Speaker 1: Growing up, Janelle Rodriguez always felt a disconnect between the
Speaker 1: life that she wanted and the life she was living,
Speaker 1: all because of a chronic skin condition.
Speaker 2: I would have played sports in high school, like I have,
Speaker 2: like this competitive nature to me.
Speaker 3: Probably would have joined a dance team.
Speaker 2: I love to dance, but I wouldn't do these things
Speaker 2: because I was so afraid of showing my skin having
Speaker 2: to wear a certain uniform. And so as the years
Speaker 2: were passing and I keep missing out on opportunities, missing
Speaker 2: out on things. Eventually, when I finished high school, I
Speaker 2: felt like those years kind of passed by and I
Speaker 2: experienced a lot of the things I would have wanted to.
Speaker 1: Plaque siasis is not just a skin condition. It's a
Speaker 1: visible barrier that can hold you back from living your
Speaker 1: life to the fullest. But as we'll hear from Janelle,
Speaker 1: with the right mindset, treatments and lifestyle adjustments, it doesn't
Speaker 1: have to Hi, guys, and welcome. I'm so glad you're here.
Speaker 1: I'm Nicole Berry and this is Skin Queries, a show
Speaker 1: all about our skin and its health as.
Speaker 4: We grow in age.
Speaker 1: Our skin is really a record of a life well lived,
Speaker 1: because there isn't one body part that I could think
Speaker 1: of that reflects our well being as clearly as our skin.
Speaker 1: So let's go on this journey together to really understand
Speaker 1: what's going on with our skin. Let's unravel the mysteries
Speaker 1: happening inside and out. Today we're talking about an inflammatory condition, placksoriasis.
Speaker 1: I can't believe this is the last episode of this
Speaker 1: season of Skin Queries. We've talked so much about the skin,
Speaker 1: whether it's nutrition, extreme temperatures, aging the sun, even my
Speaker 1: own husband's story about how stress has affected him physically.
Speaker 1: As you know, Nick has placksoriasis and it flares when
Speaker 1: he gets stressed. And one of the biggest things I
Speaker 1: learned about our journey together is that it's so important
Speaker 1: to empathize, be present, and listen.
Speaker 4: So that's what we're going to do today.
Speaker 1: Listen because Janelle read Vegas has a story to tell.
Speaker 1: It's about what it was like growing up with severe
Speaker 1: psoriasis and how she learned to cope through acceptance and
Speaker 1: community building. We're also going to hear from doctor Memina
Speaker 1: to Regano about placksoriasis and how to treat it. According
Speaker 1: to the National Psoriasis Foundation, placsoriasis affects about eight million
Speaker 1: people in the United States alone. It's one of the
Speaker 1: most common autoimmune diseases out there. First, here's Janelle. She
Speaker 1: was diagnosed with psoriasis at just four years old.
Speaker 2: I think the first place was my cheek, and I
Speaker 2: don't have too much of a memory of what that
Speaker 2: was like. Once it started to surface on my skin.
Speaker 2: I think my mother had to take action very quickly
Speaker 2: to meet with a dermatologist, especially because it surfaced around
Speaker 2: the time that I was starting school and with it
Speaker 2: kind of looking like chicken pox, for example, because of
Speaker 2: all the spots, there was always a concern even if
Speaker 2: they would say, like, it's not contagious, but they needed
Speaker 2: like some sort of medical record to prove.
Speaker 1: That, and so were they able to diagnose you with plaxorisis.
Speaker 2: I know at some point they did have to get
Speaker 2: like a piece of my skin, and I can't forget
Speaker 2: that because it was so painful when they removed like
Speaker 2: a chunk of it.
Speaker 3: I still have like the scar on my leg.
Speaker 5: Wow.
Speaker 2: And I think from there it was like a for
Speaker 2: sure it's placorisis. And with plaxorisis, it surfaces kind of everywhere,
Speaker 2: at least for me, like I got it on my elbows, knees,
Speaker 2: and the spots they appeared very small, but they started
Speaker 2: to kind of grow in time, and you know, they
Speaker 2: get very flaky. So I think with just seeing it visibly,
Speaker 2: you can tell what it is, but then having that
Speaker 2: biopsy was kind of like confirming its psoriasis.
Speaker 1: Janelle was given a prescription, but having a visible condition
Speaker 1: put her in a lot of uncomfortable situations.
