Psoriasis & nerve ending pain (gluteal cleft)
I've lived with psoriasis & psoriatic arthritis for nearly 40 years now and though my arthritis is well controlled on a TnF blocker (Simponi Aria), over the past year I have developed psoriasis and lichen sclerosus at the top of my gluteal crack that not only causes a painful itch (and sometimes bleeds), but also is now aggravating nerves in that area and causes bladder urgency (as well as minor incontinence, if I can't make it to the bathroom in time). I've tried several topicals to calm it down and what works the best so far has been Calcipotriene cream. The problem is that the actual application of the cream worsens things, since to apply the cream means touching the skin and to touch the skin causes extremely pain itching and loss of bladder control. Has anyone experienced this? I've seen a neurologist (and told my rheum and derm), but unfortunately I can't take a nerve blocker like Gabapentin bec it causes eye pressure for me. I'm at my wits end!!! Thanks for any input.
Hi
, thank you for reaching out here. Goodness, this sounds really difficult to deal with. I get psoriasis in the same area, but I haven't experienced this knock-on nerve irritation. I'm not surprised you're at your wits end with all of this. Did the neurologist have any other suggestions for dealing with this? I take a low dose of amitriptyline for nerve pain - I wonder if that would be an option? Unfortunately, I don't know too much about how it compares to gabapentin, nor whether it's suitable for someone with eye pressure issues. I suppose another option might be to look at another non-topical treatment for your psoriasis? I notice you say that your arthritis is well-controlled with Simponi Aria, but you are dealing with a new psoriasis (and lichen sclerosis) flare. Did your dermatologist or rheumatologist have any thoughts on how the Simponi Aria is working for you?
I hope others will chime in here with their experiences and ideas. Please keep us posted on how you're doing, and remember that we're here for you. Hugs! -Catherine, Community Moderator
, I am so sorry that you are going through so much. We have a disease that keeps on giving. I have had psoriatic disease for 61 years. I have an appointment tomorrow because the PsA pain has taken over my body. I see you have a good team of doctors, so I hope they can figure this out with your neurologist. They need to come up with a good plan. Please let us know what you find out. Is the Simponi Aria working at all? We would like to hear more from you. Diane (Team Member) 
Hi
. All this sounds awful. I wish I could give you some advice to help with this issue. Have you tried to contact the National Psoriasis Foundation and speak to someone in their Patient Navigation Center? I am not sure if they can offer you advice but it is worth a try. Has either your rheum or derm reached out to you about this? I must admit I was not aware Gabapentin could cause eye pressure. It is what I take daily. Vickie, Team Member
