4 Sneaky Signs You Might Have Psoriasis

From eatingwell.com 

Psoriasis may have some common symptoms, but not all skin looks the same

KEY POINTS

• Psoriasis symptoms vary and can include plaques, nail changes and discomfort like itching or pain.
• Stress management, a healthy diet and proper skin care can help reduce psoriasis flares.
• Early diagnosis and treatment by a dermatologist can improve quality of life for people with psoriasis.

Psoriasis is a chronic skin disease that affects more than 8 million people in the U.S. Caused by an overactive immune system, skin cells grow more quickly than they are shed, leading to flares of scaly skin that builds up in patches around the body.

While a health care provider like a dermatologist can diagnose you with psoriasis based on a skin exam and medical history, research indicates that there is often a delay in diagnosis—sometimes over the span of years, leading to late treatment and lower quality of life. We asked experts about things we might notice if we have psoriasis; here’s what they said.

                                                                                                  Credit:  Getty Images. EatingWell Design

1. You Have Patches in Hidden or Sensitive Areas

Common psoriasis symptoms include raised, red patches of skin with silvery-white scales, often appearing on areas like the elbows and knees. “In those cases, both patients and clinicians may quickly suspect psoriasis,” says dermatologist Sejal Shah, M.D. But symptoms can be subtle or misdiagnosed as eczema, a fungal infection, dandruff or contact dermatitis, she explains. 

However, patches can also be present in oft-missed areas, such as the scalp (which can look like dandruff), behind the ears, nails, genitals, hands, feet and skin folds like armpits, under the breasts and the groin, says Shah.

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Psoriasis.

 “Because these areas may not have the classic scaling or may be sensitive or private, patients and even clinicians sometimes miss them,” she explains. 

Given dermatologists are accustomed to seeing skin on every part of the body, don’t be shy (or ashamed) about pointing out areas of concern on your body. 

2. Your Nails Have Changed

Psoriasis can affect the nails in up to half of people with the skin disease. “Psoriatic nails typically present with small indentations we call ‘nail pitting,’ along with ‘oil spots,’ which are clear yellowish discolorations that look like a drop of oil sitting under the nail,” says dermatologist Joel Spitz, M.D. He also notes that the nail plate can thicken. Interestingly enough, nail psoriasis and nail fungus can look similar. For some folks, nail psoriasis occurs without the tell-tale skin symptoms, making diagnosis even trickier.

3. You Have Plaques, But They’re Not Red

Redness is a common feature of psoriasis skin plaques—if you have lighter skin tones. “As with many dermatologic conditions, psoriasis can look quite different depending on a patient’s skin tone,” says Spitz. For example, if you have a darker complexion, “plaques tend to appear as darker, pigmented raised lesions with overlaying scale, often without the obvious redness seen in lighter skin,” he says. This can add to the challenge of diagnosis.

4. You Have Skin Pain & Discomfort

Psoriasis isn’t just something you see—you can feel it, too. “Psoriasis is often thought of as a cosmetic skin condition, but many patients experience burning, stinging, pain, severe itching, cracking or bleeding skin,” says Shah. This can be a detriment to your health and overall well-being in a variety of ways, including by affecting your sleep, mood and daily functioning, she says.

Unfortunately, research suggests that pain associated with psoriasis is often underrecognized and inadequately managed. “Many treatment plans still focus more on visible skin clearance than on symptom burden like pain or sleep disruption,” adds Shah.  

Tips for Managing Psoriasis

Psoriasis is treated in a variety of ways, and often a well-rounded treatment plan has both medical and lifestyle components:

• Follow your dermatologist’s recommendations on topicals. There are a variety of topical medications that your derm might suggest based on your symptoms and their severity. Options that may be considered include corticosteroids, synthetic vitamin D or a calcineurin inhibitor.
• Consider systemic medications. Some people with psoriasis benefit from powerful systemic medications (meaning one that travels throughout the bloodstream to treat the whole body) called biologics. “[These] have allowed many patients to achieve and maintain completely clear skin as long as they stay on therapy,” says Spitz. 
• Focus on stress. “Stress management is important because emotional stress is one of the biggest triggers and can worsen inflammation and immune responses, leading to flare-ups,” says Shah. This, in turn, can worsen emotional stress from the condition.
• Practice good skin care. Avoid harsh soaps and over-scrubbing, and make sure to moisturize skin regularly and well with a thick emollient, says Shah.
• Maintain a healthy diet. What you eat matters for your skin and overall health, and some people may notice that their skin flares are associated with foods like ultra-processed foods, excess sugar, red meat, dairy or gluten, says Shah. “Anti-inflammatory diets rich in fruits, vegetables and omega-3s may be helpful,” she says. This eating pattern can also help you maintain a healthy weight for your body and reduce inflammation.