Speaker 2: I got a lot of attention in elementary school where
Speaker 2: my pleasorisis it's also on my scalp as well, so
Speaker 2: I had some experiences where a teacher would like pull
Speaker 2: me out of class so that I could see the nurse,
Speaker 2: and if they didn't have like a letter from the doctor,
Speaker 2: they would send me home. So very early on, I
Speaker 2: started to have experiences where I just noticed it brought
Speaker 2: some sort of attention to me. It wasn't always positive,
Speaker 2: and little by little I started to take it very
Speaker 2: personally as I started getting older, and you know, growing
Speaker 2: up in New York, a lot of times like we
Speaker 2: would go to public pools and I was getting ready
Speaker 2: to go to a pool. Then when they saw me,
Speaker 2: they kind of started to question, you know, was this contagious.
Speaker 2: Can she come into the pool and swim with other people?
Speaker 2: And I remember my oldest sister getting like upset, and
Speaker 2: my sisters would always come to my defense of this
Speaker 2: would happen, So I kind of always felt very protected.
Speaker 1: According to a study in the Journal of the American
Speaker 1: Academy of Dermatology, sarria sis carries such a huge amount
Speaker 1: of stigma, and many people have the misconception that it's
Speaker 1: contagious and infectious, which of course it is not. Thankfully,
Speaker 1: Janelle had her older sisters to protect her and look
Speaker 1: out for her, but that didn't last long. When she
Speaker 1: started in middle school, Janelle was left to face that
Speaker 1: judgment and stigma on her own.
Speaker 2: So I moved to Florida when I was about almost
Speaker 2: twelve years old. And I'm living in a state now
Speaker 2: where it's hot every day.
Speaker 3: Right, But now I'm.
Speaker 2: Going to school wearing like short sleeves, capris, maybe a skirt.
Speaker 2: And now I'm realizing I'm more conscious, like I'm more
Speaker 2: aware of my surroundings. And I would notice how kids
Speaker 2: would look at me. I would get a lot of
Speaker 2: comments about what is that, or it would be compared
Speaker 2: to something, and little by little I started to get
Speaker 2: very insecure about my skin.
Speaker 1: I think we're so self consciousnessed teeths regardless of what's
Speaker 1: going on, you know. And to add that on top
Speaker 1: of it, how did that affect your confidence?
Speaker 2: I just remember I wanted to the best way I
Speaker 2: can explain it is like I want to blend in.
Speaker 2: I don't want to draw too much attention to me
Speaker 2: where people can see my skin and ask me questions.
Speaker 2: And here in Florida, when we experienced a cold front
Speaker 2: and I wore like a sweater to school and long pants,
Speaker 2: I remember how safe I felt. And that's like the
Speaker 2: best way that I can describe how I started to
Speaker 2: kind of isolate and hide my skin. It was because
Speaker 2: for the first time, like I could sit on my
Speaker 2: desk and not not be afraid to show my arms
Speaker 2: and things like that. And over the years that affected
Speaker 2: my confidence because I started to really hide myself and
Speaker 2: isolate and I was hiding something that's a big part
Speaker 2: of who I am.
Speaker 4: And this insecurity made her miss out on a lot.
Speaker 2: Like I would have been someone that I would have
Speaker 2: played sports in high school, like I have like this
Speaker 2: competitive nature to me, probably would have joined a dance
Speaker 2: team I love to dance, but I wouldn't do these
Speaker 2: things because I was so afraid of showing my skin
Speaker 2: having to wear a certain uniform. And so as the
Speaker 2: years were passing and I keep missing out on opportunities,
Speaker 2: missing out on things. Eventually, when I finished high school,
Speaker 2: I felt like those years kind of passed by and
Speaker 2: I didn't.
Speaker 3: Experience a lot of the things I would have wanted.
Speaker 1: To got to today. And Janelle is so much more
Speaker 1: comfortable in her skin. But funny enough, that did not
Speaker 1: come from any improvement to her skin. It was the
Speaker 1: determination to change her mindset.
Speaker 2: So when I was twenty and I remember I was
Speaker 2: getting ready to move. I was moving to New York,
Speaker 2: and I was like really looking forward to the summer,
Speaker 2: like my skin was clearing up. I was thinking about
Speaker 2: all the things I was going to wear, and I
Speaker 2: was so excited for that. I was waiting for like
Speaker 2: that clear skin moment to like finally show up in
Speaker 2: the world as I wanted to.
Speaker 3: And right before I moved, I went through one of.
