Is This Diet a Waste of Time for Psoriasis?

From healthcentral.com

A trendy weight-loss plan might lessen the minutes you spend every day dealing with skin inflammation, but some studies suggest it could make your condition worse

If you have psoriasis, you'll try anything to get your flares under control. After all, you're spending more than an hour a day just trying to get your skin to behave. Naturally, if there was magic food that would fix your condition, you'd eat it for breakfast, lunch, and dinner, right? That's one reason that the keto diet, short for ketogenic, has been spreading by word-of-mouth among psoriasis patients as a possible way to curb flares. The diet, which is high in fat (more than 70% of daily calories) and low in carbohydrates, changes how your body uses energy, burning a chemical made in your liver called ketones (and, by extension, fat) instead of its usual glucose from carbs. It is touted for a myriad of health benefits, not the least of which is its ability to lower inflammation in the body—and that's music to the ears of anyone with psoriasis.

It only makes sense, if you're giving up 60 minutes of your life every day to battle skin inflammation, that you'd sign up for a diet that does it for you. So is the keto diet the timesaver you've been looking for?

The Psoriasis-Keto Connection

It’s a logical leap—but not necessarily the correct one. Last year, a study in the Journal of Investigative Dermatology found that certain fats in the keto diet might actually worsen psoriasis symptoms. In that study, researchers in Austria discovered that while a keto diet that included fats from olive oil, fish, nuts, avocado, and meats didn’t affect skin inflammation, a keto diet focused on using fat from coconut oil, especially when combined with omega-3 fatty acids from fish oil and plant sources (like nuts and seeds), did.

The reason for skin inflammation on the coconut oil-based diet likely has to do with the molecular structure of the fat itself, researchers say. Coconut oil (as well as palm kern oil and to a lesser extent whole milk and butter) is rich in medium-chain triglycerides (MCT), whereas olive oil and avocados, in contrast, are heavy in long-chain triglycerides (LCT).

Your body uses these MCTs and LCTs for energy. Since MCTs are shorter in length than LCTs, they burn faster. But the real issue, as far as your psoriasis goes, is that a diet heavy in MCTs appears to cause the body to produce more damaging pro-inflammatory cytokines, signalling molecules involved in the body’s inflammatory immune response. MCT-rich foods like coconut oil also lead to a build-up of neutrophils, a type of white blood cell that can trigger a psoriasis flare. For reasons scientists are still figuring out, LCTs do not trigger the same response.

A few caveats about the study in Journal of Investigative Dermatology: It’s considered “preclinical” as it was done using lab animals, not humans. Also, the study also didn’t look at a whole foods approach to keto, meaning it didn’t replicate exactly how the diet might be used IRL, says Sarah Brookes, a registered nutritional therapist in London and founder of Autoimmune Hub, a digital network of specialists who work with people with autoimmune conditions.

Still, the results of this study and others suggest that the keto diet might not be the best option for psoriasis patients, Brookes says. She doesn’t recommend the keto diet to her clients—largely because of the plan’s extreme rules. “Eating shouldn’t be such hard work and it shouldn’t socially isolate you either,” says Brookes. “I tend to focus on diets that correct and balance the gut microbiome.”

Psoriasis and Weight Loss

Keto diet or not, if you have psoriasis and you’re overweight (often determined by a BMI of 25-30) or obese (BMI over 30), it’s time to take action. Research has found a link between obesity and inflammation, and carrying extra pounds is both a risk factor for psoriasis and can worsen the existing skin condition, says Sharleen St. Surin-Lord, M.D., a dermatologist and assistant professor of dermatology at Howard University College of Medicine in Washington, D.C.

In addition, psoriasis is associated with cardiovascular disease and metabolic syndrome (which can raise your risk of a heart attack)—two conditions that are also seriously impacted by your weight. Shedding pounds can help reduce your cardiovascular risk with psoriasis, research shows.

And that’s another reason why the keto diet might not be ideal for people with psoriasis: The high-fat diet favours butter and whole-fat dairy products that can raise your LDL cholesterol level, upping your cardiovascular risk. “Since psoriasis also shares a link with other chronic diseases—liver disease, cardiovascular disease—the keto diet may not be appropriate for this population due to its non-heart healthy nutrient profile,” says Amanda A. Kostro Miller, R.D., a registered dietitian in Chicago.

A Psoriasis-Friendly Diet

So, if you want to lose weight to help with your psoriasis and improve your heart health, what should you do? Start by eating a balanced diet that’s low in processed foods, says Dr. St. Surin-Lord.

