Do You Need a COVID-19 Vaccine Booster if You Have Psoriasis?

From everydayhealth.com

Psoriasis drugs that work by suppressing the body’s immune response may raise the risk of COVID-19 complications. If you’re already immunized, can a booster shot help? Here’s what to know before getting that extra jab.

In mid-August, the Centres for Disease Control and Prevention (CDC) recommended that people who have compromised immune systems get an additional dose of the COVID-19 vaccine.

This includes people who have received organ transplants or are undergoing cancer treatment, as well as some individuals with chronic health conditions who are taking drugs that can suppress their immune response, raising their risk of serious, prolonged COVID-19.

If you have psoriasis and are taking an immunosuppressive medication, such as high-dose steroids or a biologic, you may wonder what the new vaccine guidance means for you — and when, how, or even if, you should get a booster shot.

Here are some answers to your most pressing questions, with insights from two leading psoriasis experts.

If I Have Psoriasis, Should I Get a Booster?

Anyone with psoriatic disease who is being treated with immune-modulating drugs and has already received two doses of a COVID-19 vaccine from Pfizer-BioNTech or Moderna is eligible for a third dose, says Joel Gelfand, MD, the co-chair of the National Psoriasis Foundation and a professor of dermatology and epidemiology at the University of Pennsylvania Perelman School of Medicine in Philadelphia.

Among those patients, Dr. Gelfand believes the following are most likely to benefit from a third shot:

• Those age 50 or older
• Those taking abatacept, cyclosporine, leflunomide, glucocorticoids (such as prednisone), methotrexate, or tofacitinib
• Those who received their second dose of the Pfizer or Moderna vaccine more than six months ago
• Those with underlying health complications known to increase the risk of severe COVID-19, such as those who are overweight; who smoke or used to smoke; or who have diabetes, cardiovascular disease, or a chronic disease affecting the lungs, liver, or kidneys

What Should I Do if I Got the Johnson & Johnson Vaccine?

Right now, psoriasis patients and other immune-compromised people who received the Johnson & Johnson (J&J) single-dose vaccine are not eligible for a booster shot.

Since the J&J vaccine has only been available since March 2021, the CDC is waiting for more data before making a recommendation about additional doses for people who are immune-compromised, as well as for the general population.

Preliminary data released by J&J on August 25 suggest that a booster shot could be highly protective.

Can I Just Go and Get the Third Shot or Do I Need to Talk to My Doctor First?

“You should talk to the physician you see for psoriasis treatment to [get their input] and determine if you are on an immunosuppressive medication prior to getting the booster shot,” says Lisa Zaba, MD, PhD, a clinical associate professor of dermatology at Stanford University School of Medicine in Palo Alto, California.

You don’t need a prescription or a doctor’s note to get a third shot, but you should bring your vaccination card. The dose will be the same as the first and second shot, and the side effects should be similar, says the CDC.

Do I Need to Get the Same Vaccine I Got for My First Two Doses?

If possible, yes, says Gelfand. The CDC is recommending that people get the same vaccine they received for their first two shots, so if you are already inoculated with either Pfizer or Moderna, you should get the same for your third shot.

If that isn’t feasible, or you don’t know which vaccine your received for your first two doses, the agency says you should get your additional dose with either the Pfizer or Moderna vaccine.

I Recently Got My Second Dose; How Long Should I Wait Before Getting a Third Dose?

“For people who are immune-compromised or taking immune-suppressing medications, it’s recommended that they wait at least 28 days after they had the second dose before getting a booster,” says Zaba.

If I Take an Immunosuppressive Medication, Does That Mean the COVID-19 Vaccine Won’t Protect Me?

“Not necessarily,” says Gelfand. “Of the treatments commonly used for psoriasis, only methotrexate has been found to result in modest reductions in antibody response to the mRNA [messenger RNA] vaccines [from Pfizer and Moderna]. And the clinical significance of this finding is not known.”

Gelfand also notes that the U.S. Food and Drug Administration (FDA) authorized expanded use of two-dose Pfizer and Moderna vaccines on the basis of data from patients who received an organ transplant and, as a result, were significantly immunosuppressed.

Research has shown that these patients were not able to mount a significant immune response to the initial two-dose vaccine and that a third dose could help increase the amount of protective antibodies in their blood.

Should I Temporarily Go Off My Psoriasis Medication After I Get the Third Shot?

It’s very important to talk to your doctor before making any changes in your psoriasis medication, says Gelfand.

He notes that patients taking methotrexate with well-controlled disease may — in consultation with their doctors — consider pausing their medication for two weeks after getting the booster.

While this approach may improve antibody response, it’s not known if it will result in any meaningful benefit in terms of the risk of contracting COVID-19 or developing severe disease, he says.

If I Went Off Medication for Previous Vaccine Doses, Do I Still Need to Get a Third Shot?

Because the effects of pausing methotrexate after getting a COVID-19 vaccine aren’t yet known, people with psoriasis who paused their medication after the first two COVID-19 vaccine doses should still consider getting a third shot, says Zaba.

If I Get a Third Shot, How Good Is the Protection?

A third dose will likely provide you with better protection, but how much better is not yet clear, says Zaba.

Some studies have found that people who were severely immunocompromised and had virtually no protection from the Pfizer or Moderna vaccine had an improved antibody response after a third shot of the same vaccine, says the CDC.

“Right now, we don’t know if a third or booster shot has clinically meaningfully benefits [for psoriasis patients on immunosuppressive medication],” says Gelfand. “But given the emergence of the Delta variant, which is much more transmissible than previous variants, it’s likely that booster vaccines will be necessary and helpful.”

