With Psoriasis, Hidden Inflammation May Persist Despite Clear Skin

From healthcentral.com

New research suggests that lack of skin plaques is not proof of disease inactivity with this condition 

If you’re one of the 8 million-plus people in the U.S. with psoriasis, you likely know that systemic inflammation is at the root of your symptoms, including thick, scaly, often itchy patches of skin. Now, new research published in the Journal of Investigative Dermatology suggests that this inflammation may persist even after those visible symptoms are reduced with medication.

The findings of the observational study were shared following an assessment of 209 people with psoriasis across three international cohorts (Spain, the U.S., and Sweden). After stable biologic therapy, each participant had a score of 2 or less on the Psoriasis Area Severity Index (PASI), a tool used by dermatologists to assess the severity and extent of an individual’s psoriasis, measured by the skin’s appearance.

But as it turned out, visual clues only told part of the story.

Hidden But Still Flaring?

Despite significant improvement in their PASI score, researchers found that about a third of participants (36.3%) had residual inflammation, demonstrated by inflammatory markers in blood tests. This was linked to higher body mass index (BMI), metabolic dysfunction-associated steatotic liver disease (MASLD), increased baseline systemic inflammation, and greater adipose tissue (body tissue). In all three cohorts, women were more likely to have inflammation than men.

“Patients with psoriasis have a reduced life expectancy due to an increased risk of cardiovascular disease,” according to lead investigator Álvaro González-Cantero, M.D., Ph.D., of the Department of Dermatology, Hospital Universitario Ramón y Cajal, and Faculty of Medicine, Universidad Francisco de Vitoria in Madrid, Spain, who explained the study findings in a press release. “With the goal of better understanding this, we wanted to explore psoriasis as a systemic disease and its broader health implications.”

The research findings are particularly important, per Dr. González-Cantero, because they highlight that despite achieving good skin responses with biologics, a significant subset of patients—predominantly those with obesity (especially central obesity), higher baseline systemic and organ inflammation (as shown by PET/CT scans), increased subcutaneous and visceral adipose tissue, and markers of MASLD—continue to exhibit residual inflammation. There is a critical need to address the systemic inflammatory burden beyond skin symptoms in psoriasis, Dr. González-Cantero believes, in order to improve overall patient outcomes.

                                                                                 GettyImages/ArLawKa AungTun

The Full Body Connection

Pasadena, CA-based board-certified dermatologist William D. Shipman III, M.D., Ph.D., welcomes the research. “It reinforces what many of us who treat psoriasis every day have observed—that even when the skin looks clear, there can be lingering inflammation beneath the surface,” he says. “This persistent systemic inflammation can quietly contribute to conditions like cardiovascular disease, insulin resistance, and fatty liver disease. The study helps connect those dots with more clarity and could push both dermatology and primary care forward in treating psoriasis as a full-body disease, and not solely a dermatologic illness.”

Dr. Shipman believes that a broader understanding of psoriasis as a systemic inflammatory disease could transform patient care. “If primary care doctors, cardiologists, endocrinologists, and even mental health providers recognize psoriasis as more than skin deep, it could lead to earlier screening for comorbidities like heart disease and metabolic syndrome,” he says. “It might also reduce stigma. Psoriasis isn’t just a rash—it’s a reflection of immune dysregulation that can affect the whole body. When patients feel seen in that way, they’re often more engaged in their care.”

As a practicing dermatologist, Dr. Shipman says it’s notable how few psoriasis patients think about the bigger picture, including the broader health implications of their condition, such as the increased risk of cardiovascular disease. “Honestly, most of my patients don’t come in thinking about heart disease or fatty liver,” he says. “They’re focused on the physical discomfort and visible appearance of their skin, which makes sense, because that’s what affects them day to day.” He adds that when he explains the connection between psoriasis and inflammation elsewhere in the body, many patients are surprised, and sometimes even a little alarmed: “That moment of awareness can be powerful.”

With Psoriasis, Knowledge Is Power

Dr. Shipman agrees with the researchers that continuous education is vital—and not just for patients but for healthcare providers, too. “Psoriasis education should be integrated into internal medicine training, cardiology, and even public health messaging,” he says. “On the dermatology side, we can do a better job of having those systemic risk conversations in the exam room. And at the policy level, insurers and healthcare systems should recognize that treating psoriasis with advanced therapies isn’t just about skin clearance—it’s a chance to reduce long-term inflammatory disease burden across the board.”

https://www.healthcentral.com/news/psoriasis/hidden-inflammation-may-persist-despite-clear-skin

What Exactly Is the Connection Between Psoriatic Arthritis and the Immune System?

