BBC Strictly Come Dancing's Aljaz Skorjanec on health issue that was 'everywhere' on his body

From uk.news.yahoo.com

A Strictly Come Dancing professional revealed he has been living with a severe health issue for 16 years. Dancer Aljaz Skorjanec, who is paired with Love Island star Tasha Ghouri this year, opened up about his diagnosis of psoriasis.

Psoriasis is a skin condition that produces painful and itchy scales on the body. Aljaz, who is now 34, revealed he was first diagnosed at the age of 20 after dealing with symptoms for two years.

The NHS says that psoriasis leads to the development of flaky skin patches and formations of scales that can be both itchy and sore. In a 2022 interview he disclosed how psoriasis severely affected his self-esteem and even chose to conceal it during his time on Strictly.

                                                                                                      Credit: (Image: Getty)

Aljaz, who is married to fellow Strictly professional-turned-It Takes Two presenter Janette Manrara, detailed his initial encounter with the condition, sharing: "When I was about 18, I stopped dancing competitively and it was a huge change in my life."

He recalled: "I'd had enough of the competition world there was so much politics involved and my parents had been supporting me financially, and I just didn't think I should do it any more. But I was unsure what I was going to do and this huge void made me stressed."

"It was around that time I started getting odd patches on my knees, which then spread to my elbows", Birmingham Live reported.

After seeking the help of a dermatologist, who diagnosed psoriasis and prescribed steroid creams, things improved. But when he left home, the condition got worse.

"I was 20 and it was really difficult because I didn't really fully understand why all of a sudden my skin was changing so drastically," he said. "It's not really the most aesthetically pleasing thing to have."

"I was getting frustrated because, for the world that I work in, appearances mean so much and it had gone everywhere, even my face. But getting stressed only made it worse."

Aljaz said he had seen around 20 specialists over the years for the condition, and tried tests for allergies and countless products, but nothing worked. He revealed he had even had an injection “straight into the psoriasis” as he was so “desperate” for it to stop.

He added: "It was very frustrating because each time, I would think I'd found a solution, but after a couple of weeks my skin would get back to its old ways and the problem seemed to come back worse than before, which felt even more infuriating."

He said he had hidden his condition on the BBC dancing show and in life in general. "I was always really conscious of what I was wearing," he added.

"I would rarely wear a short-sleeved t-shirt and still now you are never going to see me wearing shorts unless I'm on holiday somewhere hot and I have to."

Symptoms of psoriasis include:

• Patches of skin that are dry and covered in scales

• On brown, black and white skin the patches can look pink or red, and the scales white or silvery

• On brown and black skin the patches can also look purple or dark brown, and the scales may look grey

• Some people find their psoriasis causes itching or soreness.

Most cases of psoriasis go through cycles, causing problems for a few weeks or months before easing or stopping. You should see a GP if you think you may have psoriasis.

https://uk.news.yahoo.com/bbc-strictly-come-dancings-aljaz-050000841.html 

What’s the Prognosis for Psoriatic Arthritis?

From healthcentral.com

Without treatment, symptoms for PsA can get worse. Learn how to manage this disease so you can keep living an active life 

Psoriatic arthritis (PsA) is a chronic inflammatory disease that can impact practically every part of your body. The chronic condition can lead to peripheral arthritis, skin disease, spine disease, enthesitis, dactylitis, nail disease, as well as other comorbidities such as eye disease and anxiety.

The complications and symptoms of psoriatic arthritis can worsen over time and negatively impact your quality of life. In years past, the prognosis for someone with a psoriatic arthritis diagnosis wasn’t great. But recent treatment advances have improved outcomes for those with this disease and lifestyle modifications are helping people with PsA stay active longer. We asked the experts what you can expect if you’ve been diagnosed with this disease and how you can slow its progression.

Typical Progression of Psoriatic Arthritis

Psoriatic arthritis often begins as the skin disorder psoriasis. Psoriasis causes rashes with itchy, scaly patches, and can be found anywhere on the body. About a third of people who have psoriasis will also develop psoriatic arthritis, according to the National Psoriasis Foundation.