Brookes agrees. “I would suggest people aim to eat a lot of fruits and vegetables, and eat healthy fats such as oily fish, eggs, avocado, and olives,” she says. “Most importantly, I think people should eat whole foods directly from nature and focus on optimizing digestion and absorption.”

Focusing on what not to eat can be helpful, too. “It’s more of, what do you need to avoid when it comes to psoriasis, because psoriasis is an inflammatory condition,” says Dr. St. Surin-Lord. “You want to avoid inflammatory foods like sugar, red meat, and dairy.”

Keeping a food journal when your psoriasis flares can help you determine if you have particular food sensitivities. “Generally, a diet void of trigger-foods like red meat, dairy, eggs, nightshade vegetables, or gluten is suitable for anyone with psoriasis,” says Tatiana Larionova, a licensed dietitian nutritionist and certified nutrition specialist in Miami, FL.

As for whether or not you should try keto, keep in mind that it may not be the fat itself, but the type of fat, that triggers your skin’s inflammatory reaction. Stick with LCTs like olive oil over MCTs like coconut oil when you’re cooking, and smear your toast with avocado instead of butter. Even then, the keto diet may not be the best option compared to more a personalized, balanced eating plan focused on food sensitivities, Brookes says.

“There isn’t a one-size-fits-all diet, and the ketogenic diet might benefit some people. However, in the case of an autoimmune disease, the key is to heal and rebalance the gut and then personalize the diet,” she says. With a little trial and error—and some thoughtful chats with your derm and dietician—you’ll be able to come up with an eating plan that’s best for you and your skin.

https://www.healthcentral.com/article/psoriasis-keto-diet

Exploring joint pain that is caused by psoriatic arthritis

From bonnercountydailybee.com/news

It’s not the most common skin disorder, acne gets that honour, but psoriasis is the one that can lead to psoriatic arthritis (PsA) which is often painful joint inflammation. The National Psoriasis Foundation estimates more than eight million Americans — two to three percent of the total population — have psoriasis.

As high as thirty percent of those folks will develop psoriatic arthritis often between their thirtieth and fiftieth birthdays or roughly ten years after the first signs of psoriasis. It’s unusual, but one can develop psoriatic arthritis without having psoriasis.

For those of you who need a refresher, psoriasis is a skin disorder that causes skin cells to multiply up to ten times faster than usual. The result is that the skin builds up into bumpy red patches covered in white scales that can grow anywhere but mostly on the scalp, elbows, knees, and lower back. This condition is not in any way, shape, or form contagious.

“Though there is no cure, there is a growing range of treatments available to help stop the disease progression, lessen pain, protect joints and preserve the range of motion,” NPF says. “Early recognition, diagnosis, and treatment of psoriatic arthritis are critical to relieve pain and inflammation and help prevent joint damage.”

Let’s emphasize early recognition. NPF says that permanent joint damage can occur without seeking treatment in as little as six months, confirming this is not one of those conditions that you should take a wait and see the type of attitude.

PsA doesn’t follow a set pattern. Symptoms can develop quickly with severe pain, or slowly with mild discomfort. Some people may develop PsA after an injury that, at first thought, appears to be a cartilage tear.

Common symptoms include fatigue, tenderness, pain and swelling over tendons; swollen fingers and toes that make those appendages look like sausages; stiffness, pain, throbbing, swelling and tenderness in one or more joints; a reduced range of motion; morning stiffness and tiredness; nail changes (I’ll explain more in a bit), and redness and pain in the eye(s).

“There is little connection between psoriasis severity and PsA severity. Having a severe case of psoriasis does not necessarily mean you will have a severe case of psoriatic arthritis,” NPF explains. “You could have a few skin lesions, but many joints affected by arthritis.”

The National Institutes of Health says that psoriatic arthritis may be “difficult to distinguish from other forms of arthritis, mainly when skin changes are minimal or absent. Nail changes and dactylitis (digit swelling) are two features that are characteristic psoriatic arthritis, although they do not occur in all cases.

Nail changes include tiny dents described as pitting and ridges in the fingernail. And, WebMD explains that “sometimes the entire nail pulls away from the nail bed. The separated part might be opaque with a white, yellow, or green tint. Your doctor might call this condition onycholysis.”

Having PsA can put you at risk of developing other conditions. The most common are cancer (lymphoma and non-melanoma skin cancer), cardiovascular disease, Crohn’s disease, depression, eye inflammation, and vision problems, gout, and joint damage.

“Researchers have found a link between psoriasis, psoriatic arthritis, and metabolic syndrome, a cluster of conditions that include heart disease, obesity, and high blood pressure. Women with psoriasis and anyone with severe psoriatic arthritis may be almost twice as likely to get it as others,” WebMD explains.

