How Bad Is Your Psoriasis?

From everydayhealth.com

Finding the right psoriasis treatment for you depends on how bad your symptoms are. To determine if psoriasis is mild, moderate, or severe, a dermatologist relies on several criteria, from what it looks and feels like to how it affects your life.
For people like Phyllis Spool, tracking psoriasis symptoms can be a real challenge. A retired preschool teacher in Worcester, Massachusetts, Spool remembers how psoriasis made her ankles bleed when she was in kindergarten. Now she feels like she wakes up to “a new patch in a different spot every morning.”
At each visit, Spool’s doctor will take pictures of her psoriasis patches. At the following visit, they compare pictures to determine how the condition has changed, and evaluate her treatment going forward.

Body Surface Area

One of the key factors in diagnosing and treating psoriasis is assessing how much of a patient’s body surface area (BSA) is affected by the condition. The area covered by the palm of your hand and fingers, for instance, equals 1 percent of your BSA.

Based on BSA alone, psoriasis severity level is characterized as:

• Mild, if the affected BSA is less than 3 percent
• Moderate, if it’s between 3 and 10 percent
• Severe, if it’s greater than 10 percent

The Psoriasis Area and Severity Index (PASI) is a scoring system used to calculate severity based on the amount of body surface area affected as well as the combined redness, thickness, and scaling of the psoriasis lesions.
Another method of scoring used by dermatologists is the Investigator’s Global Assessment (IGA) or the Physician Global Assessment (PGA). This is a 5-point scale on which clear skin is scored as a 0 and severe patches are rated a 5.
“I go over the BSA and IGA every time I see a patient,” says Jerry Bagel, MD, director of the Psoriasis Treatment Centre at Windsor Dermatology in East Windsor, New Jersey.
The location of the psoriasis is a factor, too. Your dermatologist may characterize the condition as more severe, regardless of your BSA, if you have:

• Patches in visible or sensitive places, like your face, genitals, hands, or nails
• Patches that make it hard for you to walk or use your hands

How Psoriasis Affects Your Life

Dr. Bagel sometimes asks patients to answer a questionnaire known as the Dermatology Life Quality Index (DLQI) to measure how much psoriasis affects their lives. The DLQI assesses a skin condition’s impact on a person’s work, relationships, ability to do things, and mood.
Spool discusses her condition’s emotional and physical toll with her doctor. She describes being embarrassed in her own house whenever skin flakes fall onto the floor, or being troubled at night if she can’t bend her arms “because the skin feels too tight.”
Bagel says that your doctor doesn’t know how much psoriasis impacts your life at any given time unless you share your thoughts and feelings. “You may have felt like it was routine to treat a patch on your face before,” he explains. “But if it’s time for your prom or wedding, you may feel a new urgency.”

How Sick Is Psoriasis Making You?

Having psoriasis puts you at risk for other medical conditions, too, from psoriatic arthritis to cardiovascular disease. In evaluating your condition and treatment plan, your doctor looks at complications or comorbidities you already have, as well as others that are considered a risk.
“I tell all my patients to see their primary doctor to get a physical each year,” Bagel says.
Jashin Wu, MD, director of dermatology research at Kaiser Permanente Los Angeles Medical Centre in California, stresses the importance of factoring in emotional and mental health issues, such as depression, when evaluating the effects of psoriasis. Dr. Wu refers patients to the National Psoriasis Foundation to learn about support groups.
As Bagel puts it, “comorbidities change the algorithm of treatment plans.”
All of these factors, from the direct effects that psoriasis has on your skin to other emotional and physical complications, contribute to the management strategy that you and your doctor work out.

http://www.everydayhealth.com/psoriasis/living-with/how-bad-your-psoriasis/

Eczema and psoriasis? THIS part of your morning routine could be triggering skin problems

From express.co.uk

ECZEMA and psoriasis are two of the skin conditions which affect 60 per cent of British people.
However, having a shower could be making them worse - if you live in a hard water area, that is.
This type of water is supplied to 60 per cent of UK homes, including the south east and east midlands.
However it’s been suggested that it aggravates skin conditions like eczema and psoriasis.

                                          Hard water: It can aggravate certain skin conditions

There are currently 1.7 million people in the UK with eczema, and cases have risen by 40 per cent in recent years.

