How to manage psoriasis during chemotherapy?

Question

Hi doctor,

I am writing about my husband (age 48), whose psoriasis has gone crazy since starting his chemotherapy for colon cancer. The skin around his colostomy bag is covered in painful patches that make it impossible to keep the bag stuck on, and it leaks everywhere. His oncologist stopped his Humira injection, saying it is too risky with low immunity (neutrophils at 500), but now his skin and joints are in constant agony.

The skin on his palms and soles is so thick and cracked he cannot do basic things. His scalp bleeds every time he touches it, and the chemo port site is surrounded by red scaly patches. The latest PET scan showed his cancer responding, but these skin issues are making him want to quit treatment.

What can we safely use during chemotherapy?

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Managing psoriasis during chemotherapy is tricky, especially with low immunity. Humira is too risky, but non-immunosuppressive options like Apremilast (Otezla) or topical vitamin D analogs (Calcipotriene) may help without increasing infection risk. For colostomy site irritation, use barrier creams and silicone-based adhesives. Thick, cracked skin may improve with urea or salicylic acid creams. A dermatologist can consider light therapy if it is safe with his chemotherapy. Keeping him comfortable is key so he can continue his cancer treatment.

I hope this information will help you.

Thanks.