Even after receiving a third dose of the vaccine, you’ll need to take extra precautions to avoid exposure to COVID-19, such as wearing a mask (especially inside) and avoiding crowds.

To reduce your odds of exposure, it’s also important that your family members and other close contacts get vaccinated.

If they are already immunized, they too will be eligible for a third shot beginning on September 20. That’s when the federal government is planning to roll out boosters for all Americans who received their second vaccine dose at least eight months prior.

https://www.everydayhealth.com/psoriasis/do-you-need-a-covid-19-vaccine-booster-if-you-have-psoriasis/

Is Psoriasis Damaging Your Nails?

From health.clevelandclinic.org

Medications can reduce nail pitting, discoloration and separation

If you have psoriasis, you’re used to having red, patchy, dry and itchy skin and stiff joints. But when psoriasis starts to thicken, pit, ridge and discolour your nails, it can be hard to overlook. This is called ‘nail psoriasis.’ 

Nails can tell us a lot about our health. People often consider nail psoriasis a cosmetic issue, but “nail psoriasis is a medical disorder that can be managed with various medications and often with favourable results,” says dermatologist Amy Kassouf, MD.

This is especially important for anyone who works with their hands (surgeons, hairdressers, landscapers, etc.) or those who constantly type on a computer—the more your hands are in use, the more diminished the functionality of your psoriatic nails.

What does nail psoriasis look like?

Nail psoriasis can affect your fingernails and toenails and will often manifest in these ways:

• Discoloration. Your nails are starting to brown, yellow or turn completely white.
• Damaged nail surface. You will notice lines, cracks, pits, holes or ridges. Basically, any nail surface that isn’t smooth.
• Lifted nails. With nail psoriasis, white debris can begin to form under your nail, pushing it up and away from your skin. This is usually painful.
• Thinning or thickening texture. If your nails feels brittle or too thick, this can be the build-up of psoriatic skin cells under the nails, or it can be a fungal infection that can more easily invade the already-lifted nail. You will need a culture to determine the best treatment.
• Nail separation. Again, pretty painful. Depending on the severity of your nail psoriasis, your nail may start to separate itself from the nail bed.
• How topical medicine and injections work to fight nail psoriasis

If your psoriasis is confined to the nail bed (below the “nail plates” you may polish), topical steroids, vitamin D3 analogue ointments and retinoid creams or gels can be effective.

But psoriasis typically goes deeper, affecting the nail matrix (below the nail plate, cuticle and nail fold skin). While topical treatments don’t penetrate the matrix of the nail, steroids can be safely injected around the nail with good efficacy.

“These injections are both safe and effective in reducing the pitting, hardening, ridging and discoloration, as well as nail separation caused by nail psoriasis,” says Dr. Kassouf.

Dermatologists usually administer injections monthly, then reassess the nails to see if further treatments or dosage changes are needed.

If you can’t tolerate or don’t respond to injections, oral medications (such as cyclosporine, acitretin, otezla and methotrexate) are occasionally used — especially when you have psoriasis-related (psoriatic) arthritis or significant skin changes.

Newer ‘biologics’ available to treat nail psoriasis

“Beyond that, we can offer biologic drugs,” says Dr. Kassouf. “A systemic approach to treatment can be worthwhile, because many patients with skin psoriasis also have nail psoriasis, and both conditions increase the risk of psoriatic arthritis.”

More recently, a two-year study of the oral drug tofacitinib in over 1,800 patients with moderate-to-severe nail psoriasis showed significant improvement at four months that continued through one year. (One-quarter of these patients had psoriatic arthritis as well.)

Treat your nails to some TLC

Whatever treatment you receive, it’s important to avoid irritating or injuring your nails. “Irritation and injury can drive the inflammation that drives psoriasis,” explains Dr. Kassouf.

Avoid picking at your nails and manipulating them, and steer clear of harsh chemicals, such as those found in acetone and non-acetone nail polish removers.

Follow these nail-care tips at home, too:

• Keep your fingernails and toenails trimmed short and filed evenly (but not too short, otherwise you can develop an infection).
• If you have damaged nails, wear gloves when cleaning or doing work around the house.
• Always wear socks with shoes and make sure your shoes fit properly, so as not to irritate toenails further.

“The progress for your nails may be slow. It can take three to six months before you see any improvement,” Dr. Kassouf says. “But most people do improve with the therapies available today.”

https://health.clevelandclinic.org/is-psoriasis-damaging-your-nails/

What to know about psoriasis in the nose

From medicalnewstoday.com

Psoriasis is a chronic autoimmune condition that causes symptoms that affect the skin. Sometimes, symptoms of psoriasis can develop in or around the nose. It is more common for a person to experience psoriasis around the nose than inside it. So a person should contact a doctor to rule out other conditions.

Psoriasis is not contagious, but there is no cure. People can usually manage it with medication and lifestyle adaptations. It affects around 3% of the population in the United States.

Experts do not know what causes psoriasis, but they know it has links with a fault in the immune system. The disease speeds up the skin cell growth cycle. These cells pile up on the surface of the skin, creating flaky, itchy patches.

This article will explain what psoriasis might look like when it occurs in or around the nose. It will also outline the most common treatment options and other conditions that people can sometimes confuse with psoriasis in the nose.

Is nasal psoriasis possible?

Psoriasis patches can develop anywhere on the body. The most common locations are the elbows, knees, and scalp.