It’s a condition that causes the skin to become itchy, red, dry and cracked, according to the NHS.
Dr Sharon Wong, consultant dermatologist (www.drsharonwong.com), said: “Hard water does not directly cause eczema but is a common aggravating factor in those who are genetically predisposed to developing eczema.
“Hard water, which has a greater mineral content - mainly calcium and magnesium ions - has been linked to an increased risk of eczema and more severe disease in children.”
“When the skin's barrier function is compromised, such as in eczema, the minerals can enter the skin as allergens causing inflammation and worsening eczema.”
Similarly, psoriasis - which affects two to three per cent of the UK population - causes red, flaky, crusty patches of skin covered with silvery scales.
“Whilst there is no evidence that hard water causes psoriasis, the fact that the minerals in hard water have a drying effect on the skin can worsen psoriasis and other dry skin problems,” she explained.
Whether the water that comes out of your tap is soft or hard depends on the geology of your area, but there are ways to minimise or stop its negative effects on your skin.
Dr Wong added: “This can be minimised by installing a water softener, using bath oils not bubble bath and using emollient/cream washes instead of soap.
“Both bubble bath and soaps contain surfactant which strips away the natural oils of your skin. Finally, using a regular and good moisturiser helps because it forms a protective layer on the skin thus preventing further fluid loss.”
Sukhbinder Noorpuri, GP and CEO of i-GP, said: “Hard water contains dissolved minerals such as calcium and magnesium. When used with soaps and detergents, this leaves a skin residue which blocks pores trapping oil, leading to irritation, dryness, blemishes and itching.
“A water softener will reduce these skin issues, and convert the minerals found in hard water, into more soluble minerals that are less harmful for the skin.”
Ecocamel have created the Shower Head ORB SPA which can convert hard water into soft water.

http://www.express.co.uk/life-style/health/814611/eczema-psoriasis-skin-problems-symptoms-cure

How To Fight Fungus And Win

By Andy Gibson

They don't make a pretty sight, although they are a fairly common sight. Fungal Infections find a cozy breeding ground in the warm environment, but they needn't blight your life.

What are fungal infections?
Though we all harbor some fungus (a type of airborne, microscopic, parasitic plant that thrives on humans and animals) on our body, daily hygiene routines like bathing wash it off sufficiently to prevent infection. However, some parts of our body may unwittingly serve as fungus-friendly environments (fungus thrives in moist, warm areas). The result: disfigured, discolored and partly avulsed (torn off) finger nails/toe nails, or a rash if skin areas are affected.
Which are the body's most susceptible areas?
Susceptible sites include the toe nails, toe spaces (the infection known as athlete's foot), finger nails, groin (jock itch), scalp (ringworm, which gets its name from its symptom, a ring-like rash); rarely, other parts of the body, such as the upper torso, may be affected.
How common are fungal infections?
The incidence of fungal infections is ten times higher than in the general world population mainly because of poor hygiene, poor. nutrition which lowers immunity, the hot, humid climate which is conducive to fungal breeding, overcrowding which promotes the spread of the infection, inadequate medical facilities and low social standards (so that the condition is not seen as a social embarrassment by most sufferers and therefore goes untreated and spreads).

Who are most susceptible to fungal infections?

• Those who lack proper hygiene habits; with regular bathing and washing, fungi fall to set a foothold.
• Habits like sharing towels, combs, footwear, or the regular use of swimming pools or gymnasiums also makes a person more prone to catching the infection.
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• The obese: Fungi thrive in warm, moist places and find a cozy home in pockets like the underside of flesh folds (which create friction, thus raising the local temperature and trapping moisture). The obese also sweat profusely which, helps make the environment even more conducive for fungal growth.
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• For the same reason, those who wear tight or synthetic clothing which inhibits the skin from breathing freely are at increased risk.
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• Those who wear tight or closed footwear like sneakers or gumboots over long hour. Such footwear results in increased temperature and sweating. Synthetic socks add to the risk.
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• Thumb-suckers and those who have frequent manicures which tend to damage the cuticle and leave it open to infection.
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• The undernourished, whose immunity is lowered. As a result the Langerhans cells (located in the epidermis) and involved in combating surface infections are weakened.
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• Pet owners or animal lovers may invite infection through cuddling pets or other animals, especially those which are not cleaned regularly.
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• Those who work in wet/damp conditions, such as those involved in housework, launderers, waiters, workers in the canning and tanning industries.
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• The pregnant: During pregnancy excessive vaginal discharge and frequent urination make the moist vaginal and groin area breeding grounds for fungus.
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• Diabetics: Common sites among them are the groin/penis because the urine, high in sugar content, promotes ideal breeding conditions. Another susceptible site is the feet because, in diabetics, the blood vessels become thickened resulting in reduced blood supply to the hands and feet, which in turn disrupts the defence mechanisms there. Also, the reduced nerve sensation makes diabetics prone to hand and feet injuries that invite fungal infections.
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• The sexually promiscuous: fungal infections are also sexually transmitted - by contact and through, fluids (infected women develop a curdy vaginal discharge).
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• Those on immunosuppressant and cytotoxic drugs taken after an organ transplant are susceptible because these drugs again inhibit the immune system.
• For the same reason, those suffering from AIDS are more susceptible. In them, the infection usually manifests itself in the mouth or food pipe, although other sites may also affect.
• What are the tell-tale signs of a fungal infection?
  