There isn’t a definitive test for psoriatic arthritis. Your healthcare provider will make the diagnosis utilizing observation and the process of elimination. Blood tests, MRIs, and X-rays of the joints will help to rule out other diseases and to determine the cause of symptoms. Your and your family’s medical history will aid the diagnosis as frequently, people with psoriatic arthritis have a parent or sibling with the disease.

“The symptoms of psoriatic arthritis are similar to those of three other arthritic diseases: rheumatoid arthritis, gout, and reactive arthritis,” NPF says. It’s important to know what type of arthritis you’re suffering from because they are all treated differently.

Although there is no cure, symptoms to control inflammation are often successfully managed by medications. Sometimes steroid injections are used to reduce inflammation quickly. When PsA severely damages joints and will require surgery.

Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com

https://bonnercountydailybee.com/news/2020/jul/29/exploring-joint-pain-that-is-caused-by-7/ 

New Potential Advances In Treating Psoriasis: A Skin Condition That Affects 125+ Million People

From forbes.com
By Sai Balasubramanian, J.D.

Although psoriasis has been a well-recognized skin condition for many years, there has been significant progress over the last decade on effective therapeutic models and treatment modalities for this autoimmune condition. But what exactly is this condition that affects nearly 125 million people across the globe and more than 8 million Americans?

As explained by the Centres for Disease Control and Prevention (CDC), psoriasis “is a chronic autoimmune skin disease that speeds up the growth cycle of skin cells.” This often emanates as “patches of thick red skin and silvery scales…” which “…are typically found on the elbows, knees, scalp, lower back, face, palms, and soles of feet, but can affect other places (fingernails, toenails, and mouth).”

The condition may present as a wide spectrum of severity and skin symptoms. Furthermore, psoriasis is often linked to more severe and chronic medical conditions, such as psoriatic arthritis, diabetes, and cardiac issues, to name a few. Psoriatic arthritis is especially common in those that have psoriasis, resulting in inflammation, joint pain, and stiffness that may inevitably lead to severe mobility issues.

Given the seriousness of this condition as well as its widespread prevalence, significant research and efforts have gone into finding sustainable treatments. There are entire labs, fellowships, clinical platforms, and organizations dedicated to helping individuals with psoriasis. Notably, the past decade has seen significant improvements in various treatment modalities, ranging from topical treatments, to injections and oral medications. There are many different mechanisms of action and physiological targets for psoriasis treatments; a few examples include reducing inflammation, slowing skin growth, or altering the immune system.

Phototherapy has received a lot of attention and research in the past few years. Per The National Psoriasis Foundation, the basic premise of phototherapy “involves exposing the skin to wavelengths of ultraviolet A light (UVA) or ultraviolet B light (UVB) under the supervision of a health care provider to treat psoriasis.” The idea behind this treatment is that “UV light penetrates the top layers of skin and stops the skin cells from growing too quickly, leading to improvement in psoriasis symptoms.”

                             Using phototherapy to help with psoriasis symptoms.  Getty

More recent developments are also gaining traction. Late last week (July 16^th), The New England Journal of Medicine (NEJM) published an article titled “Trial of Roflumilast Cream for Chronic Plaque Psoriasis.” The article discusses a clinical trial in which researchers tested the use of Roflumilast cream, which contains phosphodiesterase type 4 (PDE-4) inhibitor, as a potentially viable and sustainable topical treatment modality for plaque psoriasis. The study describes that 331 patients were randomized: “109 were assigned to roflumilast 0.3% cream, 113 to roflumilast 0.15% cream, and 109 to vehicle [placebo] cream.” The results indicated that “Roflumilast cream administered once daily to affected areas of psoriasis was superior to vehicle cream in leading to a state of clear or almost clear at 6 weeks.” However, the authors explicitly conclude that “Longer and larger trials are needed to determine the durability and safety of roflumilast in psoriasis.” This is often the case with new and cutting-edge therapies—larger and well-repeated, evidence-backed trials are required in order to truly understand a treatment’s efficacy and safety.

