coronavirus, psoriasis

Did the COVID Vaccine Flare my Psoriasis and Eczema?

April 7, 2021. In line at the Woodland Community and Senior Center to receive the first Moderna vaccine dose.

The moment the needle plunged into my left arm I began to feel anxious and lightheaded. My doctors encouraged me to get the first COVID-19 vaccine available to me. That day came on April 7th.

I felt reluctant to get vaccinated for fear that my skin conditions psoriasis and eczema might flare. But getting COVID-19 sounded much worse, so I relented. Once the needle came out of my arm I knew I could not go back.

I wrote on my Everyday Health blog that I don’t like needles. I can tolerate them now, but I generally feel a bit dizzy after a needle prick. This one felt much worse than others, however. It must have shown on my face. A nurse roaming the area where those recently jabbed waited fifteen minutes stopped to check on me. “I feel a bit dizzy and woozy,” I told her. She offered a Gatorade, which I reluctantly accepted.

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coronavirus, psoriasis

Coronavirus Lockdown Journal Week 5: April 20-26

On March 19, 2020 California Governor Newsom announced a statewide stay-at-home order. Here is a screenshot from my phone:

Recently both the county and state extended the lockdown to May 1st. With the president and governors talking about opening up the economy again, there is hope this lockdown will end soon. 

Until then, Lori and I plan to post a weekly journal updated every day or two to mark thoughts, reflections, and news related to life sheltering-at-home.

This is week 5 of the lockdown.


Sunday, April 26, 2020

Resting and Sabbath

My sabbatical from church ends in about a month. Something I desperately looked forward to was a break from the grind of church ministry. After fifteen years of pastoral ministry without a longer break, together with the challenges and crises the family faced, I desperately wanted some time to rest.

Before I started my sabbatical an acquaintance asked me about my plans. I briefly mentioned travel, writing, and sleeping in whenever I wanted to. He told me those activities would no doubt be life giving. He also stressed the importance of mentally gaining distance and perspective from my daily work.

As I hit third base and turn toward home (excuse the baseball analogy), I can see the past three months have not turned out anything like I expected. I did travel a bit in February, but had to cancel the rest of my trips. I’ve blogged more, but haven’t come around to working on my book or study guide.

As I hit third base and turn toward home (excuse the baseball analogy), I can see the past three months have not turned out anything like I expected.

Sleeping in has been restorative physically, but it has been the distance from work that has renewed me in ways I didn’t anticipate. I have time to think, meditate, and process life. Lori and I can spend (relatively) stress-free afternoons together.

The mental, emotional, and spiritual renewal from this break is exactly what I needed. Although the coronavirus crisis ruined my plans (and of course it is much bigger than me and what I wanted to do), I’m glad the time turned out the way it has.


Finally, on this Sunday, I’m praying for those on the front lines of the Covid-19 response and those personally impacted by the illness. May God be merciful and bring healing to this devastation.


Thursday, April 23, 2020

Coronavirus and Psoriasis (Howard)

UPDATE: I mentioned on Monday that I messaged my dermatologist, Dr. Carroll, about taking Skyrizi before Tuesday. In her reply she surmised why my psoriasis flared recently: skin damage from phototherapy burn and possibly needing Skyrizi more frequently.

Since she said I could inject the medication anytime, I decided to go ahead last night. One dose comes in two syringes, so I injected one on the left and one on the right of my belly button (at least two inches out).

I experienced the normal lightheadedness and fatigue just after the injection. Still some after effects today, but definitely nothing to horrible.


With the lockdown I’ve had more time to write for my column on Everyday Health, The Itch to Beat Psoriasis. In particular, I’ve published three articles about psoriasis and the coronavirus pandemic.

I’ll finish today’s entry with links to each of them.