Early in the disease course, it may be hard to determine if you have psoriatic arthritis. This stage of the condition is referred to as subclinical or preclinical, according to a 2022 article in the Journal of Dermatological Treatment. At the subclinical psoriatic arthritis stage, you may have joint inflammation and/ or changes to the joint that are detectable via diagnostic imaging techniques like ultrasonography or magnetic resonance imaging.

Largely, though, the joints are pain-free at this point, making it hard to know you have the condition, unless you go looking for it. In fact, subclinical symptoms indicating early PsA are widespread among patients with psoriasis who do not yet have a diagnosis of psoriatic arthritis, according to the article authors. In one study, 41% of patients with psoriasis in whom psoriatic arthritis was identified by rheumatologists were undiagnosed by their dermatologists.

The early stage of the disease can also be a difficult time for patients, says Hannah Pugh, an occupational therapist and head of clinical experience at Reactiv, a virtual physical therapy company in Brooklyn, NY. “During the early stages of PsA, treating and managing the condition can be challenging as patients have not yet received a diagnosis, which often means they have not started appropriate medication,” says Pugh, who works with patients who have a chronic condition to help them manage their condition and equip them with tools to regain control over their disease.

Beyond the early stages of psoriatic arthritis, how the condition progresses varies greatly from one person to the next. “It is a full-body disease,” acknowledges Laura Coates, Ph.D., an associate professor and researcher of psoriatic arthritis at the University of Oxford in England. “It can affect many different types of tissues—like your joints, tendons, skin, spine—and can affect any joint in the body,” she explains. Even for a single person the disease can look different from month to month or season to season.

Still, there are some issues that most psoriatic arthritis patients share in common that were identified by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). These complications and symptoms can worsen over time. According to a 2023 study in the journal Joint Bone Spine, people with PsA were also like to have:

• Axial disease: Anywhere from 20% to 70% of people with psoriatic arthritis face the sacroiliitis and inflammatory back pain caused by this disease. Back pain typically increases as time goes on.

• Dactylitis: 15% to 48% of patients with psoriatic arthritis also have this symptom, often referred to as “sausage digits.”

• Enthesitis: 7% of psoriatic arthritis patients with a disease duration of five years have this complication.

• Nail psoriasis: Anywhere from 40% to 67% of psoriatic arthritis patients have nail issues.

• Peripheral arthritis: 64% of people living with psoriatic arthritis have this form of arthritis.

• Skin psoriasis: 77% have active psoriasis.

Will Symptoms Get Worse Over Time?

Without treatment, uncontrolled inflammation can cause multiple psoriatic arthritis symptoms to occur at once. For example, in one study, 50% of people with psoriatic arthritis experienced peripheral joint involvement and skin psoriasis at the same time.

And for those with psoriatic arthritis who have skin involvement, progression is often unpredictable, according to Christopher Sayed, M.D., an associate professor of dermatology at the University of North Carolina at Chapel Hill. “Many patients with mild psoriasis may continue to have occasional mild flares that are controlled with topical medications, but it can decide to get worse at seemingly random times,” he says. Severe disease may predict even worse outcomes, says Dr. Sayed. “Patients that have had severe flares with extensive involvement of the skin are more likely to have more frequent and more severe swings in disease activity,” he explains.

Does Psoriatic Arthritis Affect Life Expectancy?

According to a 2022 study in the journal Rheumatology, among psoriatic arthritis patients, mortality rates may be slightly higher than in the general population. Researchers relate those stats to a greater amount of cardiovascular disease in the PsA community.

In another study, researchers set out to discover whether new treatment advances have translated into normalizing life expectancy for those with psoriatic arthritis. Compared to the general population, they found a small but significant increase in all-cause and cardiovascular mortality among women with psoriatic arthritis but not men. What’s more, mortality increased among patients who had used glucocorticoids but not biologic disease modifying anti-rheumatic drugs (bDMARDs).

The three leading causes of death for psoriatic arthritis patients (as well as the general population) were:

• cardiovascular disease

• malignancies

• respiratory diseases

Death from cardiovascular disease was higher among women. The authors of the study hypothesized that risk factors such as obesity, hypertension, smoking, and diabetes may have been more prevalent among women with psoriatic arthritis.

