Question for KLD -- decubitus ulcers aggravated by psoriasis

[Don D. 73]

I have been battling skin sores along the outside of both of my calves for more than a year. I immediately began going to the wound care clinic at the University of Texas Southwestern Medical School. I have a full time staff, as well as a home health care RN, all capable of doing dressing changes. It appeared at one point that the sores would be healed in a matter of 2 or 3 weeks.
Suddenly, they all began to deteriorate significantly. They became much larger and very nasty. A culture and an MRI revealed that I have acquired MRSA, probably due to an overnight hospital stay.
I have also had a severe case of psoriasis since 1986. Fortunately, I have a world-class physician who participates on the science committee of the Psoriasis Foundation. Of course, I have consulted with him about the whole situation. His view is that until the psoriasis is under control, there's no way to heal the sores.
Meanwhile, my doctor at UT Southwestern decided to have me see another wound care physician who also happens to be a surgeon who might be able to do a skin graft. He informed me that the only surgical intervention he could do for me was amputation, not a solution I've been particularly interested in.
In the mean time, I continue to develop new sores, despite the fact I have a Clinitron bed, I'm ingesting all the protein powder, bars, and (my favorite) grilled New York sirloin steaks.
An obvious suspect is humira, the psoriasis medicine my doctor has prescribed.
I discussed with him the admonitions against using humira; infections, open sores, etc.
Never the less, he put me on the medicine anyway.
I am getting conflicting information from all my dermatology and wound care specialists.
We are having success with the old sores with sodium chloride dressing changes twice a day, but new ones keep showing up.
I intend to inform my psoriasis physician that I intend to get off humira immediately.
I apologize for the length of this post, but this situation has gotten to be more than annoying. I would appreciate any advice you might have.

[SCI-Nurse]

I am not an expert in dermatology or psoriasis, but I would recommend that you seek a second opinion, both in dermatology and in plastics, to determine what other options you may have. The combination of pressure ulcers and psoriasis is very difficult to manage in my experience, and there may not be as many options available for you as for someone with SCI who has only the pressure ulcers to deal with.

(KLD)

[Don D. 73]

KLD,

If you google Dr. Alan Menter, you will see he has no match as far as expertise in psoriasis is concerned. I have been a patient of his many years before my injury.

I have already made another appointment to inform him that I intend to get off the humira. I think it's the source of these new sores.

Dr. Menter made an appointment with an infectious disease doctor. Perhaps he can shed some light on the situation.

All of my original deep sores have filled in substantially. It's these new ones appearing that cause me to believe the humira is the problem.

[lynnifer]

I was going to say dump the humira for a while too ... at least until the wounds are closed.

Do your legs swell at all? I'll be surprised if you say they don't.

[Don D. 73]

Yes, they do. I'm quite sure the edema was the cause of the original sores.
Like you, lynnifer, I'm confident I can get the wounds to close now that I'm off the humira. I skipped my shot today for the first time.

[lynnifer]

They also won't heal until the swelling is taken care of.

So many factors go into wounds! It's never just one root cause!