Speaker 2: The worst flares that I've ever had, and it was
Speaker 2: just like such a letdown for me, and I felt
Speaker 2: like defeated in a way, like I was really looking
Speaker 2: forward to that, and I remember that's kind of when
Speaker 2: I had my AHA moment, was because I was just
Speaker 2: so devastated by that and I felt defeated and that
Speaker 2: I kind of questioned myself, like I reflected on like
Speaker 2: the past six years and how I've lived, and I
Speaker 2: kind of asked myself, like do I want to continue
Speaker 2: living this way?
Speaker 3: And I kind of made myself a promise.
Speaker 2: I'm like, I can't keep living like this, Like I
Speaker 2: can't keep hiding and waiting for the perfect moment to
Speaker 2: dress the way that I want to do the things
Speaker 2: that I want. So when I moved I started to
Speaker 2: kind of challenge myself then to really just take it
Speaker 2: as a fresh start and to wear the things that
Speaker 2: I want.
Speaker 3: And it was hard.
Speaker 2: I had so many triggers, as you can imagine, like
Speaker 2: sitting in a train and you know, my legs are
Speaker 2: covered in it, my face and people could just stare
Speaker 2: at you.
Speaker 3: But it was like the.
Speaker 2: Best decision because that kind of helped me to then
Speaker 2: kind of move forward to where I am today.
Speaker 1: It's so inspiring to hear this revelation because Janelle made
Speaker 1: the decision to not let her skin hold her back.
Speaker 4: Anymore. And what's even more, she now helps.
Speaker 1: Others who are going through the same thing by sharing
Speaker 1: her experience with psoriasis online. In fact, Janelle has cultivated
Speaker 1: a whole community, which, as my next guest will tell you,
Speaker 1: is so important when it comes to feeling better.
Speaker 4: I can't wait for you to hear.
Speaker 1: What she has to say right after this break, Welcome
Speaker 1: back to skin Qureise. Earlier, Janelle shared her journey with
Speaker 1: plaxoriasis and how she learned to feel comfortable within her
Speaker 1: own skin even when she's going through a flara. Now
Speaker 1: let's get into the science behind soriasis treatments and therapies.
Speaker 1: I'd like to introduce doctor Mamina to Regano.
Speaker 6: Hi.
Speaker 5: They're nice to meet you.
Speaker 4: Thank you for taking the time to chat with us.
Speaker 1: I would love for you to kick it off and
Speaker 1: introduce yourself and tell us a little bit about your practice.
Speaker 6: I am a triple board certified dermatologist, internist, and dermatic pathologist.
Speaker 5: I am based in New Orleans, Louisiana.
Speaker 6: I see the full gamut, including medical dermatology and some
Speaker 6: cosmetic dermatology as well.
Speaker 4: So let's start with plaquorisis.
Speaker 1: Can you explain what that is, and how does that
Speaker 1: differ from other types of psoriasis.
Speaker 6: Yes, well, placksoriasis is probably what we traditionally know as psoriasis,
Speaker 6: and it shows up on the skin as these usually
Speaker 6: like thick, scaly, pinkish red plaques. They love the elbows
Speaker 6: and knees, but they also can certainly occur everywhere on
Speaker 6: the body. The scalp is another common area I see
Speaker 6: off it on the back, like lower back, like above
Speaker 6: the buttock area. It can be pretty debilitating for a
Speaker 6: lot of people in terms of its appearance. It can
Speaker 6: be itchy, but I think the appearance is what really
Speaker 6: affects people the most.
Speaker 4: So is plackariasis.
Speaker 1: Is it a symptom of something else or is it
Speaker 1: something that stands alone.
Speaker 6: Yeah, I almost look at psoriasis as kind of like
Speaker 6: the canary in the coal mine, and so in a way,
Speaker 6: and this might sound crazy to people, but in a
Speaker 6: way could almost be a blessing if you have psoriasis,
Speaker 6: you notice any sort of psoriasis forming on your body,
Speaker 6: because it can be an indication that there is internal inflammation.
Speaker 6: So internal inflammation that potentially can transform into concerning cardiometabolic
Speaker 6: conditions like heart disease, stroke, diabetes, and it's almost like
Speaker 6: a warning sign when you see zoriasis, like, hey, your
Speaker 6: body's inflamed. Let's try to Let's try to do what
Speaker 6: we can to decrease that inflammatory load so that bad
Speaker 6: things don't happen in the future.
Speaker 1: According to the National Library of Medicine, inflammation is your
Speaker 1: body's response to an irritant. It's trying to fight something
Speaker 1: foreign in your body. Some sides of inflammation could be redness, swelling, overheating, even.
