,440 --> 00:10:40,199 Speaker 6: be itchy, but I think the appearance is what really 214 00:10:40,200 --> 00:10:41,400 Speaker 6: affects people the most. 215 00:10:41,760 --> 00:10:43,719 Speaker 4: So is plackariasis. 216 00:10:44,200 --> 00:10:46,880 Speaker 1: Is it a symptom of something else or is it 217 00:10:47,080 --> 00:10:48,319 Speaker 1: something that stands alone. 218 00:10:48,520 --> 00:10:51,360 Speaker 6: Yeah, I almost look at psoriasis as kind of like 219 00:10:51,400 --> 00:10:54,600 Speaker 6: the canary in the coal mine, and so in a way, 220 00:10:54,840 --> 00:10:57,240 Speaker 6: and this might sound crazy to people, but in a 221 00:10:57,280 --> 00:11:00,800 Speaker 6: way could almost be a blessing if you have psoriasis, 222 00:11:01,160 --> 00:11:04,480 Speaker 6: you notice any sort of psoriasis forming on your body, 223 00:11:04,720 --> 00:11:08,880 Speaker 6: because it can be an indication that there is internal inflammation. 224 00:11:09,360 --> 00:11:14,840 Speaker 6: So internal inflammation that potentially can transform into concerning cardiometabolic 225 00:11:14,840 --> 00:11:20,720 Speaker 6: conditions like heart disease, stroke, diabetes, and it's almost like 226 00:11:20,760 --> 00:11:23,920 Speaker 6: a warning sign when you see zoriasis, like, hey, your 227 00:11:23,920 --> 00:11:27,080 Speaker 6: body's inflamed. Let's try to Let's try to do what 228 00:11:27,120 --> 00:11:30,600 Speaker 6: we can to decrease that inflammatory load so that bad 229 00:11:30,640 --> 00:11:31,960 Speaker 6: things don't happen in the future. 230 00:11:32,600 --> 00:11:36,079 Speaker 1: According to the National Library of Medicine, inflammation is your 231 00:11:36,080 --> 00:11:39,600 Speaker 1: body's response to an irritant. It's trying to fight something 232 00:11:39,679 --> 00:11:46,400 Speaker 1: foreign in your body. Some sides of inflammation could be redness, swelling, overheating, even. 233 00:11:46,160 --> 00:11:46,880 Speaker 4: Loss of function. 234 00:11:47,280 --> 00:11:50,000 Speaker 1: Think about when you have a fever or can't smell, 235 00:11:50,040 --> 00:11:52,559 Speaker 1: when you have a cold. When you have psoriasis, your 236 00:11:52,600 --> 00:11:55,000 Speaker 1: T cells, which is a type of white blood cell, 237 00:11:55,280 --> 00:11:58,359 Speaker 1: can become overactive and actually attack. 238 00:11:58,000 --> 00:11:59,280 Speaker 4: Your skin by mistake. 239 00:12:00,080 --> 00:12:02,400 Speaker 1: Amina says that there are certain things that you can 240 00:12:02,440 --> 00:12:05,200 Speaker 1: do to try and decrease that inflammatory load. 241 00:12:06,440 --> 00:12:10,040 Speaker 6: So if somebody has psoriasis, I do some counseling, and 242 00:12:10,400 --> 00:12:14,280 Speaker 6: there's like certain lifestyle changes with your diet, exercise. There 243 00:12:14,280 --> 00:12:16,800 Speaker 6: are certain supplements that can be helpful when it comes 244 00:12:16,800 --> 00:12:20,160 Speaker 6: to diet. The most compelling evidence that is out there 245 00:12:20,480 --> 00:12:23,520 Speaker 6: is with a Mediterranean based diet that has been shown 246 00:12:23,640 --> 00:12:27,040 Speaker 6: to be helpful for people with psoriasis. 247 00:12:27,320 --> 00:12:31,000 Speaker 1: I'm actually wondering at what point should someone actually go 248 00:12:31,120 --> 00:12:34,720 Speaker 1: see a dermatologist. Is seeing a dermatologist the best place 249 00:12:34,760 --> 00:12:35,240 Speaker 1: to start. 