Responses: Psoriasis and Liners

Responses: Psoriasis and Liners

Thanks to all who responded. From the number of positive responses I received
I think it is worth a try. I will suggest it to the Dermatologist and see
what she says.

Below is my original post followed by the responses. There were quite a few
so there will be two postings.

I am wondering if anyone has experience fitting amputees who have severe
psoriasis (transtibial in my case) with 3S type liners, Dermo, Alpha, or
others? I am thinking about asking their Dermatologist what they think about
the idea. I thought I would see if I received any feedback, positive or
negative, here first. I will post your responses unless you request
otherwise.

Thanks in advance,
Eddie V. White, CP
Beacon P&O 

Responses:

Some people with really sensitive skin do better with a nylon sheath against
the skin, under the suspension liner.  Does your client have eczema or
psoriasis on parts of their body other than where the liner contacts them?
If so, they may have a very typical manifestation of a food allergy, such as
that seen for milk or soy intolerance.  This is often seen as a spotty rash
on the legs and abdomen.

If there is no medical contraindication for doing so, your client may try
going off all milk and soy products (that includes all packaged foods that
have 'whey' or 'milk products' listed as ingredients).
***************
Well this is strange!  A patient just left my office and he has developed
psoriasis on his Trans-tib residuum after wearing his BKP for about 8
months.  Up until a week ago he had no problems but this just erupted.  His
primary MD prescibed triamcinolone ointment to be used until a dermatologist
can see him,
*************
:  I do have experience with this in an AK and had excellent results
with a clear ICEROSS.  He was a wet fit between ICEROSS and Socket.  It was
the only way to keep him from having major problems.  Later it was found
out, 2 years later, that it was a form of athlete's foot.  He now uses
powder, athletes foot powder against the skin, and he has since ditched the
ICEROSS. 
**************
I have recently fit a pt who has psoriasis and is a Trans-Tibial amputee. 
When I saw her the psoriasis was localized in an area approximately 3 in
diameter which included the patella tendon bar.  Her residual limb was 3 in
length so I had no choice but to load the PT bar.   I had no problems fitting
her with an Alpha Liner, her skin reacted well and the condition of the skin
actually improved a bit.
**************
I of course never fitted one, but I worked with a technician who was a TT
with roll on suspension, who also suffered from severe Psoriasis and I
believe Dermatitis,
He was constantly complaining of problems because of the closed environment.
He did however find that using Aegis Liners helped a great deal with those
problems, I think Aegis adds mineral oil or some substance to help with skin
problems.
He would tell me that the benefits of that suspension out weighed the
problems.
*************
I have fitted two patients with psoriasis - both trans Tibial.

On the first, she was already on Urethane cushion liners (3S if I remember
correctly) but she complained of skin irritation.

I fitted her with a set of 9mm Alpha locking liners (with Spirit fabric) 3
months ago and she is very comfortable with no skin irritations.

For the second case - I went in right away with 6mm Alpha Spirit liner
(cushion this time) and have not seen any problems so far - 5 weeks now.
***************
I treated a patient with psoraisis on his elbows.  He was unilateral BK.
Fit him with BK prosthesis with Alpha locking liner.  Initially some
redness on the thigh but this I think was caused by perspiration which
abated in a couple of weeks.  Patient had no further skin disorders.
Please note that next door is the Dermatologist who treats his
psoraisis.  Prior to incorporating the Alpha into the prosthetic system
she was consulted.  Doctor requested a msds(?) fact sheet and after
studying the report she was positive in her decision;Let's give it a
try
(I think she didn't have a clue).
**************
Tear your hair out time. I have one client with very bad psoriasis, and have
had to return to pelite liner due to the condition worsening. Tried an ALPS
liner, and the patient asked for the old socket after a month. It should be
noted the client (and me) live in the top 1/4 of Australia so we are in an
extreme climate situation. Patient has put up with the problem for years,
but after trying the Gel liner found that the area above the socket broke
out.
************
I have used the dermo on people with psoriasis and they had no more
problems with psoriasis than normal, it wasn't any less either.

Thanks again,
Eddie,