Our Expert Take

Psoriasis signs and symptoms can take many forms, including plaques that appear in less obvious or sensitive areas of the body, changes to the nails and other varied characteristics depending on your skin tone. In addition, psoriasis symptoms can also involve itch, pain and sleep disruption. For diagnosis and to develop a treatment plan, see a board-certified dermatologist. Lifestyle management, including a healthy diet and stress reduction, can help reduce flares and improve quality of life.

https://www.eatingwell.com/sneaky-signs-you-might-have-psoriasis-11970790

Plant-Based Diets May Lower Psoriasis Risk and Severity

From medcentral.com

New research highlights nutrition’s expanding role in the inflammatory skin condition 

Dietary interventions may help reduce psoriasis severity and, in some cases, the development of the inflammatory skin condition. Nutrition may be the key.

Emerging evidence supports the role of nutrition in psoriasis management, including the potential benefits of plant-based and Mediterranean-style dietary patterns, the role of weight loss and adiposity in psoriasis pathogenesis, and the relationship between diet quality and long-term psoriasis risk. As patient interest in nutrition counselling continues to increase, the latest research outlined below may help you identify opportunities for practical, evidence-informed discussions around psoriasis diet and care.

Healthy Plant-Based Eating May Reduce Psoriasis Incidence

Goals

This prospective cohort study evaluated whether adherence to different dietary quality patterns was associated with incident psoriasis risk and whether genetic susceptibility modified these associations. Investigators used UK Biobank data to assess plant-based dietary patterns, Mediterranean diet adherence, inflammatory dietary indices, and other diet quality measures in relation to future psoriasis development.

Study Details

• Investigators analysed 121,299 UK Biobank participants without psoriasis at baseline who completed at least two Oxford WebQ 24-hour dietary recalls. Median follow-up was 11.4 years; 822 incident psoriasis cases were identified through self-report, hospital, and primary care records.

• Ten dietary quality indices were evaluated using multivariable Cox proportional hazards regression models adjusted for demographic, lifestyle, clinical, environmental, and body mass index (BMI) covariates, including the Plant-Based Diet Index (PDI), Mediterranean Diet Score, Dietary Approaches to Stop Hypertension (DASH), Healthy Diet Index, and Dietary Inflammatory Index.

• Strengths included the large prospective design, repeated dietary assessments, and integration of polygenic risk scores. Limitations included reliance on self-reported dietary intake, limited ethnic diversity, potential residual confounding, observational design preventing causal inference, and lack of psoriasis-specific immunologic biomarkers.

Key Findings

• Participants with the highest adherence to a plant-based dietary pattern (PDI scores 56 to 77) had a 19% lower risk of incident psoriasis compared with those with the lowest adherence (hazard ratio [HR], 0.806; 95% CI, 0.651 to 0.997), although no statistically significant interaction (P for trend = 0.028) between diet and genetic susceptibility was identified.

• Greater intake of less healthy plant-based foods, including refined grains (HR, 1.097; 95% CI, 1.032 to 1.165) and sweets/desserts (HR, 1.086; 95% CI, 1.030 to 1.144), was associated with increased psoriasis risk, while healthier plant-based dietary patterns appeared protective across multiple sensitivity analyses.

• Mediation analyses suggested that reductions in adiposity and serum urate partially explained the relationship between plant-based diets and psoriasis risk, with BMI mediating approximately 14% of the observed protective association.

https://www.medcentral.com/dermatology/psoriasis/plant-based-diets-may-lower-psoriasis-risk-and-severity

5 Psoriatic Arthritis Myths and Facts

From everydayhealth.com

Psoriatic arthritis (PsA) is often misunderstood, and those misconceptions can make it harder for people to recognize symptoms, seek care, or understand what living with the condition is really like. It can also be challenging to explain the effects of the condition to friends, family, and co-workers.

“Psoriatic arthritis can also be difficult to diagnose, which can add to the confusion,” says Christopher Richard Morris, MD, a board-certified rheumatologist in Kingsport, Tennessee.

From its demographics to its progression, misconceptions about this autoimmune disease can be surprisingly persistent. Here are five common myths — and the facts to help set the record straight.

                                                                                                                         Everyday Health

1. Myth: Everyone With Psoriatic Arthritis Has Psoriasis

Not everyone with one condition will automatically have the other. While there is a strong link between psoriasis and psoriatic arthritis, up to 17 percent of people with a PsA diagnosis don’t have any visible skin symptoms at the time of their joint diagnosis.

