What is psoriasis and what you can do about it

By Cathy Stephenson

"My daughter is in her 20s and has just been diagnosed with psoriasis. Can you give me some information about this?" - Anne
Psoriasis is a chronic, autoimmune condition, typified by dry, scaly, red patches of skin. It is less common than eczema, but still affects around 2-3 per cent of New Zealanders. It causes significant physical and psychological distress, and in severe cases can be quite debilitating.
Psoriasis can occur at any age, but is typically diagnosed either in the teen years, or later on in middle age. It affects males and females equally, and there is a genetic link, with a third of patients also having an affected relative.
Psoriasis is an autoimmune condition, which means that for some reason the body's immune system attacks and destroys healthy body tissue, in this case primarily the skin cells. It can be associated with other autoimmune conditions such as diabetes, and up to 25 per cent of patients with psoriasis will also suffer from a related form of arthritis.
Although you can't avoid "getting" psoriasis, there are known factors that will aggravate the condition and make your symptoms worse. These include:
* Smoking
* High alcohol intake
* A diet high in sugar
* Certain medications, including beta blockers and lithium
* Stress.
In fact the link with emotional stress is so strong that on some occasions people will have no symptoms at all until a stressful event triggers a flare-up, and once their stress is under control their psoriasis may all but disappear.
There are several different types of psoriasis, and the symptoms can vary depending on which type you have. However, in classical cases of psoriasis the following may occur:
* Distinct raised patches of overgrown, red, dry, scaly skin; these can get quite flaky and cause severe itching. They can occur anywhere, but typically are found on the elbows, knees, scalp and in the "flexures" such as underneath the breasts, in the armpits and groin
*  The amount of skin affected varies hugely – in mild cases, there may just be one or two small plaques, but in severe cases most of the body can be involved
*  In nail psoriasis, finger and toenails can become pitted and fragile
*  For people who develop arthritis with their psoriasis, the symptoms include pain, swelling and stiffness in joints and surrounding tissues
*  Many people with psoriasis, especially those with severe forms, will have low self-esteem, and anxiety around their body image – in more extreme cases, this can lead to depression.
In terms of treatment options, it will depend a little on what type of psoriasis your daughter has, and how severe it is. Milder forms respond to topical treatments including:
*  Emollients – regular use of a thick emollient or moisturiser, such as fatty cream or cetomacrogol, can be a really good way to prevent cracking and irritation of the skin. Substances like urea or salicyclic acid are known as "keratolytics" – they break down the scaly plaques and can be added to these moisturisers to make them more effective.
*  Tar products – using either coal or pine tar products, especially in the bath or shower can be an effective way to reduce the itching and discomfort.
* Corticosteroid ointments – steroids can be very useful in managing the symptoms of psoriasis, but need to be used sparingly as they can cause long-term damage to the skin; milder steroids such as hydrocortisone can be used on the face, but stronger versions (such as betnovate or dermol) are only suitable for use elsewhere on the body, and in short courses to reduce the potential harm.
*  Vitamin D analogues – calcipotriol or Daivonex works by reducing the thickness of the scale, although the redness tends to remain; they need to be used sparingly as they can be toxic if the weekly total dose is exceeded.
*  For scalp psoriasis, shampoos such as ketoconazole or steroid -based products such as betnosol can be good for symptom relief.
If your daughter's psoriasis is severe or not responsive to any of these topical treatments, she may require either phototherapy (where UV light is used to reduce the psoriatic plaques) or an oral medication.
These would usually be prescribed by a dermatologist, so ask your GP for a referral to a specialist if needed. Be mindful too that your daughter may be struggling with her condition, so don't hesitate to offer extra support or ask your GP about any local groups that might be helpful.

http://www.stuff.co.nz/life-style/well-good/teach-me/82529253/what-is-psoriasis-and-what-you-can-do-about-it

Psoriasis drug may help treat Alzheimer’s disease: Study

By Mohan Garikiparithi

Psoriasis drug may help treat Alzheimer’s disease, according to research findings. The number of people living with dementia is expected to grow exponentially by the year 2050, so there is a pressing need for treatment options for dementia and Alzheimer’s disease. Dementia is one of the most common health problems among the elderly. Researchers at the Department of Psychiatry and Psychotherapy of the University Medical Center of Johannes Gutenberg University Mainz (JGU) have found that Alzheimer’s disease may possibly be treated with a common psoriasis drug, as it activates the enzyme ADAM10 in Alzheimer’s disease patients. The enzyme is capable of suppressing Alzheimer’s disease-related effects, namely, impaired cerebral function.
Although the exact Alzheimer’s trigger is unknown, it is established that activity of certain enzymes does play a role in the onset and development of the disease. The researchers targeted ADAM10 by administering an oral drug commonly used for psoriasis to Alzheimer’s patients. The drug led to elevated levels of the nerve cell-protecting growth factor APPs-alpha in their spinal fluid. This stimulates the activity of ADAM10, which reduces the buildup of amyloid plaques commonly seen in Alzheimer’s disease. ADAM10 has been shown to improve memory and enhance learning capability.
The medication was well tolerated among the patients. A larger clinical study is needed to establish the drug’s impact on Alzheimer’s disease patients and to determine its long-term effect.