From yahoo.com

Dealing with the itchy, scaly patches that come with psoriasis is difficult enough. But having psoriasis puts you at risk of developing psoriatic arthritis, an inflammatory condition that impacts the joints. In fact, research suggests that up to 30% of people with psoriasis will eventually develop psoriatic arthritis.

The exact cause of psoriatic arthritis isn’t known, but the immune system plays a major role in its development. In general, a person will develop psoriatic arthritis when they have a genetic predisposition and are exposed to environmental triggers like infections, physical injury, emotional stress, or lifestyle factors like obesity and smoking, says Paras Karmacharya, MD, director of the Vanderbilt Psoriatic Arthritis and Spondyloarthritis Center. “This is often described as a ‘two-hit’ process,” he says.

Together, these factors can spark an immune system reaction that leads to psoriatic arthritis. Of course, the process of developing psoriatic arthritis, having flares, and getting effective treatment is more complicated than that. Here’s what doctors who treat psoriatic arthritis want people to keep in mind about the immune system’s role in the condition—and in getting proper treatment.

What is psoriatic arthritis?

Psoriatic arthritis is an inflammatory condition that impacts the joints, which can happen in combination with the chronic inflammatory skin disorder psoriasis, according to the U.S. National Library of Medicine. While psoriasis causes symptoms like red, irritated skin, psoriatic arthritis is usually linked with signs like stiff, painful joints and swelling around the joints.

People typically have psoriasis before they develop psoriatic arthritis, although that’s not always the case, says Zhanna Mikulik, MD, a rheumatologist at The Ohio State University Wexner Medical Center. “Usually, psoriatic arthritis patients have psoriasis for 10 or 12 years and then develop psoriatic arthritis,” she says. While rare, some people develop psoriatic arthritis without any obvious skin changes, Mikulik says.

OK, but how does the immune system influence psoriatic arthritis?

The immune system is a major player in psoriatic arthritis. “Psoriatic arthritis is the result of your immune system reacting abnormally because of both your genes and something in your environment that flips the switch,” says Karmacharya. “In people with psoriatic arthritis, the immune system, which normally protects the body from infections, mistakenly targets the joints, skin, and entheses—the sites where tendons and ligaments attach to bone.”

With psoriatic arthritis, “something is stimulating the immune system and it’s hyperactive in the wrong way,” Mikulik says. That causes inflammation in different areas of the body, especially around the joints, she says. Over time, that chronic inflammation leads to pain, stiffness, swelling, and eventually joint and tissue damage if it’s left unchecked, Karmacharya says.

Beyond that, the relationship between the immune system’s overreaction and psoriatic arthritis isn’t well understood, says Vivien Hsu, MD, acting chief of the division of rheumatology at Rutgers Robert Wood Johnson Medical School. However, she points out that people who have psoriasis and psoriatic arthritis share similar “abnormal” immune system reactions. Those include the over-expression of certain inflammatory cytokines, which are small proteins secreted by the immune system, she says.

But the link between the immune system and psoriatic arthritis also means that being stressed or having infections like the common cold or flu can cause a flare or worsen joint issues, Hsu says. “That’s because infections activate the immune system broadly,” Karmacharya explains. “In someone with psoriatic arthritis whose immune system is already overactive and misdirected, this can unintentionally escalate inflammation in the joints and skin.”

How do psoriatic arthritis treatments influence the immune system?

Many medications used to treat psoriatic arthritis are immunosuppressants, meaning they weaken the immune system. However, these medications are usually focused on certain cytokines. “Most treatments are selected to target the cytokines that are overly expressed in psoriatic arthritis,” Hsu says. As a result, Karmacharya stresses that they don’t shut the immune system down. “They fine-tune it to stop it from attacking the body while still allowing it to defend against real threats,” he says.

Having medications that work on the immune system is important because psoriatic arthritis is more than a joint problem, Karmacharya explains. “It’s a systemic immune-mediated disease,” he continues. “Understanding this helps explain why treatments that target the immune system directly, like biologics, are so effective.”