Speaker 4: Loss of function.
Speaker 1: Think about when you have a fever or can't smell,
Speaker 1: when you have a cold. When you have psoriasis, your
Speaker 1: T cells, which is a type of white blood cell,
Speaker 1: can become overactive and actually attack.
Speaker 4: Your skin by mistake.
Speaker 1: Amina says that there are certain things that you can
Speaker 1: do to try and decrease that inflammatory load.
Speaker 6: So if somebody has psoriasis, I do some counseling, and
Speaker 6: there's like certain lifestyle changes with your diet, exercise. There
Speaker 6: are certain supplements that can be helpful when it comes
Speaker 6: to diet. The most compelling evidence that is out there
Speaker 6: is with a Mediterranean based diet that has been shown
Speaker 6: to be helpful for people with psoriasis.
Speaker 1: I'm actually wondering at what point should someone actually go
Speaker 1: see a dermatologist. Is seeing a dermatologist the best place
Speaker 1: to start.
Speaker 6: I think that if the rash is pretty minimal, if
Speaker 6: it's if it's one or two plaques and you are
Speaker 6: using an over the counter hydrocortisone it resolves, you know,
Speaker 6: and nothing recurs, you can probably lay low. But if
Speaker 6: it resolves and it recurs, or if it's not resolving,
Speaker 6: or if you're getting more plaques or patches on the body,
Speaker 6: definitely something to see a dermatologist. And psoriasis can be
Speaker 6: a pretty easy diagnosis to make visually, but there are
Speaker 6: some subtleties to it, and if it doesn't fully fit
Speaker 6: with psoriasis, oftentimes dermatologists will do a biopsy. And that's
Speaker 6: important because there are a lot of other skin conditions
Speaker 6: out there not as common, but there are skin conditions
Speaker 6: out there that can look like zoriasis, and you would
Speaker 6: want to make sure that you have the right diagnosis.
Speaker 1: What are some of the treatments conventionally that someone can
Speaker 1: address their psoriasis?
Speaker 6: So for very mild soriasis, we will all these treatments
Speaker 6: are like anti inflammatory, So when it comes to creams,
Speaker 6: we do a lot of topical steroid creams. They're anti inflammatory, okay,
Speaker 6: and they're fine for intermittent use, but they're not long term.
Speaker 6: When people start to get more extensive psoriasis or if
Speaker 6: it's just hard to manage, like when it's in the scalp,
Speaker 6: it gets to be a pain to put creams or
Speaker 6: solutions in the scalp and shampoos consistently, so that's when
Speaker 6: systemic therapies will play a big role. There are newer
Speaker 6: oral betas which are considered more immunomodulatory, so not immunosuppressive.
Speaker 6: So in a way, I like those for people who
Speaker 6: need systemic therapy, but they're concerned about like the immune
Speaker 6: suppressing effects of some of these systemic agents, so this
Speaker 6: one is kind of like a nice like stepping stone.
Speaker 6: And then there's the injectibles, which we call biologics, and
Speaker 6: these are essentially like antibodies that bind to certain inflammatory
Speaker 6: markers or receptors that play a role in psoriasis, and
Speaker 6: you know, once again considered immune suppressive. And now there's
Speaker 6: just been a whole slew of newer ones that are
Speaker 6: I would say, more specific for people with I would
Speaker 6: say at least ten percent body surface area or higher
Speaker 6: or really bad scalp or palmer plant orsoriasis.
Speaker 5: They would be good candidates.
Speaker 1: How do your patients usually react when you finally diagnose
Speaker 1: them and get them on a treatment plan.
Speaker 5: I think people feel hope.
Speaker 2: Hmm.
Speaker 5: They are like there's a sense of relief.
Speaker 6: There's a sense of hope, And I think that that's
Speaker 6: really important too, to like take that mental burden, that
Speaker 6: stress of dealing with the disease on their own, telling
Speaker 6: them we got you. There's so many great treatments for it.
Speaker 6: Because the stress surrounding the disease can also aggravate the disease.
Speaker 6: We do have legitimate studies that show that stress increase psoriasis.
Speaker 6: Just having a plan, an action plan, I think relieves
Speaker 6: that stress. And then when the patients return and their
Speaker 6: psoriasis is better, and like could just see the confidence shift.
Speaker 5: Yeah, you could see that they're just like.
Speaker 6: Beaming with more joy and they're enjoying life more, which
Speaker 6: is so fulfilling. But yeah, there's definitely a big mental
Speaker 6: aspect when it comes to treating psoriasis.