Treatment options for Alzheimer’s disease

Treatment options for Alzheimer’s disease involve lifestyle and medical interventions. There are medications available for Alzheimer’s disease, and although they do not cure the disease they could slow down its progression and lessen disease severity. Some other treatment options for Alzheimer’s disease include:
Taking medications as recommended by the doctor

Reducing stress and anxiety

Keeping up with a regular daily routine to minimize memory problems

Using calendars, diaries, memos, and reminders

Keeping the mind active with puzzles or learning something new

Taking time to relax

Getting proper sleep

Staying social and keeping a strong social network

Visiting a memory support group

It’s also encouraged that Alzheimer’s patients maintain a healthy lifestyle as best as possible. Although there isn’t much evidence that eating well and exercising may drastically improve Alzheimer’s disease, these habits could help maintain good health, thus minimizing the risk of additional complications that could worsen Alzheimer’s disease.

http://www.belmarrahealth.com/psoriasis-drug-may-help-treat-alzheimers-disease-study/

New spray for psoriasis sufferers launched in the UK

From Belfast Telegraph

A new prescription-only foam spray treatment for psoriasis sufferers has been launched in the UK.
Trials show that the foam, called Enstilar, is more effective than traditional creams and ointments.
More than half of trial patients with the skin condition are said to have experienced significant improvement after applying the foam for four weeks.
Dr Keith Freeman, a consultant dermatologist from Sunderland, said: "The launch of Enstilar foam spray in the UK is a significant advance which provides an easy-to-apply topical combination treatment for plaque psoriasis."
A total of 81% of psoriasis patients using Enstilar reported quality of life improvement after four weeks, according to the trial data.

http://www.belfasttelegraph.co.uk/news/health/new-spray-for-psoriasis-sufferers-launched-in-the-uk-34891243.html

Gluten-free diet may improve psoriasis

By: Mohan Garikiparithi

A gluten-free diet is known to aid in celiac disease, but it may also be able to improve your psoriasis as well. Many psoriasis patients have opted to go gluten-free and have found relief for their psoriasis even though there is little scientific evidence to support this practice. But as more and more psoriasis patients go gluten-free, science is taking a closer look at this trend.
In preliminary studies, researchers examined if psoriasis patients were more likely to have gliadin antibodies. Gliadin is a wheat protein that people who are sensitive to gluten can’t ingest. Some studies revealed psoriasis patients do carry such antibodies, while others did not.
The most notable study on gluten and psoriasis was conducted based on the Nurses’ Health Study, involving questionnaires completed by over 82,000 nurses. The study found that women who drank beers five times a week were more likely to develop psoriasis compared to those who didn’t. You may not think beer has anything to do with gluten, but it contains barley, which triggers gluten sensitivities.
Dr. Jerry Bagel from the National Psoriasis Foundation believes that at least 25 percent of psoriasis patients would benefit from a gluten-free diet, but the Foundation as a whole is still indecisive about recommending a gluten-free diet to psoriasis patients.
Dr. Bagel also pointed out that patients with psoriasis affecting over 30 percent of the body seem to experience greater benefits going gluten-free than those with mild psoriasis.

Pros and cons of going gluten-free with psoriasis

As you can see, research into the association between gluten-free diet and psoriasis renders mixed results. Here are some pros and cons of going gluten-free with psoriasis.