Factors That May Affect PsA Life Expectancy

People with psoriatic arthritis have a higher burden of risk factors like obesity, hypertension, diabetes, smoking and cardiovascular disease compared to the general population. Each of these can play a role in life expectancy.

Obesity

The World Health Organization defines being overweight or obese as abnormal or excessive fat accumulation that may impair health. The prevalence of obesity among U.S. adults is about 42% where the rates of obesity for those with psoriatic arthritis is about 45%. The problem is that fat increases inflammatory proteins which promote more inflammation. Ongoing inflammation contributes to a number of different diseases that can lead to not only worse PsA but also a shorter life expectancy, according to the Arthritis Foundation. The good news? Losing weight can make a big difference. In one study, weight loss of more than 10% of body mass resulted in an increase in the percentage of patients achieving psoriatic arthritis remission from 6% to 63%.

Hypertension

High blood pressure, another name for hypertension, can damage your body over time if it goes untreated. It is measured in millimetres of mercury (mm Hg) and the optimal range is less than 120/80 mm Hg according to the American College of Cardiology. Body-wide inflammation is known to damage blood vessels, according to the Arthritis Foundation, which can put you at additional risk if your psoriatic arthritis is not controlled. Monitoring your blood pressure numbers and keeping your disease under control can be key to staying healthy.

Diabetes

The prevalence of type 2 diabetes in people with psoriatic arthritis ranges from about 6 to 20%, compared to 2 to 15% in the general population, according to a 2020 review. A higher risk of diabetes is reported in women with more severe forms of psoriatic arthritis. According to the authors of the review, the link between diabetes and psoriatic arthritis is not completely understood, but certain cytokines such as tumour necrosis factor alpha are suspected to play a role. The good news is that treating your psoriatic arthritis may help reduce your risk of diabetes.

Cardiovascular Disease

Also known as heart disease, cardiovascular disease refers to a few conditions including heart attack and stroke. According to the Arthritis Foundation, people with psoriatic arthritis actually have a doubled cardiovascular risk—they have traditional risk factors for heart disease such as obesity and diabetes and they experience whole body inflammation, which is known to damage blood vessels. Achieving and maintaining a healthy weight becomes especially important if you have PsA because obesity is associated with many cardiovascular risk factors.

Does Age of Diagnosis Matter? 

According to a 2023 study, age of onset of psoriatic arthritis can make a difference in disease outcome. In the study, participants with PsA were put into two groups, those who were diagnosed after 60 years of age (late onset) and those diagnosed before 60 years of age (early onset).

Interestingly, people with late onset psoriatic arthritis displayed an increased risk of a major cardiovascular event, even with similar smoking habits and body weight as the group with earlier onset. The authors admit that there is a lot of research needed to understand why this relationship exists.

While some may be hesitant to try a biologic as they get older for treatment, there is research available suggesting that older people with psoriatic disease respond just as well as younger people to biologic treatment. In one study looking at psoriasis treatment with a biologic, the efficacy in elderly subjects (65 or older) was comparable to that in younger subjects throughout 52 weeks of treatment. Notably, 75% clear skin was reached by 82% of the elderly subjects and 79% of younger subjects at week 52. The total rate of adverse events was similar between the elderly and younger participants.

How Severely Can Psoriatic Arthritis Affect the Body?

Thanks to better treatment options and greater awareness of the condition, psoriatic arthritis is increasingly treated early on in the disease stages. That’s a good thing, because without treatment, heightened stiffness and pain can lead to a more sedentary lifestyle, which in turn can give rise to various health issues such as cardiovascular problems, high blood pressure, and mental health disorders, says Pugh. “In more severe cases where PsA remains untreated, cumulative damage to the joints can become permanent,” she explains. Such damage can make it difficult to complete daily tasks resulting in a loss of independence and reduced sense of overall well-being, she adds.