When someone has facial psoriasis, the patches might occur on, in, or around the nose.

Around 50% of people with psoriasis experience psoriasis on their face. A common place for it to develop near the nose is on the skin between the nose and the top lip.

Psoriasis affects everyone differently. It might be mild, moderate, or severe.

Scientists do not know why some people develop patches on the face and others do not. Facial psoriasis tends to affect people with more severe psoriasis. 

Psoriasis inside the nose

According to The Psoriasis and Psoriatic Arthritis Alliance, a small number of people may experience psoriasis that appears inside the nose.

Because it is so rare, it recommends that a person who suspects they have psoriasis inside their nose contacts a doctor to rule out other possible conditions.

What does nasal psoriasis look like?

Psoriasis patches can develop:

• on the nose
• on the skin between the mouth and the nose
• inside the nose

They tend to look like separate patches of dry, scaly skin. They might be white or grey in colour, depending on a person’s skin tone. The affected skin may be:

• itchy
• sore
• sensitive

Similar-seeming conditions

Psoriasis is not the only condition that can cause scabs or itchy patches inside the nose. Other conditions include:

Nasal vestibulitis

Nasal vestibulitis is a bacterial infection that develops just inside the nostril. The symptoms include pain, swelling, discharge, and crusting.

Things that make a person more likely to experience nasal vestibulitis include:

• plucking nose hair
• picking the nose
• nose piercings

Doctors may prescribe antibiotics to treat nasal vestibulitis.

Cold sores

The herpes simplex virus (HSV) type 1, or oral herpes, causes cold sores. These sores can develop anywhere on the body, but usually they affect the area around the nose and mouth. Sometimes, they occur inside the nose.

People may feel pain or tingling before a cold sore appears. When they develop, they look like clusters of small blisters. Within a few days, the blisters will break open and ooze fluid. A crust then forms before the sore heals over.

Cold sores go away by themselves. Over-the-counter (OTC) antiviral medicines may help speed up the healing process, including:

• acyclovir
• famciclovir
• valacyclovir

Eczema

Eczema is a group of skin conditions that can look like psoriasis. It is very common, affecting more than 31 million people in the U.S.

Eczema can affect any part of the body, including the face and nose. The skin will usually look red, dry, or flaky. It might weep, be crusty, or look like a blister.

Outbreaks of facial eczema tend to get better within 1-2 weeks. Doctors can recommend treatments to help people manage eczema.

Medications to treat nasal psoriasis

The skin on the face, including in and around the nose, is very sensitive. It means people must treat facial psoriasis carefully, discussing treatment with a doctor first.

According to the National Psoriasis Foundation, doctors might recommend:

Topical treatments

Topical treatments are medications that people apply directly to their skin. They might include steroid creams such as corticosteroids.

A doctor may also recommend nonsteroidal creams and ointments that contain:

• anthralin
• synthetic vitamin D3
• vitamin A

Phototherapy

Sometimes, dermatologists might recommend phototherapy or light therapy. During the procedure, the healthcare professional exposes the affected skin to UV light. The light penetrates the skin and slows the growth of skin cells.

People will usually need a course of phototherapy. The length of the course and the duration of the treatment will depend on the severity of the condition.

Oral treatments

Oral treatments are pills, capsules, or liquids. Various oral treatments are available. Most work by targeting the immune system to reduce inflammation. Biologics are often the first-line treatment for psoriasis, but other oral treatments include: 

• acitretin
• cyclosporine
• apremilast

Over-the-counter medicines

Sometimes, OTC medicines can help reduce the appearance and symptoms of psoriasis patches.

They can include creams and lotions that contain salicylic acid or coal tar.

According to the American Academy of Dermatology Association, the ingredients in some OTC medicines can cause irritation to the skin, including coal tar. So a person should apply the medication to a small area of skin to understand how their skin will react to it.

Home remedies for nasal psoriasis

Things people can do at home to help treat facial psoriasis include:

Moisturize

People should opt for heavy creams and ointments as these lock moisture into the skin. Moisturizing tips include the following:

• Use fragrance-free products.
• Always moisturize after showering, bathing, or hand washing.
• Use moisturizing soaps.

Anti-itch treatments

Products and ingredients that can help ease itching include:

• calamine
• hydrocortisone
• camphor
• diphenhydramine hydrochloride
• benzocaine
• menthol

It is important to remember that some products can make dryness and irritation worse. If this happens, the person should stop using the product and speak with their healthcare professional.

Where else might psoriasis develop?

The most common areas of the body where psoriasis can develop are:

• elbows
• knees
• scalp
• around the belly button
• on the lower back

But psoriasis can develop anywhere on the body. It can develop on more than one part of the body at once.

Common locations and types of psoriasis include:

• Genital psoriasis: Up to two-thirds of people with psoriasis will experience patches on the skin around their genital area, as well as their upper and inner thighs.
• Scalp psoriasis: This develops around the hairline, on the forehead, on the skin in and around the ears, and on the back of the neck. It affects more than 60% of people with psoriasis.
• Palmoplantar psoriasis (PPP): This is psoriasis that affects the palms of the hands or the soles of the feet. Between 12–16% of people with psoriasis experience PPP.
• Psoriasis of the nails: This type of psoriasis occurs in around half of all people with the condition.
• Intertriginous psoriasis: Also called inverse psoriasis, this develops in the folds of the skin. Commonly affected areas include the armpits and underneath the breasts.