• Going gluten-free has potential to relieve symptoms: You won’t know if you’ll benefit from going gluten-free unless you try (and there isn’t much a harm in trying). As mentioned earlier, many patients have noticed a reduction in their symptoms while following a gluten-free diet so it may be worth the try.
• You’ll eat healthier: Food items with gluten often tend to be unhealthier options, so you will find you’re eating healthier once you start eliminating gluten.
• You’ll likely notice an energy boost: Patients note that eliminating gluten has increased their energy levels because they no longer are plagued by digestive issues.
• Gluten-free diet is difficult to follow: Beginning a gluten-free diet can be difficult as you will always have to read labels carefully. Eating out may pose a challenge as well.
• You can’t cheat: Don’t think that slipping in a meal with gluten is okay – it’s not. The moment you consume gluten you will begin feeling horrible once again (if you are sensitive to gluten).
• Gluten-free foods may contain empty calories and more sugar: Just because it is labeled gluten-free doesn’t necessarily make it healthier. Once again, carefully read food labels to ensure you’re not consuming unnecessary sugar or empty calories.
• Shopping time will increase: Now that you’re focusing on gluten-free items, you’ll find you’re spending more time in grocery stores – you may have to do some homework to cut down on your time!
• You can’t drink beer: Although gluten-free beers are becoming more popular now, as a general rule, you should steer clear of this beverage.

Whether you have celiac disease or psoriasis, going gluten-free can be beneficial albeit difficult. It may seem hard at first, but over time it does get easier. And the fact that you’ll be feeling better is enough motivation to keep you going.

http://www.belmarrahealth.com/gluten-free-diet-may-improve-psoriasis/

Persistent itch may signal a more serious problem

By Donna Alden-Bugden

Do you have an itch that simply can’t be scratched?
If so, you are not alone. Every year millions of Canadians find themselves dealing with skin problems that drive them to distraction.

In most cases, the itch can be attributed to something relatively minor, such as dry skin or a mild case of eczema or dermatitis. Usually, this condition can be dealt with by over- the-counter medications.
But there are occasions when the itchiness may signal a more serious health issue. This is particularly true in cases of psoriasis.
Psoriasis comes from the Greek words "psora" meaning itch and "iasis" meaning a condition.
The Canadian Dermatology Association estimates about one million Canadians are affected by one of five types of psoriasis. They are:
Plaque psoriasis: Also known as psoriasis vulgaris, this is the most common type of psoriasis, representing about 90 per cent of all cases. It usually presents with raised red patches and silver scales on top. These patches are frequently found on the front of the knees or shins, the back of the elbows or forearm, and the scalp.
Guttate psoriasis: Usually marked by patches that present in teardrop-like lesions over large areas of the body, this type of psoriasis can often be found on the trunk of the body. It is triggered by streptococcal infections such as strep throat.
Inverse psoriasis: Sometimes misdiagnosed as a fungal infection, this type of psoriasis presents as flat, smooth, inflamed patches of skin that are found in skin folds such as the groin, in the buttock crease, armpits and under the breasts.
Pustular psoriasis: This condition usually presents as red raised vesicles filled with pus. They are often painful and can be found on the hands or feet, or more generalized over the large parts of the body.
Erythrodermic psoriasis: This type of psoriasis is marked by an extensive inflammation and exfoliation of most of the body. It can be fatal.
The cause of psoriasis remains unknown, but experts say the condition can be attributed to a misfiring of the body’s immune system that causes skin cells in a particular area to multiply out of control, resulting in patches of red, scaly and itchy skin. Environmental elements, such as infections or trauma, can trigger a flare-up of psoriasis, and symptoms tend to be worse with physical and psychological stress, in the winter, and while on certain medications.
People with psoriasis can experience significant discomfort and a serious loss in quality of life. In addition, the condition has been linked to increased risk of other chronic conditions, including psoriatic arthritis, diabetes, cardiovascular disease, hypertension, atrial fibrillation, cholesterol problems, Crohn’s disease, certain cancers, including skin cancer, and depression.
As a result, people who suspect they may have psoriasis are well advised to discuss the issue with their health-care provider.
The good news is most cases of psoriasis (67 per cent) are considered mild and only eight percent are considered severe. There are effective treatments that can help minimize the discomfort associated with this condition.
Cases of mild to moderate psoriasis are usually treated with high-potency topical steroid creams, vitamin D creams such as paricalcitol, and phototherapy.
Cases of severe psoriasis, meanwhile, are generally treated with systemic medications such as methotrexate and biologic drugs such as infliximab, adalimumab and etanercept. Biologic drugs are manufactured proteins that modify the immune response in psoriasis. Other medications such as ciclosporin and vitamin A derivatives (retinoids) are also used.
Individuals can also take steps to reduce flare-ups. They include:
• Avoiding skin injuries and infections. • Taking steps to reduce stress.
• Exercising daily and maintaining a healthy weight.
• Avoiding drinking too much alcohol. • Taking care of your skin. Your health-care provider can suggest soaps, lotions and cosmetics that will help you manage your condition.
Psoriasis is a serious condition that can cause significant discomfort. In most cases, this condition can be managed with proper care.

http://www.winnipegfreepress.com/local/persistent-itch-may-signal-a-more-serious-problem-386908391.html

What is psoriasis?