250 00:12:35,640 --> 00:12:38,440 Speaker 6: I think that if the rash is pretty minimal, if 251 00:12:38,480 --> 00:12:41,839 Speaker 6: it's if it's one or two plaques and you are 252 00:12:41,960 --> 00:12:46,120 Speaker 6: using an over the counter hydrocortisone it resolves, you know, 253 00:12:46,559 --> 00:12:50,559 Speaker 6: and nothing recurs, you can probably lay low. But if 254 00:12:50,559 --> 00:12:53,480 Speaker 6: it resolves and it recurs, or if it's not resolving, 255 00:12:53,800 --> 00:12:57,040 Speaker 6: or if you're getting more plaques or patches on the body, 256 00:12:57,480 --> 00:13:02,000 Speaker 6: definitely something to see a dermatologist. And psoriasis can be 257 00:13:02,000 --> 00:13:05,280 Speaker 6: a pretty easy diagnosis to make visually, but there are 258 00:13:05,320 --> 00:13:09,440 Speaker 6: some subtleties to it, and if it doesn't fully fit 259 00:13:09,559 --> 00:13:14,680 Speaker 6: with psoriasis, oftentimes dermatologists will do a biopsy. And that's 260 00:13:14,720 --> 00:13:17,600 Speaker 6: important because there are a lot of other skin conditions 261 00:13:17,600 --> 00:13:20,480 Speaker 6: out there not as common, but there are skin conditions 262 00:13:20,480 --> 00:13:23,840 Speaker 6: out there that can look like zoriasis, and you would 263 00:13:23,880 --> 00:13:26,200 Speaker 6: want to make sure that you have the right diagnosis. 264 00:13:26,240 --> 00:13:29,520 Speaker 1: What are some of the treatments conventionally that someone can 265 00:13:29,600 --> 00:13:30,840 Speaker 1: address their psoriasis? 266 00:13:30,960 --> 00:13:34,680 Speaker 6: So for very mild soriasis, we will all these treatments 267 00:13:34,679 --> 00:13:37,560 Speaker 6: are like anti inflammatory, So when it comes to creams, 268 00:13:37,679 --> 00:13:41,439 Speaker 6: we do a lot of topical steroid creams. They're anti inflammatory, okay, 269 00:13:41,480 --> 00:13:44,240 Speaker 6: and they're fine for intermittent use, but they're not long term. 270 00:13:44,360 --> 00:13:47,280 Speaker 6: When people start to get more extensive psoriasis or if 271 00:13:47,320 --> 00:13:49,640 Speaker 6: it's just hard to manage, like when it's in the scalp, 272 00:13:49,720 --> 00:13:51,720 Speaker 6: it gets to be a pain to put creams or 273 00:13:51,720 --> 00:13:55,800 Speaker 6: solutions in the scalp and shampoos consistently, so that's when 274 00:13:55,840 --> 00:13:59,480 Speaker 6: systemic therapies will play a big role. There are newer 275 00:13:59,559 --> 00:14:04,880 Speaker 6: oral betas which are considered more immunomodulatory, so not immunosuppressive. 276 00:14:05,000 --> 00:14:07,240 Speaker 6: So in a way, I like those for people who 277 00:14:07,320 --> 00:14:09,840 Speaker 6: need systemic therapy, but they're concerned about like the immune 278 00:14:09,840 --> 00:14:13,679 Speaker 6: suppressing effects of some of these systemic agents, so this 279 00:14:13,720 --> 00:14:16,360 Speaker 6: one is kind of like a nice like stepping stone. 280 00:14:16,720 --> 00:14:20,200 Speaker 6: And then there's the injectibles, which we call biologics, and 281 00:14:21,080 --> 00:14:26,040 Speaker 6: these are essentially like antibodies that bind to certain inflammatory 282 00:14:26,080 --> 00:14:30,480 Speaker 6: markers or receptors that play a role in psoriasis, and 283 00:14:30,800 --> 00:14:34,480 Speaker 6: you know, once again considered immune suppressive. And now there's 284 00:14:34,520 --> 00:14:36,480 Speaker 6: just been a whole slew of newer ones that are 285 00:14:36,520 --> 00:14:38,960 Speaker 6: I would say, more specific for people with I would 286 00:14:38,960 --> 00:14:41,640 Speaker 6: say at least ten percent body surface area or higher 287 00:14:41,760 --> 00:14:45,920 Speaker 6: or really bad scalp or palmer plant orsoriasis. 288 00:14:45,920 --> 00:14:47,160 Speaker 5: They would be good candidates. 289 00:14:51,080 --> 00:14:54,480 Speaker 1: How do your patients usually react when you finally diagnose 290 00:14:54,560 --> 00:14:56,400 Speaker 1: them and get them on a treatment plan. 291 00:14:56,960 --> 00:14:59,960 Speaker 5: I think people feel hope. 292 00:15:00,360 --> 00:15:00,520 Speaker 2: Hmm. 293 00:15:01,320 --> 00:15:03,640 Speaker 5: They are like there's a sense of relief. 294 00:15:03,760 --> 00:15:07,000 Speaker 6: There's a sense of hope, And I think that that's 295 00:15:07,000 --> 00:15:10,680 Speaker 6: really important too, to like take that mental burden, that 296 00:15:10,800 --> 00:15:14,600 Speaker 6: stress of dealing with the disease on their own, telling 297 00:15:14,640 --> 00:15:17,640 Speaker 6: them we got you. There's so many great treatments for it. 298 00:15:17,840 --> 00:15:22,960 Speaker 6: Because the stress surrounding the disease can also aggravate the disease. 