Frailty can be another outcome of untreated psoriatic arthritis, per an American College of Rheumatology study. Frailty is defined clinically as the state of increased vulnerability due to physical and functional decline. “The prevalence of frailty in older adults with psoriatic arthritis was higher than the prevalence found in older adults in the general population in prior studies,” says Sarah Lieber, M.D., a rheumatologist at Hospital for Special Surgery in New York City and co-author of the study.

The frailty in people with PsA was compounded by issues such as comorbid conditions and falls, says Dr. Lieber, who also found that other PsA-related symptoms seemed to multiply when frailty was not addressed. For instance, “we found that anxiety was more common among adults with psoriatic arthritis who were frail than those who were not frail,” she says.

How Does Psoriatic Arthritis Impact Quality of Life?

The presence of enthesitis, dactylitis, inflammatory back pain, and peripheral joint involvement when you have PsA is significantly associated with a worse general quality of life, according to a 2023 study in the journal Joint Bone Spine.

In addition, if left untreated, the functional limitations and chronic pain of psoriatic arthritis can have a profound impact on a person’s mental health, says Pugh. In turn, “a decreased mental state can impact a person’s ability to hold a job, maintain healthy relationships, and affect their physical abilities,” she adds.

Research supports the risk that untreated psoriatic arthritis can have on mental health. In a 2022 study, researchers discovered that depression prevalence was higher in patients with than without PsA. Anxiety prevalence was also higher among psoriatic arthritis patients. According to the same study, depression remains underrecognized and undertreated in over half of moderately-to-severe patients.

Fortunately, a revolution in psoriasis disease treatment over the last 25 years has led to the development of many effective treatments. “Even the worst cases often respond very well to treatments, and because we have more than a dozen drugs that range from very good to great, we can troubleshoot when one doesn’t work well,” says Dr. Sayed.

Many of these drugs lead to substantial improvement within one to two months, and by three to four months, most medications reach their maximum effectiveness, he says. The key: Early diagnosis—timely detection and treatment of psoriatic arthritis is known to result in improved outcomes over time.

Beyond Medication

Researchers now know that psoriatic arthritis outcomes are based on more than medication alone. For instance, both physical and occupational therapy have been shown to improve PsA symptoms over time. “Physical therapy is a very important part of treating psoriatic arthritis,” says Laura Coates, Ph.D., an associate professor and researcher of psoriatic arthritis at the University of Oxford in England. PT along with medication is an effective way to treat inflammation, control pain and maximize function with psoriatic arthritis, she adds.

Other lifestyle factors that may help with your psoriatic arthritis prognosis include:

• Diet

• Exercise

• Maintaining a healthy weight

• Smoking cessation

• Stress reduction

How to Increase Life Expectancy With PsA

Having psoriatic arthritis doesn’t mean that you are destined to live with comorbidities or enjoy less of your life compared to others without the condition. However, it does mean that there is an increase in risk factors and complications, especially with untreated disease. The good news is that you can control your destiny by taking charge of your lifestyle and medical care.

According to the Arthritis Foundation, the first order of business in increasing your life expectancy with psoriatic arthritis is to quit smoking since tobacco increases inflammation and decreases treatment effectiveness. Eating a heart healthy diet and moving with intention can also make a difference—cutting the risk of heart disease nearly in half. The importance of staying on top of your treatment is also critical, since under treatment of PsA leads to uncontrolled inflammation which is the driver of many serious conditions.

Takeaways

Psoriatic arthritis impacts different people in different ways. Skin, joints, tendons, and bones including the spine are commonly impacted. If psoriatic arthritis isn’t diagnosed and treated early, over time the symptoms can worsen, multiply, and lead to permanent joint damage. A reduced quality of life, including a negative impact on mental health, often accompanies more severe disease. Fortunately, new and more targeted treatments today make it possible to slow disease progression and prevent future damage in a matter of months. Physical and occupational therapy along with lifestyle changes such as smoking cessation and weight loss can also help you to live your best life.

https://www.healthcentral.com/condition/psoriatic-arthritis/psoriatic-arthritis-prognosis?ap=nl2060&rhid=&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGWC2m5XsM8_OU1a6tRF6FOZtmidGOUQI-y8HniLjz9F7K_wjY0M-g3srSiprpNx8Rp0n0KCpdzQVWOHHPpyaM6rlZBNAuiUhtbHQn3kj0fpHtu36c 