By Selene Daly

This skin condition can appear at any age and can sporadically come and go.
Psoriasis is a skin condition that affects about 2 per cent of the world’s population.

Psoriasis occurs equally in men and women, may appear at any age and can sporadically come and go. The normal rate of turnover for the skin is three to four weeks.

In people with psoriasis this process happens in just three to four days, meaning skin is regenerating at a much quicker rate than normal. Skin affected by psoriasis is scaly, red and raised off the surface of normal skin. It is not contagious and it does not cause scarring of the skin.

The inflammatory nature of the condition means that psoriasis is also linked to an increased risk of developing heart disease and diabetes.

Research also shows that the disease is linked to an increased risk of depression and arthritis.

Unfortunately, there is no cure for psoriasis but there are effective medical interventions for the disease that can vary from mild to moderate or severe.

Mild psoriasis can be managed with topical treatments such as soap substitutes and moisturisers, these include products like Silcocks Base and Elave total emollient therapy.

Vitamin D analogues (calcipotriol) have a similar impact to moderate strength topical steroids, but without the side effects. Dovonex is a simple, once-a-day calcipotriol ointment that is now available direct from pharmacies. Other topical treatments frequently prescribed for mild psoriasis include tar and dithranol.

Moderate to severe psoriasis can be treated with phototherapy light in combination with topical treatments. More severe psoriasis often requires oral medications or injectable drugs known as biologics.

Read more about psoriasis at irishskinfoundation.ie and bad.org.uk and consult your doctor if you think you need treatment or advice.

 

http://www.irishtimes.com/life-and-style/health-family/what-is-psoriasis-1.2704131

 

 

Family history biggest predictor of heart attacks in people with psoriasis

By Lisa Rapaport

(Reuters Health) - People with psoriasis, a chronic inflammatory disease, are more likely to have heart attacks and strokes when they have a family history of cardiovascular problems, a Danish study suggests.

Psoriasis wasn't associated with higher risk of heart attacks or strokes when people with the skin condition didn't have a family history of cardiovascular disease, the study found.

But when people with mild psoriasis and a family history of major adverse cardiac events like heart attacks and strokes were compared to psoriasis sufferers without such a family history, their risk was 28 percent higher. With severe psoriasis and a family history of heart problems, the risk was 62 percent higher.

"It is generally believed that patients with psoriasis are at increased risk of cardiovascular disease due to the inflammatory nature of psoriasis," said lead study author Dr. Alexander Egeberg of the University of Copenhagen.

"While psoriasis itself may still confer an independent cardiovascular risk compared with the general population, our findings suggest that there may exist a genetic predisposition for cardiovascular disease," Egeberg added by email.

To assess the link between psoriasis and a family history of heart disease, Egeberg and colleagues reviewed Danish data from 1997 to 2011 on more than 2.7 million people, including almost 27,000 individuals with mild psoriasis and about 4,500 with severe psoriasis.

At the start of the study, people were around 27 years old on average.

Approximately two-thirds of those with psoriasis in the study had a family history of cardiovascular disease, which was slightly more common with severe psoriasis than with mild psoriasis.

Without a family history of heart disease, the rate of major adverse cardiac events was 1.3 per 10,000 people per year among those who didn't have psoriasis. That compared with 1.85 cases per 10,000 people per year with mild psoriasis and about 6 per 10,000 with severe psoriasis.

But after researchers adjusted for other factors that might influence the odds of heart attacks and strokes, they no longer found a difference between people with psoriasis and the general population when there was no family history of cardiovascular disease.

There was, however, a significant difference in the risk of heart attacks and strokes when people did have a family history of cardiovascular disease, the researchers report in the Journal of the American Academy of Dermatology.

One limitation of the study is that researchers excluded more than 2.6 million people who had incomplete data on family history in Danish health registry records, which made the study population skew younger, the authors note. This makes it unclear if the findings would apply to people diagnosed with psoriasis later in life, the authors said.

Even so, the findings suggest that doctors should be asking psoriasis patients about their family histories, said Dr. Nehal Mehta, chief of the inflammation and cardiometabolic diseases section at the National Heart Lung and Blood Institute in Bethesda, Maryland.

"The major take-home message from these findings should be for providers to inquire about a family history of major adverse cardiovascular events since it is also a cardinal risk factor for future major adverse cardiovascular events in non-psoriasis patients," Mehta, who wasn't involved in the study, said by email.

http://www.reuters.com/article/us-health-psoriasis-heart-risks-idUSKCN0ZG230