299 00:15:23,320 --> 00:15:27,400 Speaker 6: We do have legitimate studies that show that stress increase psoriasis. 300 00:15:27,880 --> 00:15:31,200 Speaker 6: Just having a plan, an action plan, I think relieves 301 00:15:31,200 --> 00:15:33,680 Speaker 6: that stress. And then when the patients return and their 302 00:15:33,680 --> 00:15:38,160 Speaker 6: psoriasis is better, and like could just see the confidence shift. 303 00:15:38,320 --> 00:15:40,640 Speaker 5: Yeah, you could see that they're just like. 304 00:15:40,720 --> 00:15:44,640 Speaker 6: Beaming with more joy and they're enjoying life more, which 305 00:15:44,680 --> 00:15:47,520 Speaker 6: is so fulfilling. But yeah, there's definitely a big mental 306 00:15:47,560 --> 00:15:49,600 Speaker 6: aspect when it comes to treating psoriasis. 307 00:15:50,160 --> 00:15:53,160 Speaker 1: I know firsthand that stress can be a common trigger 308 00:15:53,360 --> 00:15:56,560 Speaker 1: when it comes to psoriasis. In a recent episode about 309 00:15:56,600 --> 00:15:59,360 Speaker 1: stress and skin, we talked about how it affects my 310 00:15:59,440 --> 00:16:02,960 Speaker 1: husband with his flare ups. So managing stress is actually 311 00:16:03,040 --> 00:16:05,160 Speaker 1: such an important part of the treatment plan. 312 00:16:05,880 --> 00:16:09,560 Speaker 6: So just setting aside like sixty seconds and just noticing 313 00:16:09,600 --> 00:16:12,120 Speaker 6: your breath for those like sixty seconds, like setting up 314 00:16:12,160 --> 00:16:15,120 Speaker 6: timer and just noticing your breath work. And then the 315 00:16:15,200 --> 00:16:19,680 Speaker 6: other thing is community, like making sure that you are 316 00:16:20,080 --> 00:16:23,680 Speaker 6: in touch with those loved ones around you, staying in 317 00:16:23,720 --> 00:16:27,760 Speaker 6: communication with them, whether it's family, friends, but being involved 318 00:16:27,800 --> 00:16:29,000 Speaker 6: in community. 319 00:16:29,320 --> 00:16:31,680 Speaker 1: And what would your message be to someone who is 320 00:16:31,720 --> 00:16:35,240 Speaker 1: feeling isolated or discouraged because of their skin condition. 321 00:16:35,760 --> 00:16:39,000 Speaker 6: I first want to encourage people that it's it's not 322 00:16:39,120 --> 00:16:42,040 Speaker 6: their fault, and also want to encourage people that they're 323 00:16:42,080 --> 00:16:42,760 Speaker 6: not alone. 324 00:16:43,000 --> 00:16:44,760 Speaker 5: It's so common. 325 00:16:44,880 --> 00:16:48,760 Speaker 6: And there are so many great treatments, even like just 326 00:16:48,880 --> 00:16:52,440 Speaker 6: from when I started practicing, over the last ten years, 327 00:16:52,600 --> 00:16:55,400 Speaker 6: the amount of new treatment options there are for crisis 328 00:16:55,800 --> 00:16:58,480 Speaker 6: has been amazing, And you don't have to live with 329 00:16:58,800 --> 00:17:00,280 Speaker 6: this condition on your skin. 330 00:17:00,840 --> 00:17:03,560 Speaker 1: Thank you, Mamina, Thank you so much for taking the 331 00:17:03,640 --> 00:17:04,440 Speaker 1: time to chat. 332 00:17:04,640 --> 00:17:06,240 Speaker 5: Oh my gosh, thank you so much for having me. 333 00:17:06,280 --> 00:17:07,440 Speaker 5: I love talking about this. 334 00:17:08,000 --> 00:17:11,399 Speaker 1: I love that doctor Mamina mentions the importance of community 335 00:17:11,520 --> 00:17:14,760 Speaker 1: and support as we heard it's something that Janelle relied 336 00:17:14,800 --> 00:17:15,720 Speaker 1: on when growing up. 337 00:17:16,280 --> 00:17:19,280 Speaker 2: When I was a teenager, I did find a blog 338 00:17:19,440 --> 00:17:24,440 Speaker 2: called Sarisis Secrets, and people would anonymously share experiences that 339 00:17:24,480 --> 00:17:27,639 Speaker 2: they were having with crisis, for example, like the isolation, 340 00:17:28,040 --> 00:17:30,800 Speaker 2: wearing sweaters in the summer, having