Still, these treatments aren’t perfect. “Because these medications suppress parts of the immune system, they can also slightly increase the risk of infections. You do have the army to fight against viruses and bacteria, but you just have less of an army,” Karmacharya says. “That’s why monitoring and infection prevention, like staying current on vaccines, are important parts of treatment planning.”

How to support your immune system while living with psoriatic arthritis

If you have psoriatic arthritis, doctors stress the importance of working with a healthcare provider to come up with a treatment plan that works for you. But beyond taking any recommended medications as prescribed, there are certain lifestyle moves you can make to support your immune system.

Consistent, high-quality sleep is crucial. “Poor or insufficient sleep increases inflammation and can make symptoms feel worse,” Karmacharya says. He recommends that most people aim to get seven to nine hours of sleep a night.

Stress management is also important to support a healthy immune system, Mikulik says. “Chronic stress can disrupt immune regulation and trigger flares,” Karmacharya explains. “Techniques like deep breathing, yoga, or mindfulness can help bring things back into balance.”

Regular exercise can help keep joints mobile, too, Mikulik says. Your diet is also important, with Karmacharya recommending a nutrient-rich, anti-inflammatory diet, like the Mediterranean diet. “Foods like fatty fish, leafy greens, colourful fruits, whole grains, and healthy fats like olive oil can help calm inflammation,” he explains. “At the same time, it’s important to limit processed foods, added sugars, and unhealthy fats, which can fuel inflammation.”

That doesn’t mean that lifestyle treatments alone will get rid of psoriatic arthritis symptoms—but doctors say they can help you to feel more comfortable. “While these steps won’t replace treatment, they can make a real difference in how well the immune system functions and how the disease behaves day to day,” Karmacharya says.

https://www.yahoo.com/news/exactly-connection-between-psoriatic-arthritis-160000798.html  

Science-Backed Tips for Easing a Psoriasis Flare

From healthcentral.com

Right this way for fast relief of your itchy, painful skin 

Flares are a fact of life with psoriasis, the skin condition that appears as scaly plaques on areas of the body like the scalp, elbows, and knees. Not only can psoriasis flares make people feel self-conscious, “they can be very itchy and uncomfortable for patients to deal with,” says Lauren Penzi, M.D., a board-certified dermatologist in New York City.

Psoriasis flares can describe any time that you’re not in remission, and they can reduce your quality of life, impair your activity, and increase your anxiety, according to a study in the Journal of Psoriasis and Psoriatic Arthritis. And they tend to be a long-term game: If psoriasis plaques are there on Monday, “they’re probably still going to be there on Friday—but maybe they're not as itchy, as white, as flaky, or as bothersome,” says Elizabeth Kiracofe, M.D., a board-certified dermatologist in Chicago. “But they’re still going to be there because psoriasis doesn’t come and go that quickly.”

That’s because psoriasis is a chronic disease that stems from a disruption in the immune system which affects skin cells. This “increases the inflammation that goes on in the body that then signals the skin to make the psoriasis lesions that we see with our eyes,” says Dr. Kiracofe.

The good news? The sooner you can treat a psoriasis flare-up, the faster you’ll get relief—and this is the month to start. Depending on the severity of your psoriasis, you may need to explore long-term options like biologics, a type of medication that works from within the body to control and clear plaques. “A biologic can be part of the marathon plan,” she says.

However, there are steps you can take at home to get relief in the meantime. Here’s what the experts recommend for getting your symptoms under control ASAP.

                                                                                          GettyImages/triocean

Slather Moisturizer Everywhere

Moisturizing is a must for anyone with psoriasis, since it can be associated with a compromised skin barrier—but especially if you’re dealing with a flare. Pro tip: Moisturize your skin from head to toe, not just where you notice an initial plaque. “A common misconception with psoriasis is that you only need to treat the lesions, but in patients who have psoriasis, all of their skin is compromised, and so their barrier is disrupted everywhere,” says Dr. Kiracofe.

She recommends any moisturizer that you can scoop from a tub or squeeze out of a tube, “because that implies it’s a little heavier,” she says. Look for skin-soothing formulas with occlusive ingredients—like oils and butters—as well as ceramides, since these types of lipids can be missing from the skin barrier when it’s compromised.

At night, you can take your skin hydrating game up a notch by topping off areas where plaques appear with wet dressings that can lock in ointments—follow this how-to in order to do it properly.