Another fascinating research trial by Harvard University’s Wyss Institute for Biologically Inspired Engineering and John A. Paulson School of Engineering and Applied Sciences (SEAS) was published yesterday, describing the use of small interfering RNA (siRNA) to help control psoriasis-related activity at the genetic level. The article explains that using siRNA based therapies on the skin has traditionally been challenging, given the compound’s instability and the skin’s barrier function. However, in this study, the authors claim that they found a way to effectively deliver the treatment molecule into the skin, resulting “in down-regulation of psoriasis-related signals.” Though more testing will be required to fully determine the safety and efficacy of this treatment model, this new development may potentially open the doors to a new way of delivering topical medications.

https://www.forbes.com/sites/saibala/2020/07/23/new-potential-advances-in-treating-psoriasis-a-skin-condition-that-affects-125-million-people/#674a4a4e53f2

Help Manage Your Psoriasis by Managing Your Lifestyle

From pressherald.com
By Jamie Lowery, NP-C, APRN, DNP

As a dermatology nurse practitioner, my specialty areas mostly include skin cancer detection, inflammatory and non-inflammatory dermatoses and other women’s health issues including acne, GYN dermatology, hair loss and anti-aging.
However, I have also found a niche in managing patients with plaque psoriasis, and today I want to share some lifestyle changes that can help manage this condition.

Plaque psoriasis is a chronic, inflammatory, multisystem condition of skin and joints. It affects more than three percent of the U.S population according to the American Academy of Dermatology. There are many different ways that psoriasis will present itself, but most of the time it presents as patches of thick raised skin covered with a silvery scale.

Psoriasis is complex and has negative physical and psychological effects. A dermatology practitioner can work with you to develop an individualized treatment plan with the option of using advances in modern therapeutics to help treat psoriasis safely and effectively.

Besides modern-day therapeutics, these lifestyle changes could make a major difference in how your psoriasis is managed.

Stop smoking. Smoking increases your risk of psoriasis flare-ups and skin cancer. Smoking can also lead to premature lines and wrinkles, accelerated loss of elasticity and dry skin.

Eat healthy. Some patients report better control of their psoriasis with healthy eating. An anti-inflammatory diet that is full of fruits, vegetables, lean proteins and healthy fats will improve your health in other areas as well.

Alcohol consumption. Alcohol can cause inflammation and can lead to inadequate control of psoriasis. Quit drinking or greatly reduce how much you drink in a given week.

Skin injury. Be aware that small injuries to the skin can induce a flare-up. This may include bug bites, intense scratching, sunburns, tattoos and piercings, and nicks or scrapes while shaving.

Stress is a common trigger for psoriasis. Are there emotional stressors in your life that you can work on managing? Your dermatology practitioner can help you find ways to cope with stress.

Prioritize sleep. Levels of the stress hormone cortisol fall during sleep, which helps skin repair overnight.

Are you wondering if you have plaque psoriasis? Please see your dermatology practitioner for diagnosis and treatment.

https://www.pressherald.com/2020/07/16/help-manage-your-psoriasis-by-managing-your-lifestyle/

How to Cope When Psoriasis Gets Itchy as Hell

From menshealth.com

By Daisy Melamed Sanders

Exactly how to ease symptoms when you need it (and prevent them before you do)

A psoriasis flare-up can affect every part of your daily life—the discomfort can be so bad, it’s hard to focus on anything else. And it doesn’t just feel like it’s taking over; it actually does affect your whole body.

“Psoriasis is a condition in which your immune system attacks your own skin, causing moderate to severe inflammation,” explains Sarah Dolder, MD, a board-certified dermatologist and the founder of Greenwich Point Dermatology. It most commonly manifests as scaly patches, but it can also be associated with painful arthritis in the joints.

While there is no cure for the disease, science has made huge strides in giving patients ways to mitigate some of that itching, including prescription treatments, so they can get back to living life. “These newer drugs have minimal, if any, side effects and are revolutionary in clearing psoriasis disease activity,” Dr. Dolder says.

To help you deal with your next flare-up (and potentially avoid one altogether) , we asked Dr. Dolder the best ways to get back to feeling comfortable in your own skin, from drugs and topical treatments to lifestyle management changes. Here are five strategies to remember when you and your skin need it most.

Keep stress to a minimum

Keeping your skin in top shape requires examining every part of your life. “Stress is a big contributor in psoriasis flares, so adopting a lifestyle with regular exercise, healthy diet, good sleep patterns, and relaxation can really help,” Dr. Dolder recommends.

In rare cases, psoriasis can be associated with an increased risk of heart attacks and other cardiovascular diseases, she continues. So it’s also important to monitor your blood pressure and cholesterol even when you’re not focused on mitigating or calming symptoms.

Reach for topical treatments

In general, Dr. Dolder says, a combination of topical prescriptions and UV therapy is the first line of defence against itchy psoriasis flares. Relief might also be found in less likely places: One study published in the Open Access Macedonian Journal of Medical Sciences found that some mild to moderate cases may be successfully managed with topical application of honey and/or aloe vera.