Speaker 1: I know firsthand that stress can be a common trigger
Speaker 1: when it comes to psoriasis. In a recent episode about
Speaker 1: stress and skin, we talked about how it affects my
Speaker 1: husband with his flare ups. So managing stress is actually
Speaker 1: such an important part of the treatment plan.
Speaker 6: So just setting aside like sixty seconds and just noticing
Speaker 6: your breath for those like sixty seconds, like setting up
Speaker 6: timer and just noticing your breath work. And then the
Speaker 6: other thing is community, like making sure that you are
Speaker 6: in touch with those loved ones around you, staying in
Speaker 6: communication with them, whether it's family, friends, but being involved
Speaker 6: in community.
Speaker 1: And what would your message be to someone who is
Speaker 1: feeling isolated or discouraged because of their skin condition.
Speaker 6: I first want to encourage people that it's it's not
Speaker 6: their fault, and also want to encourage people that they're
Speaker 6: not alone.
Speaker 5: It's so common.
Speaker 6: And there are so many great treatments, even like just
Speaker 6: from when I started practicing, over the last ten years,
Speaker 6: the amount of new treatment options there are for crisis
Speaker 6: has been amazing, And you don't have to live with
Speaker 6: this condition on your skin.
Speaker 1: Thank you, Mamina, Thank you so much for taking the
Speaker 1: time to chat.
Speaker 5: Oh my gosh, thank you so much for having me.
Speaker 5: I love talking about this.
Speaker 1: I love that doctor Mamina mentions the importance of community
Speaker 1: and support as we heard it's something that Janelle relied
Speaker 1: on when growing up.
Speaker 2: When I was a teenager, I did find a blog
Speaker 2: called Sarisis Secrets, and people would anonymously share experiences that
Speaker 2: they were having with crisis, for example, like the isolation,
Speaker 2: wearing sweaters in the summer, having to like dust off
Speaker 2: the scalp flakes that fall on your shoulder. That helped
Speaker 2: me so much to know I wasn't doing some of
Speaker 2: these things like on my own, that there were other
Speaker 2: people out there in the world that were experiencing the
Speaker 2: same thing and also dealing with it in the same way.
Speaker 2: I would definitely say that's top is really reaching out
Speaker 2: and talking about what you're experiencing and getting help if needed,
Speaker 2: and to really give yourself grace in this journey because
Speaker 2: it is difficult. Flares can really in a way impact
Speaker 2: you a lot, not just the physical but mentally, So
Speaker 2: it's so important to be graceful with yourself while you're
Speaker 2: in the process of figuring out what medication works for you,
Speaker 2: what lifestyle is going to look like.
Speaker 4: I love this advice.
Speaker 1: I'm sure that a lot of people are going to
Speaker 1: find that so helpful. Well, that is a wrap on
Speaker 1: this season of skin Queries. Thank you so much for
Speaker 1: joining me throughout all these episodes. I don't know about you,
Speaker 1: but I've learned so much so to really feel the
Speaker 1: most confident and at home in my skin, it's essential
Speaker 1: first to be present and accept everything that is happening
Speaker 1: to it. But that doesn't mean we are left to
Speaker 1: our own devices. On the contrary, we have so many
Speaker 1: resources to help our skin glow and be the best
Speaker 1: it can be. As always, it's important to care for
Speaker 1: our bodies inside and out.
Speaker 4: It means eat.
Speaker 1: Well, take care of ourselves, find resources to relax, find
Speaker 1: peace and enjoy. But if there's something specific that our
Speaker 1: skin is calling for attention, never hesitate to reach out
Speaker 1: and ask for help. Follow your intuition, be your own
Speaker 1: advocate so you can feel your best, whatever that means
Speaker 1: for you. Skin Queries is hosted by myself Nicole Berry,
Speaker 1: An executive produced by Evon Sheehan.
Speaker 4: Our senior producer is Tory Weldon.
Speaker 1: Our junior producer is reem Al mcgrabi, with help from
Speaker 1: Austin Johnson. The show is mixed and features original music
Speaker 1: by Sam Sagan. The entire first season of skin Queries
Speaker 1: is now available to binge on America's number one podcast network,
Speaker 1: iHeart Listen in on the iHeartRadio app, Apple podcasts, or.
Speaker 4: Wherever you get your podcasts, and we'd
Speaker 1: Love to know what you think, so make sure to
Speaker 1: leave a review until next time.