“Though most adult patients develop psoriasis concurrently or before the symptoms of arthritis, there is a small subset of patients where arthritis develops before the skin manifestations,” says Nayaab Bakshi, DO, a fellow at Stony Brook Medicine’s division of rheumatology in Stony Brook, New York.

That said, Dr. Morris points out that there are PsA patients who may not be aware they also have psoriasis, which manifests in different ways. There can be patches of thick, scaly skin that can appear on the scalp, elbows, knees, or lower back; yellow-brown spots on the nails; or pustules can develop on the hands or feet.

“Psoriasis is not recognized easily, and you may not know what to be looking for,” Morris says. If you do notice a skin eruption, he adds, make an appointment with a dermatologist for a thorough examination.

2. Myth: PsA Is Caused by ‘Wear and Tear,’ Like Osteoarthritis

While both conditions are defined by joint pain, they are driven by different biological processes. Osteoarthritis is a degenerative disease in which the cartilage in the joints breaks down over time due to age, injury, or repetitive use.

PsA is inflammatory, which means joint damage is caused by an overactive immune response.

“Inflammation in psoriatic arthritis triggers a cascade of immune responses that cause joint pain, swelling, and destruction through multiple mechanisms: synovial tissue invasion, cartilage breakdown, and bone erosion,” says Dr. Bakshi. The synovium is the lining in the joints that can become inflamed, causing pain, swelling, and stiffness.

In psoriatic arthritis, your immune system also mistakenly tells your body to strip away bone in some spots while simultaneously building extra bone in others. This uneven process can reshape the joint, whereas osteoarthritis involves the gradual breakdown of protective cartilage.

3. Myth: If Your Skin Is Clear, Your Joints Are Fine

While there is some correlation between the severity of skin symptoms and the severity of the joint pain, the two don’t always move in tandem. The skin and the joints are independent targets of the same overactive immune system.

“We have an immune system that can be directed in many different ways,” says Aly Cohen, MD, a rheumatologist and an integrative health specialist in Princeton, New Jersey, and the medical director of the online education platform the Smart Human. “Because of that variability, you can’t always predict what’s going to become inflamed.”

One study found that some immune cells can migrate from the skin into the joints, where they may continue to trigger inflammation. This could help explain why your joints are affected while your skin looks perfectly healthy.

But it is true that if your skin isn’t clear, your joints may also be affected. Bakshi says the severity of skin symptoms can mirror the severity of joint pain. On the other hand, patients can also have severe psoriasis with mild joint disease, or minimal skin issues with significant joint pain and damage.

4. Myth: Psoriatic Arthritis Primarily Affects Elderly People

Since PsA isn’t an aging-joint issue like osteoarthritis, it doesn’t take decades of living for it to emerge. PsA is triggered by a malfunctioning immune system, and that can activate at any age, including in childhood. Studies suggest that the disease is most common in people 40 to 59 years old.

“There is no great way to understand the demographics,” says Dr. Cohen. “It used to be considered male dominant, but I’ve seen it equalize over the years.” It was also long considered a Caucasian disease, but research now suggests Hispanic and non-white PsA patients may experience more pain and limitations in their daily activities.

More than 1.5 million people in the United States have PsA, and about one-third of people who have the skin condition will develop it. Most people develop psoriasis about 10 to 20 years before being diagnosed with PsA.

5. Myth: The Symptoms Are Limited to Joint Pain and Skin Rash

PsA is often thought of as a condition that is limited to two specific areas, but that view is incomplete. “Psoriatic arthritis (PsA) is a multisystem inflammatory disease that extends beyond joint and skin involvement,” says Bakshi.

In addition to achy joints and skin rashes, other symptoms of PsA include:

• Fatigue or a lack of energy
• Tenderness in the areas where tendons or ligaments attach to bones, such as the back of the heel or sole of the foot
• Painful, sausage-like swelling of a whole finger or toe
• Nail changes, such as pitting (tiny dents), crumbling, or separation from the nail bed.
• Eye inflammation, especially uveitis, which can cause eye pain, redness, and blurry vision, and must be treated promptly to avoid vision loss.
• Inflammatory bowel disease
• An increased risk of heart disease

The Takeaway

• Misconceptions about psoriatic arthritis (PsA) are common, largely because it can be difficult to recognize and diagnose; it can have both a joint and a skin component, and doesn’t always present in obvious or predictable ways.
• PsA is an inflammatory disease, not the result of cartilage deterioration. It’s caused by an overactive immune system that damages joints in complex ways, and skin symptoms don’t always reliably reflect what’s happening in the joints.
• PsA can affect the whole body, can develop at almost any age, and can impact more than joints and skin. It can also affect your eye, digestive, and cardiovascular health.
• Understanding the condition and the effects it may have can help you manage it better.