How Aloe Vera Can Help You Manage Psoriasis Pain

From healthcentral.com

This medicine-cabinet staple can serve as a soother for mild-to-moderate psoriasis. Experts share how to maximize its benefits 

Chances are, you already know about aloe vera’s ability to soothe sunburns and comfort otherwise irritated skin—making it a summertime must-have. But there’s a reason you might want to slather it on year-round, too: Aloe vera may be an effective treatment for psoriasis. 

Psoriasis (PsO) is a chronic condition caused by an overactive immune system that produces excessive skin cells, which appear as itchy or painful plaques on the skin. Aloe vera seems to ease psoriasis skin symptoms in the way that it calms a sunburn: through its powerful anti-inflammatory properties. Curious to know more? We asked top dermatologists what makes aloe vera one of the most effective home remedies for psoriasis, and how to use it to get the best results.

Can Aloe Vera Help Treat Psoriasis?

Aloe vera has been shown to be a promising treatment for several skin concerns, including psoriasis. “Aloe vera has established itself as a natural remedy for treating skin conditions because of its soothing and anti-inflammatory properties,” says Brendan Camp, M.D., a board-certified dermatologist in New York City. (For that same reason, it’s also a popular home remedy for eczema.)

Multiple studies support aloe’s effectiveness for fast psoriasis flare relief, according to Steve Daveluy, M.D., a board-certified dermatologist and professor at Wayne State University School of Medicine in Detroit, MI. In fact, the results are so promising that aloe just might merit a spot in your psoriasis medicine cabinet.

Benefits of Aloe Vera for Psoriasis

The main advantage of aloe vera is that it may reduce the prominence of visible skin lesions that appear with plaque psoriasis, the most common kind of psoriasis. Dr. Camp points to a study in Tropical Medicine and International Health, which found that aloe vera can clear plaques and lower patients’ Psoriasis Area and Severity Index (PASI) scores, which is a measure of how severe a given case of psoriasis is. The research determined aloe was “helpful in addressing psoriasis symptoms such as redness, scaling, and number of patches,” he says.

Another study in the Journal of the European Academy of Dermatology & Venereology compared it to 0.1% triamcinolone acetonide (TA), a topical steroid, among patients with mild to moderate plaque psoriasis. By the end of eight weeks, the aloe vera cream seemed to be more effective at reducing patients’ PASI score, with the authors concluding: “Both treatments have similar efficacy in improving the quality of life of patients with mild to moderate psoriasis.”

Risks of Aloe Vera for Psoriasis

If you’re thinking about trying it, you should know that there are few to no risks of using aloe vera to treat psoriasis, since an allergy to aloe is very rare, according to Dr. Daveluy. “In fact, it’s the other ingredients in aloe vera products, like the preservatives, that have the potential to cause an allergic reaction,” he explains. “That means the risk of allergy to aloe vera products is no more than other skin-care products—and lower than many.”

A review in Phytotherapy Research of the current research on using aloe vera to treat psoriasis determined that it’s well-tolerated, and no serious side effects were reported.

                                                                            Getty Images/bymuratdeniz

How Does Aloe Vera Affect the Body?

Despite its effectiveness, “we don’t fully understand exactly how aloe vera works, since it contains multiple components that may be helping,” admits Dr. Daveluy. Some of those components contribute to aloe vera’s “immunomodulatory and antioxidant effects, which are likely beneficial in psoriasis,” he adds.

The impact on the immune system is a big deal. Aloe vera contains molecules called polysaccharides, which have been found to lower inflammation, accelerate wound healing, and even promote skin regeneration—so they’re great for your average cut or skin injury, even if you don’t have psoriasis. But one study in Molecular Medicine Reports, which measured the effect of the primary aloe polysaccharide on various cell cultures (including one that mimicked psoriatic skin), found that it could inhibit the production of skin cells triggered by the immune system. This ability is important because the immune system triggers skin cells to grow much more quickly than normal in people with psoriasis.