Summary

Some people with psoriasis develop patches in and around the nose. It is common to experience psoriasis around the nose, but rare for it to occur inside the nose.

Doctors might recommend a range of psoriasis treatments for psoriasis of the nose, including steroidal creams or pills. OTC medicines and home remedies, such as moisturizing using a heavy, non-fragranced cream, can also help.

Other conditions that might look like nose psoriasis include eczema, cold sores, and nasal vestibulitis.

https://www.medicalnewstoday.com/articles/psoriasis-in-nose

Mental Health Spotlight: The Stress-Psoriasis Connection

From healthline.com

Living with a chronic condition can be stressful. That’s especially true of any visible condition, like psoriasis.

Psoriasis is an autoimmune disease that causes inflammation in the body and red, scaly, itchy patches on the skin. Often, these patches are in visible places like the knees, elbows, and scalp.

While there’s no cure for psoriasis, treatments can prevent skin flares and relieve related stress.

The link

The connection between stress and psoriasis is complex, and it goes both ways. Stress is a known trigger of psoriasis flares. And people who develop these patches may stress about the way psoriasis makes them look and feel.

Could stress actually cause psoriasis? “In and of itself, stress is not going to be something that causes psoriasis to develop out of the blue,” says Evan Rieder,MD, assistant professor of Dermatology at NYU Langone Health.

He adds, “But it could cause a flare of the disease in someone who is already genetically predisposed to having psoriasis.”

Researchers have discovered more than 80 genes linked to psoriasis. When your relatives have this condition, you’re more likely to get it. If both of your parents have it, your risk is 75 percent. If only one parent has it, your risk is 15 percent.

Exactly why stress causes flares, researchers don’t know. People with psoriasis seem to have a problem with the hypothalamic-pituitary-adrenal (HPA) axis, the system that controls their body’s reaction to stress.

They have lower levels of the stress hormone cortisol, which normally helps tame inflammation. So when they are under stress, inflammation starts, and psoriasis flares up.

The stress of living with psoriasis can escalate this process and make symptoms even worse. Psoriasis patches are itchy and cause discomfort. There is also a stigma from having plaques on your skin.

People you meet might react to the redness by making comments or by shrinking away from touching you. “You can imagine what that does to someone’s self-esteem,” Rieder says.

Stress management tips

One effective way to manage stress is with relaxation techniques such as meditation and deep breathing.  Exercise is also a good stress reliever, and it’s great for boosting self-esteem.

Hypnosis and biofeedback are other techniques to help ease stress. It takes regular practice of relaxation techniques for them to be effective.

Self-advocacy is important when it comes to managing psoriasis, according to Rieder. Your dermatologist may focus only on your skin and not ask questions about your mental health.

“People with psoriasis can get depression and anxiety, and it doesn’t necessarily correlate with what’s going on with their skin. Their skin can look clear,” he says.

In addition to seeing your dermatologist, he recommends talking to a therapist. “Focus on whatever is getting in the way of you being able to live your best life,” he says.

You might want to consider seeing a therapist who has experience working with people with psoriasis or other chronic conditions.

Benefits of support groups

A support group is a place where you can connect with other people who have psoriasis, and learn from their experiences. “I think they can be very helpful,” Rieder says. “Unless you’re living with the condition, it’s very hard to truly empathize.”

Support groups are held in places like hospitals, community centres, and churches. You’ll also find them online. The best place to start looking for a support group is through an organization like the National Psoriasis Foundation.

How to talk to your friends

It may be hard to talk to people about your psoriasis, even those closest to you. But starting the conversation can help the people that love you most give you the support you need.

For people in your outer circle, your explanation can be brief and to the point. Say something like, “It’s not infectious and you can’t get it from me,” Rieder suggests.

Be more open and honest with friends and family. Help them understand what it’s like for you to live with this disease. Once they understand, they can be better allies.

Benefits of therapy

Having clearer skin can go a long way toward emotional improvement. When you’re less stressed about your skin, you may find you get fewer flares.

At least one psoriasis treatment — biologic drugs — serves double duty. Biologics are genetically engineered medications that target certain molecules in the body involved in causing inflammation, helping your immune system to operate properly.

In the case of psoriasis, these medications help relieve depression and improve quality of life while they clear the skin.

You have many options for treating psoriasis. The treatment dermatologists usually try first is a topical steroid, which slows cell production and brings down inflammation in your skin. Other, nonsteroidal topicals include anthralin, synthetic vitamin D3, and vitamin A.

Phototherapy exposes your skin to UV light to stop skin cells from growing. You can get this treatment at your doctor’s office or at home.

Systemic (body-wide) treatments such as biologics, methotrexate, and cyclosporine stop your immune system from causing inflammation in your skin. You may get one of these treatments if your psoriasis is severe or it doesn’t respond to topical treatments.

The key to getting on the right treatment is to find a doctor you trust. “Make sure you see a board certified dermatologist and get the best recommendations,” Rieder says.

“Psoriasis is a difficult condition to live with, but there’s never been a better time to live with psoriasis. We can get people clear or almost clear in the majority of cases.”

These treatments “can really improve people’s quality of life and the way that they feel,” he adds.

The takeaway

Stress and psoriasis are closely linked. You’re more likely to have flare-ups when you’re stressed, and psoriasis can increase your stress levels.

Seeing a dermatologist and getting on the right treatment can lead to clearer skin and less stress. A counsellor or other mental health provider will help you manage the emotional symptoms of psoriasis while your treatment goes to work.

https://www.healthline.com/health/psoriasis/stress-psoriasis-connection

Your Guide to Managing the Social Impact of Psoriasis

From healthline.com

Psoriasis can have a big impact on your quality of life, and social stress, in turn, can worsen psoriasis.