 https://www.everydayhealth.com/psoriatic-arthritis/myths-and-facts/

4 Best Foods for Psoriasis, According to Nutrition Experts

From eatingwell.com

Learn what foods to include in a psoriasis-friendly diet 

KEY POINTS 

• A Mediterranean-style diet may help reduce psoriasis-related inflammation and improve symptoms.
• Foods rich in fibre, antioxidants and omega-3s, like fruits, whole grains and fatty fish, are beneficial.
• Limiting processed foods, alcohol and stress can help manage psoriasis flare-ups and inflammation.

Psoriasis is a chronic autoimmune condition that affects around 3% of adults in the United States. It causes red, scaly and inflamed patches on the elbows, knees, scalp and other parts of the skin. These develop because the immune system overreacts to common triggers and produces too many skin cells.

It’s unclear exactly what causes the overactive immune response in psoriasis, but researchers know a combination of genetics and environmental factors are involved. Often, people have a family history of the disease, but factors like infections, medication reactions and stress also play a role. While your eating choices can’t cure psoriasis and there’s no specific diet to follow when you have the condition, some foods like fruits, vegetables, olive oil, nuts, fish, whole grains and beans may help with managing inflammation, research shows. In turn, psoriasis symptoms may be less severe.

Curious which specific foods can help with psoriasis and how? Here’s what nutrition experts recommend.

Fruits & Vegetables

Fruits and vegetables are rich in nutrients including polyphenols, carotenoids and vitamin C that act as antioxidants and may help reduce psoriasis-related inflammation.

“They’re also an excellent source of fibre, which is associated with lower inflammation levels,” says Jennie Miremadi, M.S., CNS, LDN. She recommends pairing berries—which provide antioxidants and fibre—with walnuts for an easy snack.

Some other great antioxidant and fibre-rich fruits and vegetables include dark leafy greens, purple sweet potatoes, carrots and tropical fruits like passion fruit and kumquats, says Amy Davis, RD, LDN.

Olive Oil

Across a number of studies, researchers have found that following a Mediterranean-style diet—which includes olive oil and other foods like fruits, vegetables, whole grains, fish and beans—can be helpful for people with psoriasis.

Containing healthy monounsaturated fats and polyphenols, “diet patterns rich in olive oil, like the Mediterranean diet, are associated with lower inflammation overall and may help improve psoriasis symptoms by targeting underlying inflammatory pathways,” says Ilana Schachter, RDN.

Curious how to incorporate more olive oil into your diet? Davis recommends using olive oil as your primary cooking oil and as the base for your salad dressings. She also suggests making a kale salad with purple sweet potatoes, hazelnuts and an olive oil vinaigrette.

In the warmer months, “a watermelon salad with feta, olive oil and fresh herbs can be a refreshing, anti-inflammatory side,” Schachter says. 

Whole Grains

Whole grains are a good source of dietary fibre, which has been associated with lower levels of inflammation in the body. Whole grains like oats and barley contain fermentable fibres that gut bacteria break down in the colon to produce short-chain fatty acids. These compounds help reduce inflammation and modulate immune responses, Schachter explains.

While no single food is a standalone treatment for psoriasis, replacing refined grains with whole grains is a dietary pattern that’s consistently associated with lower markers of systemic inflammation.

“Swap white refined grains with whole grains like rolled oats, quinoa, brown rice and whole-grain bread,” Davis says. Other ideas include overnight oats, a bulgur pilaf side dish or quinoa stuffed peppers. For an anti-inflammatory meal that includes whole grains and many other psoriasis-friendly foods, Miremadi recommends combining leafy greens, roasted salmon, farro or quinoa, and then tossing it with lots of extra virgin olive oil and fresh lemon juice.

Fatty Fish

                                                          Credit: 

Photographer: Robby Lozano. EatingWell design

Fatty fish like salmon, sardines and mackerel are rich in the omega-3 fatty acids DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), which research suggests can help reduce systemic inflammation. The body can’t produce omega-3s naturally, so it’s important to get them from the food you eat.

“In a disease like psoriasis, which is characterized by chronic inflammation and immune activation, fatty fish may be supportive for managing inflammation and symptoms,” Miremadi says.

Looking for ways to eat more fatty fish? Consider sardines on whole-grain crackers, a high-protein canned salmon salad or even grilled mackerel. Additionally, “options like salmon burgers or Moroccan-style fish provide omega-3s while still feeling satisfying and flavourful,” Schachter says.