How I’m Managing My Psoriasis in the Shadow of the Coronavirus (3/31/20)

man in front of window at home

Preventing Coronavirus Exposure When You Have Psoriasis and Eczema (4/6/20)

Preventing-Coronavirus-Psoriasis-and-Eczema Moisturize After Cleaning Hands

Facing My Anxieties During the Coronavirus Crisis (4/21/20)

illustration man stressed with papers virus bacteria

Wednesday, April 22, 2020

Cooking Together (Lori)

I have been longing for Howard and I to cook together for many years. His work as a minister is very demanding—both early morning and evening meetings in a given week that would require him to be away from home.

When would come home from work, I would want him to either take some personal time or just spend time with the children. I would figure out the dinner menu. Some days were full for me as a minister’s wife so I would skip cooking dinner completely—get some takeout from a restaurant or fast food.

It was “kid food” anyways, I reasoned, so the kids and I would all feast on fried chicken, hamburgers and fries, chicken nuggets, etc. Especially if Howard attended a small group church meeting, there were often potlucks where he could eat dinner and sample church members’ home cooking.

It was a win-win. Except I felt like something was missing. Long gone were the days when I was at my grandmother’s house helping her fix a homemade meal and then talk with her over washing the dishes afterwards—she would wash, I would dry. 

Fast-forward to today.

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Journal

Coronavirus Lockdown Journal Week 3: April 6-12

On Thursday, March 18, Yolo County, CA instituted a shelter-in-place order to begin the next day until April 7th. Here’s a tweet where I marked the event.

On that same day the Governor Newsom announced a statewide stay-at-home order. Here is a screenshot from my phone:

Recently both the county and state extended the lockdown to May 1st, and it could be even longer. I plan to post a weekly journal updated every day or two to mark thoughts, reflections, and news related to life sheltering-at-home.

Friday, April 10, 2020

Happy Good Friday. Here’s a tweet with a link to a message I shared in 2017 at Davis Chinese Christian Church:


Dr. Francis Collins Prayers from Science and Faith in Pandemic Times

Dr. Francis Collins, the current NIH Director, gave an interview on a webcast Monday. In Science and Faith in Pandemic Times, Collins provided timely information on the coronavirus pandemic. About half way in he begins to address matters of faith.

Near the end, he shared what he is praying for. Lori and I have used his thoughts for our own prayer times, which I share here.

  1. Healthcare providers who are putting themselves in harms way and many quarantined from their families.
  2. Families who have lost jobs and are in severe economic distress.
  3. Researchers working night and day to come up with a treatment and vaccine to save lives.
  4. Church, that this would be a time where church fellowship can provide spiritual nurture.
  5. Myself, that I would understand something about myself and learn from it. Joshua 1:9 to be strong and courageous, and not to grow weary.

How are you praying during the pandemic? Is it difficult to pray in the face of so much tragedy?


Follow the Coronavirus Journal Series!

Coronavirus Lockdown Journal Week 4: April 13-19

Coronavirus Lockdown Journal Week 5: April 20-26


Wednesday, April 8, 2020

Creative Art During the Covid-19 Outbreak (Lori)


Recently, I recalled a creative exercise I did with a small group last summer. I was looking for a way to incorporate an artistic element into reading an excerpt from the Bible.

Although I’m not the best at drawing or painting, I modified the exercise for myself so that I could enjoy it and remember what part of the reading impacted me. I repeated the exercise during this pandemic—it’s the same reading from the Bible: Psalms 1. Using leftover scrapbook pages, I created the background and banner that I wanted.

In the future, I feel depicting Spring in full bloom will remind me when the coronavirus outbreak happened. I have confidence that I will look back on this unusual time in my life and remember how my faith in God sustained me like a tree planted by streams of water.


Tuesday, April 7, 2020

Treating My Lungs While Not Worsening My Skin (Howard)

One of my biggest concerns during the lockdown is needing to go to the medical clinic or hospital. I want to avoid exposure to the novel coronavirus if at all possible. That even means having groceries from Costco delivered to our house where we disinfect before putting them away in the kitchen.

It especially means avoiding medical facilities.