Social support, self-acceptance, and mental health resources are important in managing the condition.

Psoriasis can interfere with sex and dating, but touch is important for well-being.

Navigating sex, dating, and relationships is always tricky. But if you’re among the estimated 7.5 million Americans with psoriasis, a chronic autoimmune condition that causes painful patches of red or scaly skin that can crack and bleed, that challenge is multiplied.

The external symptoms of psoriasis can have an impact on your quality of life and ability to socialize.

“When strangers ask if you have herpes or you’ve been burned or just continue staring, I don’t think they realize the impact it has on you or your mood, or even the confidence it took just to get out of bed when you’re flaring horribly,” says Michelle Lee, 24, of Los Angeles, who was diagnosed with plaque psoriasis at age 20.

Lee recently joined a Healthline roundtable of people living with psoriasis. They discussed the ways psoriasis can impact your social life, and things you can do to manage.

An autoimmune disease with external symptoms

This chronic autoimmune disease causes a rapid build-up of skin cells that appear as thick, scaly patches typically on the joints, such as elbows and knees, but also on the hands, feet, neck, scalp, face, and genital region.

It ranges from mild to severe, according to the placement, body surface area, and severity. It often comes and goes in cycles.

Psoriasis is caused by an interplay of genetics and the immune system. Symptoms vary by individual and by type:

• Plaque psoriasis is the most common type. Red, inflamed patches, often covered with whitish-silver scales or plaques, cover spots such as the elbows, knees, and scalp.
• Guttate psoriasis, more common in children, causes small pink spots that aren’t typically thick or raised, usually on the torso, arms, and legs.
• Pustular psoriasis, more common in adults, causes white, pus-filled blisters and large swaths of red, inflamed skin, but typically affects smaller areas of the body, such as the hands or feet.
• Inverse psoriasis typically appears as patches of red, shiny, inflamed skin, most often around the armpits, breasts, or groin.
• Erythrodermic psoriasis can affect large areas of the body and cause scales that slough off in sheets. This rare and severe type of psoriasis can be life threatening and requires immediate medical attention.

Along with the physical effects of the condition, people with psoriasis can experience: 

• a loss of self esteem
• self-stigma
• social anxiety
• distress
• thoughts of self-harm
• changed sexual function

Psoriasis can have a huge impact on your quality of life.

Participating in activities and socializing are part of what give you a full and meaningful life, says Dr. Matthew Boland, a Nevada-based clinical psychologist who specializes in chronic conditions. So if shame or stigma about a person’s appearance interferes with their daily life, the burden can grow.

His first step for someone in this situation is “validating how stressful this really can be.”

The mental health connection

The first time Jassem “Jas” Ahmed, 30, became bed-bound from a severe flare-up of his plaque psoriasis, he remembers thinking, “My life is over — I don’t want to live like this anymore. I literally can’t move. This is not any life to live.”

But once he recovered, he learned that even the worst outbreaks are ultimately temporary.

“Stress creates this inflammatory response in the body and an activation of your nervous system to just be revved up,” says Boland. “That can actually activate periods or episodes of increased inflammation, so a lot of what my work focuses on is breaking that pattern of stress.”

Social stress can worsen psoriasis. But management strategies can help.

Finding social support

DaQuane Cherry, 23, originally from North Carolina, was diagnosed with plaque psoriasis at age 12, developing patches on his scalp that were visible through his short haircut.

“Growing up, anything foreign can easily make you a target for bullies,” Cherry says. “I was the only person I knew who had psoriasis and it made me feel like an outcast.” He remembers being asked if his condition was contagious (it’s not) or if it hurt. “That deteriorated my confidence,” he says.

So how do you combat the stigma, shame, and embarrassment that may come with having visible psoriasis patches on the skin?

For Ahmed, who’s based in London, a core group of friends he’s had from age 5 never let him wallow. “They forced me to go out,” he says. “They didn’t treat me like I was sick.”

He appreciates that they teased him, making up a superhero name for him, “Joriasis,” and saying his superpower was leaving skin on the floor. “I like that they didn’t let psoriasis define me,” he says. “It allowed me to become more me.”

“Hooking into resources like support groups can provide some sense of acceptance or accepted ability,” says Boland.

Some support groups to try are:

• MyPsoriasis Team, an online community run by the National Psoriasis Foundation
• Healthline’s Living With Psoriasis Facebook group

Understanding negative self-talk

Lex Beckman, a copywriter and inclusion advocate in California, was diagnosed just 6 months ago. With psoriasis, she explains, you have to weather the peaks and valleys that come along with it, in addition to managing a chronic skin condition.

“It takes a positive mindset and a lot of resilience to talk yourself through those moments of doubt, when you feel really low, to where you can eventually get back to that peak,” says Beckman.

When you’re experiencing anxiety or depression, “there are so many negative things you’re telling yourself through those moments,” says Boland.

He uses cognitive behavioural therapy to walk people through those moments and understand the thoughts and beliefs at work, helping them see things more objectively.

The goal is to “talk yourself through those moments to reduce stress and reduce inflammation.”

Having courage with dating

After her diagnosis, Lee photoshopped her profile picture on social media because she wasn’t ready to reveal her psoriasis to the world. When she finally did post a photo, it was on a separate page, as if compartmentalizing that part of herself.