Get some vitamin D

Getting outside is a great way to keep symptoms at bay. However, whenever dealing with the skin and sun, it’s always important to remember to wear protective clothing and sunscreen. “Sunlight exposure in small doses and with adequate protection, and vitamin D, can also minimize flares,” Dr. Dolder says.

If you aren’t able to spend time in natural sunlight, talk to your doctor about taking vitamin D supplements and trying phototherapy to help. A study published in the International Journal of Molecular Sciences echoes Dr. Dolder’s suggestion that these remedies, among others, can help mild to moderate psoriasis.

Turn to oral options

If and when topical treatments don’t seem to be working, or aren’t working well enough, doctors will often consider prescribing oral medication, Dr. Dolder explains. And while it’s still unclear how effective oral treatments can be in the long term, according to one study, it’s evident that they work pretty reliably in the short term as long as the patient is actively taking them.

Care for your scalp

If your psoriasis is making your scalp itchy, don’t treat it like a case of dandruff. Instead, reach for the right hair-care products to provide some relief. “OTC tar and selenium-sulfide shampoo can reduce scalp flaking,” says Dr. Dolder. Brands commonly found at the drugstore or online retailers can help ease symptoms.

Talk to Your Doctor About Biologics

If your psoriasis is more severe and other options aren't working, it may be time to look into biologic treatments, which work within your body to stop the reaction that causes the painful skin condition. According to the American Academy of Dermatology, these treatments, which are injectable (in other words, given via shot or IV), can be safe and very effective in certain patients. And while the specific drug that's right for you is between you and your doctor, scientists are excited about the increasing number of options available.

Dr. Dolder agrees: “These new biologic treatments for psoriasis are very effective in blocking the impaired part of the immune system that causes rapid turnover of skin cells, resulting in psoriasis flare-ups,” she says. “These targeted therapies have a low side effect profile and are often life-changing in their dramatic ability to clear patients of their psoriasis.”

https://www.menshealth.com/health/a31787492/how-to-cope-when-psoriasis-gets-itchy-as-hell/

Eczema symptoms: Whats the difference between eczema and psoriasis?

From express.co.uk

ECZEMA AND PSORIASIS are skin conditions with similar symptoms, so how do you tell the difference?

Eczema symptoms

Eczema, also known as atopic eczema or atopic dermatitis, is a common skin condition affecting up to 15 million people in the UK.

The condition causes areas of skin to become itchy, dry, cracked and sore.
Flare-ups can happen two or three times a month, but there may also be periods of time where symptoms improve.

Eczema can be genetic, but it could also be caused by soaps, shampoos, hard water and central heating– all of which increase dryness of the skin.

Eczema can occur all over the body, but is most common on the hands, insides of the elbows, or backs of the knees.

At least one in five children in the UK have eczema, and they may find it on their face and scalp.
Eczema is more severe in some than others, and can affect the whole body with constant itching.

The scratching can disturb your sleep, cause nose bleeds, and lead to infections.
If the skin gets infected, you may notice fluid oozing from your skin, swelling, and hot and cold flushes.

                        Eczema symptoms: Eczema can occur all over the body (Image: Getty)

Psoriasis symptoms

Psoriasis is just like eczema, but it typically affects the outside of the elbows, knees or scalp.
However, it can appear anywhere on the body including the eyelids, ears, mouth, lips, hands, feet, and nails.
Psoriasis is itchy, and it burns and stings, and causes red, flaky and crusty skin with silvery scales.
People with other health conditions such as diabetes, heart disease and depression may have psoriasis.

About two percent of Brits are affected by psoriasis, and it can start at any age.

However, it most often develops under 35-years-old and severity varies from person to person.
Psoriasis is a long-lasting disease, and it occurs due to an increased production of skin cells.

Skin cells are normally made and replaced every 3 to 4 weeks, but in psoriasis this process only takes about 3 to 7 days.
This is thought to be related to a problem with the immune system, and psoriasis can run in the family.

The build-up of skin cells creates the patches associated with psoriasis.

What’s the difference between eczema and psoriasis?

Both conditions cause patches of itchy skin, and they occur in the same sort of places on the body.
Neither are contagious, but they can both lead to unpleasant infections.

The biggest difference is the fact that psoriasis is an autoimmune disease, with your immune system causing your cells to grow too fast.
Eczema, however, could be caused by genetic or environmental factors.

Additionally, the itching sensation is slightly different.
Psoriasis often causes milder itching and a terrible burn, but eczema leads to a very intense itching.

https://www.express.co.uk/life-style/health/1304192/eczema-symptoms-difference-between-eczema-and-psoriasis