Other Tips for Managing Psoriasis

• Minimize your intake of processed foods. Consuming ultra-processed foods, like packaged sweet or savoury snacks, processed meats and soft drinks, is linked with a higher risk for psoriasis. A diet high in ultra-processed foods has also been linked with increased inflammation and may worsen or trigger psoriasis flare-ups.
• Limit your alcohol intake. Alcohol is known to trigger or worsen psoriasis flare-ups.
• Steer clear of smoking. Smoking has been linked with more severe psoriasis and can also increase the risk of developing psoriasis.
• Find ways to minimize stress. Stress can trigger psoriasis flare-ups. Habits like journaling, meditation and gentle movement can all help with managing stress.

  National Psoriasis Foundation. A Few Self-Care Tips to Manage Psoriasis Itch and Scaling

• Our Expert Take

  There’s no standard diet that people with psoriasis need to follow. And no single food can treat or cure the condition. But research suggests that eating specific foods like fruits, vegetables, olive oil, whole grains and fatty fish can help reduce inflammation. This may help support a balanced immune response, which can be beneficial for individuals with psoriasis. Keep in mind that dietary changes work best as a complement to medical treatment, not a replacement for it. And of course, it’s always a good idea to speak with a physician or registered dietitian before making any major changes to your diet. 

• https://www.eatingwell.com/best-foods-for-psoriasis-according-to-experts-11954200
  

'Life-changing' psoriasis pill gets FDA approval

From imb.uq.edu.au

An important new psoriasis medicine developed under a collaboration between Johnson & Johnson and University of Queensland (UQ) spin-out Protagonist Therapeutics has received approval for use by the United States Food and Drug Administration (FDA). The new drug, icotrokinra, will be marketed as ICOTYDE. 

Protagonist was launched from UQ’s Institute for Molecular Bioscience (IMB) in 2001 to pioneer the development of new oral peptide drugs for hard-to-treat conditions. ICOTYDE was jointly discovered by Protagonist and JNJ scientists. The Protagonist team included members of Protagonist’s embedded research team at IMB.   

Image: Protagonist Therapeutics founder Professor Mark Smythe.

“I believe this is a life-changing drug for people with this debilitating condition,” said Greg Bourne, the head of Protagonist’s IMB research team. “The science we undertake in Australia, and here at IMB, can transform lives around the world.”

Protagonist founder Professor Mark Smythe added, “These diseases affect millions of people around the world, and currently, most advanced treatments are through injection. But we also know 75 percent of people don’t like needles, especially children, so this oral drug brings targeted treatment and safety expectations with the gentleness and convenience of a once-daily pill.”

Professor Smythe held several executive positions at Protagonist until 2022, when he stepped down to become Chief Executive Officer of Infensa Bioscience Pty Ltd. 

Medical milestone 

Psoriasis is a chronic autoimmune condition causing inflamed skin patches that affects an estimated 60 - 125 million people worldwide.  Millions of people suffer from moderate to severe forms that can have deep physical, social and psychological impacts.

IMB Executive Director Professor Ian Henderson said what it means for those patients is what makes the FDA approval so exciting.

“ICOTYDE offers a convenient, once-daily treatment for those living with psoriasis, and it paves the way for further research into oral therapeutics for other immune-mediated conditions,” Professor Henderson said.

“It highlights the power of collaborative research, reinforces IMB’s reputation as a powerhouse of scientific innovation and positions Australia as a global leader in next-generation therapeutics. Our researchers are accelerating innovation through industry partnerships to tackle diseases with high unmet needs, reaching global markets to improve the lives of millions worldwide.”

ICOTYDE is under additional assessment for the treatment of psoriatic arthritis and inflammatory bowel diseases.

IMB Translation Director, Professor Mark Blaskovich, said “Australia has played an important role in many important medical advancements, including cervical cancer vaccine Gardasil and the discovery that bacteria Helicobacter pylori causes ulcers. We’re very proud of the contribution the IMB made to ICOTYDE as well.”

Protagonist, headquartered in the US with additional research operations at IMB, is one of 20 companies launched by IMB, and one of more than 136 companies originating from UQ intellectual property.

Protagonist, in partnership with Takeda Pharmaceutical Company, is also seeking approval from the U.S. Food and Drug Administration for another drug, rusfertide, another drug developed from Protagonist’s peptide platform to treat polycythemia vera, a form of blood cancer.

https://imb.uq.edu.au/article/2026/04/life-changing-psoriasis-pill-gets-fda-approval