  Skin and nails that are infected by fungus change their appearance in three ways:
  1. A ring-like rash (tinea or ringworm) makes its appearance; the centre is relatively clear, compared to the periphery which contains fluid, and is marked by rings that spread outward.
  In adults, common sites for this rash are the feet (athlete's foot); nails, which get brittle and crumble or break off; the groin; the waist, in women wearing their dresses tightly; the scalp and beard (loss of hair, skin peeling, soreness and pain and, in severe cases, pus formation).
  Among children, who lack 'the protective sebaceous secretion against infection, a common site is the scalp, to which the infection spreads easily through barbers tools, bed linen, hair-bands etc. The rash is always accompanied by severe itching.
  2. Patches on the skin (either light-coloured, red, brown or even blackish) that appear on the upper torso and face where the sebaceous glands exist in profusion. This infection is called pityriasis versicolor and is often mistaken for leprosy or leucoderma. It usually affects young adults.
  3. Whitish or reddish soggy skin around the finger and toe-nails, in between the toes and/or fingers, in body folds like the underarms and groin, and below pendulous breasts in older and obese women. The nails become lack-lustre, brownish or blackish, rough and wavy. This infection is called candidiasis.
  In infants, the symptom may appear as a curdy coat on the tongue; as nappy area rash (that often follows persistent, loose motions); or in the neck folds.
  It is always accompanied by pain, itching and burning.
  In pregnant women, the vagina is a likely site for the rash and, in women taking the oral pill; it's the vulvo-vaginal area that is prone to this infection.
• Among diabetics, the groin, penis and feet are susceptible areas.
  
  
• Is the incidence of fungal infection higher in certain seasons?
  The ringworm type, which usually infects the finger-nails and toe-nails (the incidence is 25 per cent and 75 per cent respectively) is more common in summer, because the high temperature promotes sweating, providing a congenial environment for this fungus to breed.
  Candidiasis, which infects nails, finger and toe spaces, and body folds, and in infants the tongue and groin, is more common in the monsoon because this fungus thrives in a moist environment.
  How easily does fungal infection spread?
  Fungal infection are highly contagious; they may spread directly, (by touching an infected person) or indirectly (by using an infected person's clothes, comb, towel, shoes etc.). Once fungus finds a base, it spreads easily, say, from one toe to the next and then to the other foot and to the fingers. From there, it may well spread to the scalp when the head is scratched, or to other susceptible body parts. Often, an entire family living under one roof can get infected if rigorous hygiene and precautions are not maintained.
  How is a fungal infection different from psoriasis?
  The main distinguishing feature is the absence of itching in psoriasis. Psoriasis is a genetic disorder which is non-infective, and non-contagious. The nails get pitted (thimble nail) or form ridges and separate from their bed. The surrounding areas are red, dry and scaly. This condition commonly appears on the scalp, elbows, knees, palms and soles.
  In a fungal infection, on the other hand, white spots appear on the nail or they get discoloured or dark, a powdery (chalky) substance may be visible on the underside of the nail and the portion below the free nail may thicken, thus lifting the nail. The nail may become brittle and crumble and the surrounding skin may scale or form blisters and scabs. This may spread to the groin area, underarms or other susceptible parts.
  Is a fungal infection just a cosmetic nuisance, or can other health problems result?
  In a person who has a genetically weak immune system (or is on immunosuppressants), frenetic scratching can cause wounds through which the fungus could enter internal organs like the brain (bringing on symptoms like fever, » headache, vomiting, convulsions and even coma); the respiratory system (breathlessness, chest pain); and the food pipe (difficulty in swallowing). This is why early diagnosis is particularly important in the case of diabetics and other susceptible groups.
  If the fungus affects the fingernails, social embarrassment is major fallout. Besides, an infected finger leaves itself wide open to bacterial infections and abscesses like whitlow. If it is localized in the groin area, the person suffers great discomfort in public because he cannot obtain relief from scratching. In the case of symptoms like hypo-pigmentation or light-coloured patches, the patient often wrongly associates them with leucoderma or leprosy, causing himself undue anxiety and tension which may affect his health in other ways.
  Do fungal infections need to be treated by a dermatologist or will a chiropodist do?
  A chiropodist will only trim, cut the nail and provide local treatment which is far from sufficient.
  A dermatologist is better equipped to identify the associated susceptible areas, and to prescribe adequate treatment in the form of local applications and tablets.
  After a physical examination with a Wood's lamp which emanates ultra-violet light and makes some types of fungus glow, he will scrape out a small sample of the finger-nail, mount it on a microscope and look for the chain formation characteristic of fungus and its spores, to confirm the diagnosis. Or the dermatologist may do a culture, where the scraped sample is allowed to grow in an artificial medium.
  What is the usual line of treatment?
  As far as ringworm nail infections are concerned, oral and local medications and, in some cases, surgery may be advised. Commonly prescribed tablets contain griseofulvin or ketoconazole, both taken with milk because fats enhance absorption.
  But the hitch with oral medications is that they have to be taken until the new nail grows out, which may take from a year to a year and a half in the case of a toe-nail infection and about six months in the case of the finger-nail.
  