to like dust off 341 00:17:30,800 --> 00:17:34,000 Speaker 2: the scalp flakes that fall on your shoulder. That helped 342 00:17:34,040 --> 00:17:36,840 Speaker 2: me so much to know I wasn't doing some of 343 00:17:36,840 --> 00:17:39,000 Speaker 2: these things like on my own, that there were other 344 00:17:39,000 --> 00:17:41,280 Speaker 2: people out there in the world that were experiencing the 345 00:17:41,320 --> 00:17:44,879 Speaker 2: same thing and also dealing with it in the same way. 346 00:17:45,440 --> 00:17:49,520 Speaker 2: I would definitely say that's top is really reaching out 347 00:17:49,520 --> 00:17:52,919 Speaker 2: and talking about what you're experiencing and getting help if needed, 348 00:17:53,320 --> 00:17:57,440 Speaker 2: and to really give yourself grace in this journey because 349 00:17:57,440 --> 00:18:01,680 Speaker 2: it is difficult. Flares can really in a way impact 350 00:18:01,720 --> 00:18:04,840 Speaker 2: you a lot, not just the physical but mentally, So 351 00:18:04,920 --> 00:18:08,239 Speaker 2: it's so important to be graceful with yourself while you're 352 00:18:08,280 --> 00:18:11,520 Speaker 2: in the process of figuring out what medication works for you, 353 00:18:12,040 --> 00:18:13,919 Speaker 2: what lifestyle is going to look like. 354 00:18:14,600 --> 00:18:15,600 Speaker 4: I love this advice. 355 00:18:15,720 --> 00:18:17,800 Speaker 1: I'm sure that a lot of people are going to 356 00:18:17,840 --> 00:18:24,240 Speaker 1: find that so helpful. Well, that is a wrap on 357 00:18:24,280 --> 00:18:27,560 Speaker 1: this season of skin Queries. Thank you so much for 358 00:18:27,680 --> 00:18:30,960 Speaker 1: joining me throughout all these episodes. I don't know about you, 359 00:18:31,040 --> 00:18:34,200 Speaker 1: but I've learned so much so to really feel the 360 00:18:34,240 --> 00:18:37,880 Speaker 1: most confident and at home in my skin, it's essential 361 00:18:37,960 --> 00:18:41,160 Speaker 1: first to be present and accept everything that is happening 362 00:18:41,200 --> 00:18:43,159 Speaker 1: to it. But that doesn't mean we are left to 363 00:18:43,200 --> 00:18:46,359 Speaker 1: our own devices. On the contrary, we have so many 364 00:18:46,440 --> 00:18:49,399 Speaker 1: resources to help our skin glow and be the best 365 00:18:49,440 --> 00:18:52,359 Speaker 1: it can be. As always, it's important to care for 366 00:18:52,400 --> 00:18:53,880 Speaker 1: our bodies inside and out. 367 00:18:54,160 --> 00:18:55,360 Speaker 4: It means eat. 368 00:18:55,160 --> 00:18:59,600 Speaker 1: Well, take care of ourselves, find resources to relax, find 369 00:18:59,680 --> 00:19:03,199 Speaker 1: peace and enjoy. But if there's something specific that our 370 00:19:03,240 --> 00:19:06,800 Speaker 1: skin is calling for attention, never hesitate to reach out 371 00:19:06,840 --> 00:19:10,200 Speaker 1: and ask for help. Follow your intuition, be your own 372 00:19:10,240 --> 00:19:13,480 Speaker 1: advocate so you can feel your best, whatever that means 373 00:19:13,560 --> 00:19:19,720 Speaker 1: for you. Skin Queries is hosted by myself Nicole Berry, 374 00:19:19,840 --> 00:19:22,200 Speaker 1: An executive produced by Evon Sheehan. 375 00:19:22,520 --> 00:19:24,479 Speaker 4: Our senior producer is Tory Weldon. 376 00:19:24,800 --> 00:19:28,040 Speaker 1: Our junior producer is reem Al mcgrabi, with help from 377 00:19:28,080 --> 00:19:31,879 Speaker 1: Austin Johnson. The show is mixed and features original music 378 00:19:32,000 --> 00:19:35,280 Speaker 1: by Sam Sagan. The entire first season of skin Queries 379 00:19:35,359 --> 00:19:39,120 Speaker 1: is now available to binge on America's number one podcast network, 380 00:19:39,240 --> 00:19:43,280 Speaker 1: iHeart Listen in on the iHeartRadio app, Apple podcasts, or. 381 00:19:43,200 --> 00:19:45,240 Speaker 4: Wherever you get your podcasts, and we'd 382 00:19:45,240 --> 00:19:47,199 Speaker 1: Love to know what you think, so make sure to 383 00:19:47,280 --> 00:19:49,280 Speaker 1: leave a review until next time.