Second, as an antioxidant, aloe vera may help counteract oxidative stress, an imbalance of free radicals and antioxidants in the body that leads to cell damage and is closely linked with inflammation in the skin. Finally, a systematic review of studies shows that polysaccharides found in aloe vera may also increase collagen production—which is key to helping wounds heal—and help skin retain moisture.

Applying Aloe Vera for Psoriasis

The current research has only found aloe helpful in treating mild to moderate psoriasis—so it may not be ideal for severe cases. And, as always, it’s best to use home remedies like this in conjunction with an overarching psoriasis treatment plan, so talk to your doctor first to make sure it fits into your management strategy.

If you’re using aloe vera directly from the plant on your skin, “it is a good idea to do a patch test first before using the gel more liberally on your skin,” says Dr. Camp. Watch out to be sure you’re not applying the aloe vera latex, which can cause skin irritation. (The latex is yellow, whereas the aloe vera gel is clear, according to the Mayo Clinic.)

What Type of Aloe Vera Should You Buy?

“If you’re using an over-the-counter aloe vera gel extract, make sure that it contains a high concentration of aloe vera,” says Dr. Camp. “Some products may claim to be aloe vera-based products, but list it far down on the ingredient list, meaning that aloe vera is present only in a small percentage.” (The National Psoriasis Foundation recommends looking for creams that contain at least 0.5% aloe.)

Creams may be your best bet, since gels can contain alcohol, which “carries a risk of stinging when applied,” says Dr. Daveluy. Still, if you already have an aloe vera gel that doesn’t cause discomfort, he says it’s likely OK to use.

If you don’t want to go with a pure aloe vera product, another option is to find the ingredient paired alongside other science-backed active ingredients for psoriasis. MG217 Psoriasis Medicated Multi Symptom Relief Ointment pairs aloe with coal tar, while TriDerma Psoriasis Control Face and Body Cream blends it with salicylic acid and colloidal oats. Both have the Seal of Recognition from the National Psoriasis Foundation, which indicates that they’ve been reviewed for safety by a panel of experts.

Psoriasis can cause serious discomfort, but in addition to a derm-approved treatment plan, aloe vera can bring you relief from symptoms. Try aloe for yourself and see if it helps—just make sure you’re buying the real deal to get real benefits!

https://www.healthcentral.com/condition/psoriasis/aloe-vera-for-psoriasis?ap=nl2060&rhid=&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGWC2m5XvgQlhlrLhwgFchs9ZYpM2WomCNNvwWO0ypDznGuMJGDb6J3xpqfHPsjTDRwgVSXx5jDq_8zkNzSEidOpVG65T2SFd-8Q4vlfRaty8pnsKY

A cure for psoriasis: could a faulty iron hormone in the skin be the key?

From bath.ac.uk 

Scientists believe the hormone hepcidin, when produced in the skin, may be the root cause of psoriasis – a chronic disease affecting 2-3% of the population

Scientists may have uncovered the root cause of psoriasis, a chronic and sometimes debilitating skin disease that affects 2-3% of the global population. The condition is characterised by red, scaly patches that impact the quality of a patient’s life and can sometimes be life-threatening.

New research strongly suggests the hormone hepcidin may trigger the onset of the condition. This marks the first time hepcidin has been considered a potential causal factor. In mammals, hepcidin is responsible for regulating iron levels in the body.

The international research team behind this discovery – which includes Dr Charareh Pourzand from the Department of Life Sciences, the Centre for Therapeutic Innovation and the Centre for Bioengineering and Biomedical Technologies at the University of Bath – hopes their finding will lead to the development of new drugs able to block the action of the hormone.

Those most likely to benefit from such a treatment are patients with pustular psoriasis (PP) – a particularly severe and treatment-resistant form of the disease that can affect a patient’s nails and joints as well as skin.

Dr Pourzand, who studies ways to mitigate iron imbalances in the skin, said: “Psoriasis is a life-changing dermatological disease. Patients face a potentially disfiguring and lifelong affliction that profoundly affects their lives, causing them both physical discomfort and emotional distress. The condition can also lead to other serious health conditions.