Target Plaques With Topical Steroids

With moderate to severe psoriasis, systemic meds may be needed to treat the underlying disease. But for immediate plaque-itch relief, topical steroids are your best friend. “Use it twice a day until the plaque is gone, plus two extra days,” says Dr. Kiracofe. “Then we know it’s going to stay gone—versus if you just use it once a day for a few days a week.”

Apply your medication first, and then top it with moisturizer. Most of the prescription topicals prescribed for psoriasis “are stripping of the skin barrier, so they’re dehydrating to the skin,” says Dr. Kiracofe. And when skin is dehydrated, the moisture barrier is more fragile—so using medication alone is “kind of like three steps forward, two steps back,” she says.

Both Dr. Penzi and Dr. Kiracofe agree that if you don’t have prescription-strength topicals on hand, go ahead and use a 1% hydrocortisone cream. It’s not a long-term solution, but it can help you manage your flare until you see a doctor.

And, if you can’t get in with your dermatologist right away, consider seeing your primary care doctor, who can start you off with a prescription for a more powerful topical steroid. And, of course, “we want to make sure that—in addition to whatever active ingredient—we’re still moisturizing the skin as well,” says Dr. Kiracofe.

Apply a Cool Compress

Psoriasis flares can come with intense itchiness and you want to do all you can to prevent yourself from scratching your plaques, since it further traumatizes an already compromised skin barrier.

As you wait for topical formulas to bring healing, apply cool compresses to temporarily calm inflammation and itching, says Dr. Penzi. (If you’re able to make it to the drugstore, she also points to pramoxine as a good, over-the-counter topical anaesthetic that helps numb the skin to control itchiness.) Cooling the skin can actually have a big impact on the intensity of itch; one study found that it acts directly on sensory receptors that oversee itchiness in skin.

Download a Mindfulness App

According to the American Academy of Dermatology Association (AAD), many things can trigger a psoriasis flare, from summertime exposures—such as a sunburn or even sitting in air conditioning—to chronic issues like increased stress. Stress and psoriasis are closely linked; even changing jobs or a breakup out of nowhere can trigger some psoriasis flares, as stress releases hormones like cortisol, which can exacerbate inflammation. For that reason, the skin is often the first place you’ll see signs of stress, says Dr. Kiracofe.

On the bright side: “Anything that can bring down the production of that stress hormone is beneficial,” says Dr. Kiracofe. In fact, she recommends mindfulness apps to her psoriasis patients, asking them to meditate two to three minutes a day. It may also help you fight the urge to scratch, she says. A systematic review of the relationship between mindfulness and psoriasis found that it can in fact be a short-term tool for improving both the severity of psoriasis as well as quality of life (meaning people with psoriasis experience less worry, anxiety, and depression stemming from the condition).

Layer on Extra Protection

Depending on the weather, this might be a good time to spring for long sleeves and pants to protect your skin, since any scratches or even tiny wounds can trigger the development of a new plaque. It’s called the Koebner Phenomenon, where “new psoriasis lesions form on previously unaffected skin due to trauma,” says Dr. Penzi.

So, it’s critical to protect your body from any incidental trauma, according to Dr. Kiracofe. That’s also part of the reason moisturizing is so important: It acts as an extra shield. “If your skin is healthy and moisturized and prepared, that trauma is less likely to have an impact,” she says.

Your Flare Game Plan

Unlike some skin conditions, psoriasis is an autoimmune disease. And, as an immune-mediated problem stemming from within your body, “it generally needs prescription medicines to help solve it” from the inside, says Dr. Kiracofe. Since there is no cure for it (yet), the objective is for psoriasis that’s “well controlled,” as she puts it: “My goal as your doctor is to make sure that psoriasis is no longer the first thing you think about when you get up in the morning.”

So, while these tips can offer quick relief and quell inflammation from the outside, they can’t address the autoimmune disease that’s triggering the plaque-causing inflammation in the first place—which is why it’s worth getting in touch with your doctor if your current treatment plan isn’t cutting it. “There are so many new things that we have to offer in the world of psoriasis—because, frankly, over-the-counter stuff just can't solve the problem,” Dr. Kiracofe says.

https://www.healthcentral.com/condition/psoriasis/science-backed-tips-for-easing-a-psoriasis-flare

6 Reasons People Quit Their Psoriatic Arthritis Medication — and Why You Shouldn’t

From msn.com

When it comes to taking psoriatic arthritis medication, following your doctor’s instructions to a T is essential for good health. Not taking medication as prescribed can cause symptoms to worsen and may lead to disease progression.