Ahmed took the opposite approach. “My online dating game was trial by fire,” he explains. After talking to someone on a dating app, he’d offer to send photos — and he’d send shots of his psoriasis at its worst.

“One of two things would happen: They either didn’t say anything, blocked me, or deleted me,” he says, “or, they would say, ‘Oh, that’s really bad, can I help?’ And then we’d carry on the conversation as if it’s nothing, and that way I would know, ‘OK, there’s something here.’”

Cherry has learned that when it comes to intimacy, he gets in his own way. “It’s more me that’s the problem when it comes to dating and sex life, versus partners that I’ve had in the past,” he explains.

“I’m an overthinker, I have a lot of anxiety, so it caused me to feel self-conscious, especially when I would have flare-ups down there.”

His feeling has been, “Before they could judge me, I’m going to judge for them.”

Sex during flares

There’s no doubt that having psoriasis on your body — especially genital psoriasis, with its itching and pain — can affect your approach to getting intimate.

“Even in a relationship, even when you’re so close to somebody and you live with them, and you see them every day, it can be difficult to have those hard conversations,” says Beckman, who initially shied away from sex after her diagnosis.

“Ultimately,” she adds, “my partner loves me no matter what, and he’s been extremely supportive, and that’s helped instil confidence in me.”

Lindsey Bliss, a childbirth educator in Queens, New York, who’s been married for over two decades, says her psoriasis sometimes interferes with her sex life.

“I’ve had plaques all over my vulva and in my butt crack. I haven’t been physically intimate for extended periods of time because it hurt — I was bleeding,” she says, adding, “it impacted my marriage.”

A 2018 review found that the prevalence of lesions in the genital area was lower than reported changes in sexual function in people with psoriasis. The authors found that anxiety, depression, self-stigma, and treatments for psoriasis could contribute to sexual distress.

Touch is important for well-being, notes Dr. Susan Bard, board certified adult and paediatric dermatologist in private practice in New York City and clinical instructor at Mt. Sinai and Cornell. “When you treat somebody’s physical manifestations, the psychological manifestations of their disease can improve dramatically as well,” she says.

Mood during flare-ups

Accepting the feelings that go along with flare-ups has been helpful for Cherry. “I know a lot of people try to ignore the depression or ignore the sad feelings, but I embrace them,” he says.

“I’m a big believer in acknowledging when I’m sad or angry because I know it’s temporary — this is not my feeling for the rest of my life.”

Bonding with fellow people with psoriasis can be validating. When Lee first Googled psoriasis, she fixated on the idea that it would be forever.

“I was in a dark, dark place,” she says. But joining the psoriasis community on Instagram helped her “realize there are so many other people living through it,” Lee says, “and hearing and seeing their journeys is what ultimately got me out [of that dark place].”

When anxiety or depression gets overwhelming, medication can help.

A 2020 study in the Journal of Affective Disorders found that antidepressants appeared to have a protective effect against psoriasis in people with depression, actually lowering inflammation, which in turn alleviates both depression and autoimmune problems, according to the findings.

After her diagnosis during the summer of civil unrest following George Floyd’s death, Beckman took an online self-assessment and decided to be proactive about seeking treatment for her anxiety and depression. “Once I started, I saw a huge change in my mindset — and then a huge change in my psoriasis and in my skin.”

Achieving self-love and acceptance

Ahmed’s best advice to the newly diagnosed: “Learn to accept it,” he says. “Once you do, you can then start learning to enjoy your life again and stop obsessing."

Self-acceptance is the key to gaining the acceptance of others for people with psoriasis, according to 2020 findings in the journal Experimental and Therapeutic Medicine.

A key to acceptance for Ahmed has been to put things in perspective. When he was bed-bound and longed to be able to wear a T-shirt again without feeling pain, he learned how trivial a lot of his problems were. “Now whenever I have a problem with work, I don’t care as much because I can wear a T-shirt!” he says.

It took moving on from a victim mindset for Bliss, who also has psoriatic arthritis, to make peace with her condition. “I shifted the narrative to, ‘this is just a thing that I have to live with — it’s not something that defines me,’” she says. “It’s taken me probably, like, my whole life to get to this place and to realize that healing is not a destination.”

For Beckman, self-love comes from rock climbing, yoga, meditation, and taking oatmeal baths. “I’m making time for myself, living with gratitude and slowing down,” she says.

Cherry’s road to self-love involved showing his skin to the world and being more mindful about his negative self-talk. He’ll say, “I know I’m having this type of feeling — but it’s not going to define me.” It’s made a difference. “You’re still going to have psoriasis, but it’s going to affect you in a different way,” he says.

Lee also challenges her critical inner voice. “Psoriasis taught me how to speak to myself,” she says. “Now when I think, ‘Oh, are you stupid, or oh, why do you look like this, I know how to stop myself. I’m like, ‘No, your body is your vessel, you’re doing great. You look beautiful.’ It sounds so silly and cheesy,” she adds, “but speaking to myself in a beautiful manner changed so much for me.”

https://www.healthline.com/health/psoriasis-moments-that-matter/staying-socially-active-with-psoriasis-what-to-know

What to Know About Psoriasis and COVID-19

From verywellhealth.com

Risks, Complications, Considerations, and More

Living with psoriasis, you might wonder how COVID-19 might affect your health and your treatment plan. Fortunately, researchers have learned a lot since early 2020 about coronavirus, the virus that causes COVID-19, and how it affects different health conditions, including psoriasis.

