Psoriasis in miserable area

I am 42, diagnosed with psoriasis in my early 20s.  Married, no children.  Hypothyroid, RA and PCOS among my issues.  I take enbrel for the P and RA, I also use taclonex or dovonex/steroid for the P.  

My body patches are small and manageable now -- limited to my underarms, belly button and lower back, at the tail of my spine.  I have never found a working solution for my scalp.  But considering the other issue, I can live with that.

The other issue -- my groin/vagina.  From the patch of hair, to the anus, I am all scale.  It itches, burns, bleeds, oozes.  I have tried ointment after ointment, bathing in dead sea salts, dietary restrictions ... even prayer.  I am married, happily, and I love my intimacy with my husband, but it can be so painful, it's just not worth it.  The ointments I try either make it itch more, bleed more or cause other problems like yeast infections.  I get some very temporary relief from itching from the soaks, but I need them daily, with pounds of salts, and it gets too expensive.   As soon as I stop, the issue is back full force.  

I lost my favorite derm a few years ago to cancer, and have no luck finding a new one.  The derms in my area of the country seem to be only interested in the cosmetic side of the field.  I have been made to feel very uncomfortable with this area of the scales, with one doctor refusing to even look.  

I don't know where else to turn.  I need advice and guidance.  A reason for hope.

[BhumikaMD]

Hi,

Though nothing can be said with surety without having a look at the lesions - Thick red patches with a well defined edge could indicate psoriasis.

' Flexural psoriasis (inverse psoriasis) appears as smooth inflamed patches of skin. It occurs in skin folds, particularly around the genitals (between the thigh and groin), the armpits, under an overweight stomach (pannus), and under the breasts (inframammary fold). It is aggravated by friction and sweat, and is vulnerable to fungal infections.'

As a first step, medicated ointments or creams like corticosteroids, cvutamin D analogues, anthralin, etc, called topical treatments, are applied to the skin.

If topical treatment fails to achieve the desired goal then the next step is to expose the skin to ultraviolet (UV-B) radiation or PUVA therapy (PSORALEN +UV-A). This is called phototherapy.

The third step involves the use of medications which are taken by pills or injection including methotrexate, cyclosporine and retinoids.. This approach is called systemic treatment.

Over time, psoriasis can become resistant to a specific therapy. Treatments may be periodically changed to prevent resistance developing.

More information on Psoriasis may be found at :

http://en.wikipedia.org/wiki/Psoriasis

and

http://www.emedicinehealth.com/psoriasis/article_em.htm

Let us know if you need any other information.

Regards.