But research has found that as little as 57 percent of people who have psoriatic arthritis take medications as prescribed.

Before you skip the next dose, talk to your doctor about what’s bothering you. “It’s always better to try to address the underlying issue, so you can continue taking your medication as prescribed or find better alternatives,” says Angelica Gierut, MD, a rheumatologist at Northwestern Medicine in Warrenville, Illinois.

Here are six reasons you may be tempted to stop taking medications — and why you shouldn’t.

1. The Disease Seems to Be in Remission

When psoriatic arthritis treatment is working well, you should experience few or no symptoms, such as joint pain and swelling. As a result, you might wonder why you have to continue taking the medication.

The truth is, if you stop the meds, you’re at risk of symptoms returning. One small study on the effects of withdrawal from biologics found that symptoms returned within two years for 85 percent of the participants with psoriatic arthritis who had stopped taking medication. What’s more, another study found that interrupting biologic treatment increases the risk of developing a resistance to these drugs.

The Arthritis Foundation recommends continuing to take medication, even if you have low disease activity. Talk to your doctor about potentially lowering the dose or stopping one medication if you currently take several.

2. You’re Dissatisfied With Treatment

Results from a survey of a quarter million people with psoriatic disease found that anywhere from 66 to 84 percent of respondents found treatment burdensome, depending on whether the treatment was topical, taken orally, or injected.

If you’re not satisfied with the treatment regimen you’re on for any reason — cost, method of administration, side effects — you’re more likely to consider stopping it altogether. But there are many psoriatic arthritis medications to choose from, and even more are coming down the pike. If you’re unhappy with the medication you’re currently taking, work with your doctor to find a drug that works for you.

3. You’ve Already Missed One Dose

When life gets busy, it’s easy to occasionally forget to take medication. Missing a dose likely won’t cause a major arthritis flare, according to Dr. Gierut. But it’s important to get back on track as soon as possible.

Talk to your doctor about what to do if you miss a dose. If you need help remembering to take medication on time, try using a pill organizer or putting reminders in your smartphone or on your daily calendar.

4. You’re Dealing With Uncomfortable Side Effects

Results from another survey of people with psoriatic disease found that the majority of respondents who reported being “very or quite dissatisfied” with treatment cited side effects as the reason.

If you’re experiencing medication side effects, such as headache or stomach upset, discuss them with your doctor. Together, you can work to find ways to manage side effects. With your doctor’s approval, you may even be able to lower the dose until you can build up a tolerance or even switch to another medication instead.

5. The Medication Is Too Expensive

Some research has found that total healthcare costs for biologics can range from about $19,000 to $60,000, depending on which biologic is prescribed. And the price tag can potentially be more than $500,000 for the most expensive options.

The good news: Most insurance companies should cover a large portion of these prescription drug costs. Even with good insurance, though, the out-of-pocket costs for biologics can still be high.

If you’re having trouble paying for psoriatic arthritis medication, talk to your doctor. “Rheumatologists can suggest alternatives that may be less costly for patients,” Gierut says. Or your doctor may be able to help you find a drug assistance program to cover some of the costs, either through the drug’s manufacturer or private foundations.

6. You Prefer Natural Remedies

Although natural remedies, such as acupuncture and turmeric, won’t cure psoriatic arthritis, some people find them effective at easing symptoms when used in combination with traditional treatment. But Gierut notes that there are no robust or large-scale studies that show whether they truly work. Also, some so-called natural remedies may interfere or interact with prescription medications.

Before adding complementary therapies to a psoriatic arthritis treatment plan, carefully review your options with your rheumatologist.

The Takeaway

• Stopping psoriatic arthritis treatment on your own often leads to an increase in symptoms and flares and can lead to disease progression.
• Be open and honest with your doctor about any issues preventing you from sticking to the treatment plan.
• Together, you and your doctor can come up with a solution to keep psoriatic arthritis under control.

https://www.msn.com/en-us/health/other/6-reasons-people-quit-their-psoriatic-arthritis-medication-and-why-you-shouldn-t/ar-AA1Ihkwf  

What To Know About Psoriasis on Your Eyelid

From health.com

Psoriasis is a skin condition that causes patches of inflamed, scaly, flaky skin. It's most likely to affect your elbows, knees, or scalp, but psoriasis can affect any part of your body. About 10-12% of people with psoriasis will have symptoms that affect their eyes, including psoriasis on their eyelids.