  Taking these drugs over such a long period of time is dangerous because of their side-effects. Ketoconazole is associated with nausea, vomiting, liver damage (jaundice), and increase in the level of fats in the blood (triglycerides and cholesterol) and, rarely, even damage to the kidneys and bone marrow. Griseofulvin may bring on nausea, vomiting, photosensitivity (when the skin becomes oversensitive to light and light exposed areas become sore) general skin rash, and pigmentation, liver and bone marrow damage.
  Because these drugs are so strong, they are contra-indicated in the case of pregnant women sufferers.
  For other sites like the scalp and body folds, the oral treatment is limited to only one and a half to two months.
  For candidial infections, once the susceptible factor is identified and then steered clear of, this opportunist plant dies natural death. But the recovery will be hastened by the administration of oral ketoconazole and local antifungal lotions, creams, powders. (Only in a few stubborn and recurrent cases of ringworm of the nail, the sufferer may have to endure it for the rest of his life).
  Antifungal lotions or cream containing clotrimazole, miconazole and ketoconazole have limited benefits when used alone as the nails are solid dead cells and medication cannot penetrate. Except in the case of candidiasis of the nail, where nail changes are only a secondary effect, surgery where the infected portion of the nail is removed under local anesthesia, enabling a new nail to grow out is by far the best treatment. It is a quick way to eliminate a large quantum of infection and thus effectively stem its spread.
  
  
  
• Tips for keeping nails dry:
  The nails are the most common sites for fungal infections. The best way to stay fungus proof is to keep them cool and desert dry. Try some of these techniques:
  
  

  1. After a bath or wash, dry your feet thoroughly by fanning out your toes under a fan. Follow this by liberally sprinkling talcum powder in the spaces between the toes.
  2. Change your socks (preferably choose cotton ones) at least once a day.
  3. Wear shoes that are well ventilated. Walking shoes with mesh sections and perforated leather are good choices.
  4. Make sure your shoes dry out completely overnight. Air out removable inner soles, Stuff soaked shoes with newspaper and put then near (not on) a heat source or have more than one pair of shoes and wear a different on alternate days.
  5. After a run or jog, change out of your sweat dampened shoes and socks and wash and dry your feet thoroughly. And if you walk to work, or your feet are wet or damp by the time you arrive, change into fresh footwear.
  6. Use rubber gloves, preferably cotton lined, for dish washing and other soggy chores.
  7. Wear dry gloves while gardening or doing similar outdoor jobs; remember fungus thrives in soil as well.
  8. Wear open sandals while walking around wet public places such as gym and swimming pool showers. And make sure you keep a can of powder in your gym/poolside lockers.

  
  
  
  
  I firmly believe that the whole universe is inter-connected. Our body, mind and spirit are deeply rooted with each other. If body is sick, the mind cannot relax or feel good. And if mind is not relaxed, it will give birth to stress and that will lead to chronic health problems.
  So, it is clear that in order to posses a sound body we must have a calm and peaceful mind. Without a sound mind we cannot expect our potential growth or development.
  
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