Two weeks ago my breathing became quite labored. As the tree pollen counts elevated, my asthma flared. I needed the rescue inhaler two to three times a day. The steroid inhaler couldn’t control my asthma any longer. With Covid-19 attacking the lungs, I desperately wanted my breathing to improve just in case.

I then remembered asking my primary care doctor for a stronger asthma inhaler last June. Fortunately, I stored the filled prescription in my drawer for the combination steroid powder inhaler. It took about five days after starting treatment before I could breathe easily without the rescue inhaler.

In the back of my mind I wondered if the inhaler photosensitizes my skin. I still use ultraviolet light treatments at home to mainly control my atopic dermatitis. I didn’t want to create a new problem when solving another.

My skin slightly burned from the first phototherapy treatment after starting the new inhaler. I backed down the dose about a third for the next treatment. Again my skin burned. And again the next time. I concluded that the asthma medication photosensitizes my skin.

In the back of my mind I wondered if the inhaler photosensitizes my skin. I didn’t want to create a new problem when solving another.

I’m taking a break from phototherapy for a few days to let my skin recover. I don’t want to stop my asthma medication since it’s working so well. I’ll try to step down my dose even more to see if I can still control the rashes on my skin on half or less of the dose I used before.

I’ve missed my dermatology check-up appointment already due to the pandemic. Good thing my doctors are quick to reply to messages. Hopefully, I can control my asthma and eczema without the need to see them in person.


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psoriasis, Psoriasis Treatments

38 Weeks with Tremfya: The Q&A Edition

Cloud Gate (a.k.a The Bean) in Millenium Park, Chicago. I’m clearly thinking about the Questions about Tremfya included in this PsoHoward blog entry.

This past week I joined the HealtheVoices conferencein Chicago for the fourth straight year.  Here’s a description of the conference: “In an effort to connect, support and further empower the online health advocate community, Janssen created HealtheVoices™ – a groundbreaking leadership conference created exclusively for those using social platforms to advocate for themselves and their communities.”

I absolutely love how this conference brings people from forty different chronic disease conditions together to get inspired, connected and empowered. Before the conference started a group of psoriasis advocates joined Janssen to discuss Tremfya (guselkumab). A perfect lead into today’s blog topic.

Tremfya Question/Answer

My psoriasis update is not super exciting. I’m mostly stable, with more psoriasis breaking through than before. I just passed the week 38 mark, about two and a half weeks after taking my sixth injection of Tremfya. I hope to include an unboxing of my new phototherapy light panel that’s slated for delivery at the end of the week. Stay tuned!

In the meantime, I’ve noticed various search terms and questions about Tremfya  that have led readers to PsoHoward.com. Below you can find the top queries and my thoughts on each one as I journey with Tremfya.

[Disclaimer: Please note that I am not a medical doctor, nor do I have the definitive answer on these questions. The responses are from what I’ve experienced so far on Tremfya as a patient, or from talking to healthcare providers and a Janssen representative at the Medical Information and Services group.]

How often do you take Tremfya?

The dosing at first was a bit confusing, but didn’t take too long to figure out. I started with a “loading dose” which consisted of Week 0 as the first injection, then Week 4 as the next dose. After those first two injections I was instructed to take it every 8 weeks (week 12, week 20, week 28, etc.).

I recently asked my dermatologist and Janssen about more frequent dosing, perhaps every four or six weeks. Since the label use is for every eight weeks after the initial loading doses, my doctor will need to submit an exception to insurance. I’m not holding my breath.

Does the Tremfya injection hurt?

The first injection caused me some anxiety as detailed in my first Tremfya blog. in years past I used an injection pen with Enbrel. I would press it on the skin (usually my belly or on my leg) and then push the button. The Tremfya injection uses a syringe with a small needle. The injections do not hurt at all. In fact, I can see the needle go into my skin, but do not really feel much as it goes in.

I did use a syringe previously with Enbrel about a decade ago, which prepared and somewhat trained me for Tremfya. The first Tremfya injection I took at the dermatology clinic with a nurse observing. I’m glad I did as I felt safer in case I had any unusual reaction.