Symptoms

People tend to develop psoriasis near their eyes after they've already developed it on other parts of their skin, such as near their elbows and knees.

Symptoms of psoriasis around your eyes and on the eyelid may include:

• Raised reddish, scaly bumps on or near your eyelids
• Crusting or flaking on your eyelashes
• Eyelid swelling
• Eye redness, dryness, itching, burning, or tearing
• Vision problems
  

Psoriasis on the eyes and eyelids is often associated with other eye conditions. For example, people with psoriasis symptoms on or near their eyes may experience:

• Dry eye syndrome
• Blepharitis, which is inflammation and swelling of the eyelid
• Conjunctivitis, which is when the white of your eye becomes red and inflamed

                                         Psoriasis on the eyelid is rare and can cause swelling, skin flaking, and other eyelid symptoms.

                                                                                      Credit:  Mireya Acierto / Getty Images

What Causes Psoriasis on the Eyelid?

Psoriasis occurs when your immune system becomes overactive and causes your body to produce too many skin cells. This overproduction of skin cells results in many symptoms of psoriasis, including psoriasis plaques and inflamed, scaly skin.

Experts don't fully understand why some people experience this immune system reaction, but the cause likely involves a combination of genetics and environmental triggers. Many people with psoriasis have family members who also have it.

In general, factors that may increase your risk of psoriasis include:

• Certain infections, like HIV and strep
• Some medications
• A history of smoking
• Obesity
• Alcohol overuse
• Skin injuries or other skin traumas
• Weather changes
• Dietary triggers

How To Treat Psoriasis on the Eyelid

If you have psoriasis symptoms on your eyelid, it’s important to see a healthcare provider right away. Untreated psoriasis on or near your eyes can lead to complications, including vision loss.

Healthcare professionals who treat psoriasis of the eye include primary care providers, dermatologists (doctors who specialize in treating the skin), and ophthalmologists (doctors who specialize in treating the eye). Your provider will likely do a thorough examination of your eyes and provide an individualized plan of treatment for you.

Psoriasis treatment usually involves medication, at-home remedies, or a combination of the two. You can help treat psoriasis on your eyelid with options such as:

• Warm compresses
• Eyelid massages
• Eyelid scrubs
• Eyelid cleansers
• Lubricant eye drops
• Antibiotic ointments
• Topical (on the skin) steroids

When applying medications near your eye, follow your healthcare provider's instructions carefully. This can help you avoid irritation and reduce the risk of other eye problems. Contact your healthcare provider if you have questions about following your psoriasis treatment.

Is It Psoriasis or Eczema on the Eyelid?

Eczema is a group of inflammatory skin conditions that can resemble psoriasis. Eczema near your eyes and eyelids may be more common than eyelid psoriasis. Here's how to help tell the difference.

	Eyelid Psoriasis	Eyelid Eczema
Colour	Reddish, purplish, or discoloured skin, sometimes with silvery scale on top	Reddish, brown, or discoloured skin
Texture	Scaly or flaky	Scaly or flaky
Border	Rashes are in clearly defined patches	Rashes don't have clear border
Cause	An overactive immune reaction that leads to skin overgrowth and build-up	Contact with an allergen or irritating substance
Itch	May be mild or feel more like burning or stinging	May be more severe

If you aren't sure whether your eyelid symptoms may be due to eczema or psoriasis, consider making an appointment with a dermatologist, ophthalmologist, or primary care provider. Eczema and psoriasis have some similar treatments, but they can vary. It's important to get treatment specifically for the skin condition you have.

A Quick Review

Symptoms of psoriasis on the eyelids include eye or skin redness, skin crusting or flaking, itchiness, burning, and eyelid swelling. If you have symptoms of psoriasis on your eyelids, face, or anywhere else, visit a healthcare provider so that they can properly diagnose you and prescribe a treatment plan tailored to your condition and individual needs.

https://www.health.com/psoriasis-on-eyelid-11753571