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