The good news is that most of the data suggest the additional risks COVID-19 might pose to people with psoriasis are minimal. This includes people with psoriasis who are on medicines that affect the function of their immune systems.

Keep reading to learn more about the potential risks of COVID-19 for people with psoriasis, including treatment effects, how to stay healthy and reduce your risk for COVID-19 complications, and answers to frequently asked questions.

Psoriasis and COVID-19 Risk

Coronavirus has affected people all across the globe. For those with chronic health conditions like psoriasis, there is concern about the risk of contracting COVID-19 and for complications in an immune system that is already fragile.

What is known is that certain groups are particularly vulnerable to contracting COVID-19 and becoming severely ill, including people older than age 65 and people who have serious medical conditions, such as heart disease, diabetes, lung conditions, and kidney and liver disease. 

While the Centers for Disease Control and Prevention (CDC) doesn’t include people with psoriasis or other autoimmune diseases among those being at high risk, many people with psoriasis may have additional conditions that might put them at higher risk for COVID-19.

People with psoriasis also have a higher risk for infection, including respiratory infections and pneumonia, compared to others in the general population. The risk is even higher for people with severe psoriasis.

According to a 2021 report in the British Journal of Dermatology, people with psoriasis have a 36% increased risk for infection and a 33% increased risk for death due to infection. That risk exists with and without factors related to comorbidity (existing conditions).

Data were presented at the American Academy of Dermatology Virtual Meeting Experience 2021 regarding the connection between psoriasis and COVID-19 risk, and systemic (whole-body) treatments for psoriasis and how they might contribute to risk.

Overall, the study’s researchers found people with psoriasis were more likely to get COVID-19 when compared to others in the general population. Data showed a 33% increased risk based on the number of people with psoriasis who contracted COVID-19 compared to those without psoriasis (controls) who also contracted the virus.

They speculated that the increased risk was attributable to the use of systemic therapies that could increase the risk for upper respiratory infections, like COVID-19. People with psoriasis also have a higher risk for comorbidities, such as obesity and high blood pressure—conditions that have been linked to severe COVID-19 infections.

In this study, researchers reviewed data covering more than 280 million people. They identified people ages 20 and older who had either psoriasis or psoriatic arthritis from May 1, 2019 to January 1, 2020. They compared these cases to a follow-up period from January 1 to November 11, 2020.

The researchers found that the data subjects who were using biologic drug therapies (TNF inhibitors) had a lower risk than those using topical treatments for psoriasis. The use of TNF inhibitor biologic therapies showed an 18% reduction in COVID-19 occurrence, and TNF inhibitor users were 13% less likely compared to those on topical therapy to contract COVID-19.

In addition, people with psoriasis and/or psoriatic arthritis on some oral-systemic drugs, including methotrexate, had a lower chance of infection from COVID-19 when compared to people treating with topicals. With methotrexate, that reduction was 25% compared to 31% of controls.

People with psoriatic diseases using other types of biologic therapies—Stelara (ustekinumab) and IL-17 inhibitors—had a higher risk for contracting COVID-19. IL-17 inhibitors were linked to a 36% increase in COVID-19 occurrence, and Stelara was linked to a 37% increased risk compared to the controls.

This study doesn’t appear to have looked at the disease severity of COVID-19 once contracted by people with psoriatic disease (psoriasis and/or psoriatic arthritis) or COVID-19 outcomes among this group. Researchers only note that further research is needed to understand the full impact of systemic and biologic therapies on COVID-19 outcomes in people with psoriatic disease.

Symptoms of COVID-19 With Psoriasis

The symptoms of COVID-19 you might experience with psoriasis are the same as they would be for anyone else who gets COVID-19. The most common symptoms are fever, body aches, cough, fatigue, chills, headache, sore throat, and loss of smell or taste.

Some people might experience more severe symptoms, such as a high fever and shortness of breath. It takes about two to 14 days to develop symptoms if you have been exposed to COVID-19.

Complications of Psoriasis and COVID-19

If you test positive for COVID-19, have symptoms, or think you have been exposed to the virus, you should reach out to your primary doctor right away. Be sure to tell them you are taking immunosuppressive drugs to treat psoriasis.

If you test positive, you should also reach out to the doctor who treats your psoriasis so they can tell you how to manage your psoriasis care while you are recovering. They might suggest you alter or delay your next dose or treatments that suppress your immune system.

Your doctor will also give you information about treatment options for preventing a flare-up (period of high disease activity) during this time.

There isn’t enough evidence on how COVID-19 affects people with psoriasis or if they might be affected differently than people without psoriasis. Regardless, COVID-19 is highly transmissible and spreads rapidly, which means everyone is at risk. Even if you don’t have symptoms, you can still spread COVID-19.

Complications of COVID-19—acute respiratory distress, cardiac injury, blood clots, and more—can affect anyone who contracts the infection, especially those with a higher risk for the condition.

But it is unknown whether people with psoriasis have an elevated risk for these types of complications. The small amount of research available seems to indicate that their risk isn’t different from others in the general population.

One small study reported in 2020 in the New England Journal of Medicine found that people with inflammatory diseases like psoriasis who took biologics and developed COVID-19 were not more likely to develop complications than people who weren’t taking these drugs. 

Additionally, the number of hospitalizations reported in this study was consistent with what was experienced by people without inflammatory conditions. However, the researchers found people with inflammatory diseases could have an increased risk for COVID-19 complications in the presence of co-occurring medical conditions like heart disease and chronic obstructive pulmonary disease (COPD).