“A new treatment targeting iron hormone imbalance in the skin offers hope. This innovative approach could significantly enhance the quality of life for millions, restoring their confidence and wellbeing.”

We need skin iron – but not too much

Iron is an essential trace metal, not just for transporting oxygen through the body’s circulatory system but also for maintaining healthy skin: it’s involved in many essential cellular functions, including wound healing, collagen production and immune function. However, iron overload in the skin can be harmful, amplifying the damaging effects of UV sunlight and causing hyperproliferative chronic diseases (where cells grow and multiply more than normal), including psoriasis.

Studies going back 50 years have reported high iron concentrations in the skin cells of psoriatic patients, however the cause of this excess and its significance to the condition have remained unclear until now.

The new study – published in the high-impact academic journal Nature Communications – is the first to name hepcidin as the likely link.

Hepcidin is responsible for controlling how much iron is absorbed from food and later released into the body. In healthy individuals, it’s produced exclusively in the liver, however the new study has found that in people with psoriasis, the hormone is also generated in the skin.

                                                             A drug that targets the hormone hepcidin may stop psoriasis in its tracks

Exposure to hepcidin triggers iron overload

In the new study, mice (which have many genetic and physiological similarities to humans) developed a rodent form of psoriasis after being exposed to high levels of skin-produced hepcidin.

This over-abundance of the hormone caused the animals’ skin cells to retain far more iron than was required. In turn, this excess iron triggered both a hyperproliferation of skin cells and an abnormally high concentration of inflammation-inducing neutrophils (a type of immune system cell) in the topmost layer of skin.

These two outcomes – an overproduction of skin cells and an abundance of neutrophils – are main features of human psoriasis.

Psoriasis runs in families though experts believe ‘environmental’ factors such as weight, infections and smoking are also triggers.

A disease with no cure

Currently there is no cure for psoriasis, though treatments that include topical creams, light therapy and oral drugs can help keep symptoms under control for patients with some forms of the condition. Recent treatments have focused on targeting the immune pathways that contribute to psoriasis developing.

Dr Pourzand believes a drug targeting hepcidin has the potential to dramatically improve treatment options for all psoriasis patients.

She said: “Our data strongly suggests hepcidin would be a good target for skin psoriasis treatment. A drug that can control this hormone could be used to treat flare-ups and keep patients in remission to prevent recurrence.

“Also, by adjusting the excess iron in psoriatic skin with customised iron chelators (substances that bind to excess iron in the body and help remove it), we would aim to halt the uncontrolled proliferation of psoriatic skin cells. This hyperproliferation is a major focus of our laboratory’s research on psoriasis therapy, conducted in collaboration with national and international scientists from the Skin@Bath Network, including those from this study.”

Dr William Tillett, a senior lecturer at the University of Bath and a consultant rheumatologist specialising in the diagnosis and treatment of psoriatic arthritis, said: “This research from Dr Pourzand and colleagues is an exciting step forward for people living with psoriasis and for the clinical teams treating them.

“We don’t know exactly why people develop psoriasis but the identification of hepcidin as an important factor in the development of the disease opens doors not only to potential new treatments but also to the possibility of preventing the disease developing in people at high risk. Existing drugs – called biologics – can be highly effective but they are costly and rationed in the UK. Furthermore, these drugs don’t work for everyone and they can stop working after a while, so a new approach to treatment would be very welcome."

He added: “However, developing drugs is notoriously time consuming and costly, so a new treatment won’t be available immediately and it’s important for patients to manage expectations."

Dr Penelope Pratsou, a consultant dermatologist and spokesperson for the UK charity the British Skin Foundation, said: “The findings of this study shed new light on the pathophysiology of psoriasis, with hepcidin overabundance in psoriatic skin thought to be another culprit. These results appear promising for patients, though more research is required to further elucidate the role of hepcidin and its potential as a prospective treatment target in psoriasis.”

https://www.bath.ac.uk/announcements/a-cure-for-psoriasis-could-a-faulty-iron-hormone-in-the-skin-be-the-key/