Ask about training for self-injection if you are feeling anxious about it at all.

How long before I see results with Tremfya?

This question is by far the most frequent one asked in searches that led to PsoHoward. It’s the question I had foremost on my mind so I’m not surprised. I hated that my health providers told me to be patient. But that’s the truth about many psoriasis treatments I’ve tried: it takes the time it’s going to take.

It makes sense that response rates depend on the individual, although studies and graphs show the overall trends. I started noticing some improvement on my extremities, lower legs and arms, within a few weeks. But my dermatologist told me to wait a bit longer as the data showed response rates coming later into the ten to twelve week time frame. The pharmacist said the same. Around week 8, I excitedly saw a good response, although improvement continued for a few weeks longer before leveling off.


Follow my Tremfya journey!

Tremfya (Guselkumab) Week One  

3 Weeks with Tremfya: The Waiting Game

6 Weeks with Tremfya: Redefining Expectations

8 Weeks with Tremfya: It’s Working!

12 Weeks with Tremfya: The Third Injection

16 Weeks with Tremfya: The Verdict?

20 Weeks with Tremfya: Read the Instructions! (4th Injection)

24 Weeks with Tremfya: A Pattern Emerges

28 Weeks with Tremfya: Still Working? (Injection #5)

42 Weeks with Tremfya: Coping with a Skin Flare


Does my skin itch with Tremfya?

I don’t have a great answer for this question as my skin always itches. However, I can say that my psoriasis does not itch as much as the inflammation lessened overall on my body. A few new spots broke out along the way that felt itchy, but they faded in a couple weeks like the other spots. I do have a comment about my scalp, though. See below.

Will Tremfya clear my scalp psoriasis?

My scalp itches quite a bit with scalp psoriasis. Tremfya data shows good response for scalp psoriasis, but unfortunately not so much for me. Definitely not as bad as without treatment–no large flakes peeling off my scalp–but not as good as I hoped.

See the Tremfya prescribing informationfor more details about scalp psoriasis from Janssen.

Is Tremfya for eczema?

At first I feared Tremfya caused my eczema to worsen, but I never could substantiate any causal relationship between injecting Tremfya and worsening or improving eczema. Either way, it is not indicated for atopic dermatitis at this time, which means I need to find a different way to treat my eczema.

What do I do if my insurance won’t cover Tremfya?

I hate that when I start a discussion with my dermatologist about a new treatment we invariably talk about insurance coverage. I have faced insurance denials in the recent past for Otezla, and also for a home phototherapy unitI thought I might for Tremfya as well. Thankfully, insurance provider approved my taking Tremfya, although it took a few weeks for the system at the specialty pharmacy to get it to me because it was new back last summer.

My dermatologist did tell me at the time, though, that I would get the medication one way or another. At that time the manufacturer Janssen provided the medication for a time for certain individuals who could not receive it through insurance.

I would personally go to Janssen’s CarePath Tremfya website to ask their representatives, or to the National Psoriasis Foundation’s Patient Navigator Center with insurance issues that arise.

Does Tremfya give you high blood pressure?

My blood pressure hasn’t elevated that I can tell since taking Tremfya. The Janssen Medical Information and Services representative said that elevated blood pressure is “not something reported or seen in clinical trials or post marketing data.” Certainly something to talk to your doctor about if you have a concern.

Is it okay to take a dose of Tremfya a week late?

The Janssen representative said that it wasn’t studied that way–taking it later than the regular dosing schedule. She said that if you are late, the risk is for the disease to break through. She added the importance of sticking to the interval period as much as possible.

Can I drink while taking Tremfya?

I happen to not drink alcohol, not for religious reasons, but because it flares my skin conditions. Janssen said there is no specific concern or direct contraindication to drinking alcohol with Tremfya, but ask your doctor.

Do you have any questions about my experience with Tremfya not covered here? Feel free to leave a comment or message me and I’ll be sure to respond to those.

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