An April 2021 report in the Journal of Clinical Medicine suggests biologics are beneficial to people with psoriasis who contract COVID-19. The report’s authors note that there are many case reports of people with psoriasis who are presenting with mild COVID-19 infections, and these cases mainly seem to have more favorable outcomes.

The authors also note that while higher levels of TNF have been found in people with COVID-19, overall they believe that TNF inhibition is effective in reducing coronavirus and associated complications of COVID-19, including organ damage.

IL-17 inhibition might also be effective in controlling inflammation that could lead to COVID-19 severe disease, but the study’s authors note that the role of IL-23 inhibition and processes in COVID-19 was not yet known.

The study’s authors emphasize the importance of adherence to psoriasis treatments during the current pandemic. They also stress that psoriasis treatment isn’t a prevention tool for COVID-19, and they encourage people with psoriasis to get the COVID-19 vaccine.

Long COVID-19 and Psoriasis

Most people who get COVID-19 recover completely within a few weeks. But some will continue to have symptoms, or long COVID, after their initial recovery. The term used to describe these people is “long haulers.” Symptoms in long COVID persist for more than four weeks after the initial COVID-19 diagnosis.

Older adults and people with serious medical conditions are more likely to experience lingering COVID-19 symptoms. Still, even younger, generally healthy people can feel unwell for weeks or months after their infection.

Common long COVID symptoms might include: 

• Fatigue
• Joint and/or muscle pain
• Shortness of breath or breathing difficulties
• Memory or concentration troubles
• Chest pain or cough
• Sleep problems
• Fast or pounding heart rate
• Loss of taste or smell
• Depression or anxiety
• Dizziness
• Fever

Researchers don’t know if people with psoriasis or other autoimmune disease have a higher risk for long COVID. However, some have been studying the link between COVID-19 and the development of autoantibodies—similar to the same autoantibodies responsible for psoriasis inflammation.

Autoantibodies are immune cells that mistakenly target healthy tissues and organs. The research has shown that these autoantibodies can act as a driving force in long COVID.

While this research is helpful, it doesn’t explain if having pre-existing autoantibodies in psoriasis and other autoimmune conditions could contribute to more severe COVID-19. Additionally, it doesn’t give any indication of how long COVID might affect someone with psoriasis.

Even if an additional risk of long COVID for people with psoriasis exists, most people who have severe psoriasis are already on medications that counteract the inflammatory response of autoantibodies, which could potentially reduce the risk for long COVID.

Unfortunately, the researchers in the long COVID study did not discuss this issue or the effects of treatment of long COVID in people with psoriasis.

Psoriasis Treatments and COVID-19

People who are immunocompromised are believed to have a higher risk for COVID-19. While this usually applies to people with cancer on chemotherapy and those with poorly controlled HIV/AIDS, it can also apply to people who take medications that affect the function of their immune systems. 

People with psoriasis will use different immunosuppressive drug therapies, including methotrexate, biologics, cyclosporine, and Janus kinase inhibitors. Taking these medicines can partially inhibit your immune system, which adds to your infection risk.

The current guidelines of the American Academy of Dermatology recommend that people who take immunosuppressive drugs continue to take them unless they test positive or if they have symptoms of COVID-19. 

Further, most recent research suggests people with psoriatic disease, including those on biologic drug therapy, are at no additional risk for contracting or being seriously harmed by COVID-19 from their psoriasis treatments.

According to the National Psoriasis Foundation COVID-19 Task Force, the overall existing data suggest that most treatments for psoriasis “do not meaningfully alter the risks of contracting SARS-CoV-2 or having a worse course of COVID-19 illness.”

The effects of immunosuppressive therapy on the immune system aren’t a reason to stop treatment. Your doctor is the best person to answer questions about your treatment plan. They can also best advise you on how the pandemic might affect your health situation and current treatment plan.

It is never a good idea to make any changes to your treatment plan without first consulting with your doctor. Provided you have not been diagnosed with COVID-19 and don’t have symptoms, sticking to your treatment is an important way to stay healthy. It is also the best way to keep your psoriasis from flaring up and increasing your infection risk.

How to Stay Safe

Having psoriasis and a compromised immune system is a good reason to want to stay healthy.

To minimize your risk for COVID-19, take the following CDC precautions:

• Stay home as much as you can.
• Avoid crowds, and limit close contact with others when out in public.
• Avoid touching your face, nose, and mouth when out.
• Avoid touching frequently touched surfaces—such as doorknobs and shopping carts—when out in public. Carry disinfecting wipes for when you need to touch surfaces.
• Wear a mask when in a crowded place.
• Talk to your doctor about whether the COVID vaccine is an option for you, and if it is, get vaccinated as soon as you can.
• Wash your hands with soap and water for at least 20 seconds or use hand sanitizer after coming inside or after touching commonly touched surfaces.

Handwashing With Psoriasis

People who have inflamed skin or scaly plaques on their hands may have a harder time washing their hands or using alcohol-based sanitizers.

Try using hypoallergenic foaming soaps, and avoid ones with harsh abrasives and antibacterial formulas. Make sure you rinse well with water.

Last, use a thick, hydrating cream after patting your hands dry to moisturize skin. Petroleum-based moisturizers like Vaseline are a good bet.

If you find your skin becomes irritated from handwashing or moisturizing, ask your dermatologist about products that might be safer for your psoriasis-prone skin.

Summary

Having psoriasis does not put you into a high-risk group for COVID-19 infection or complications. People with psoriasis who are taking immunosuppressive therapy should continue to do so. If you test positive for COVID-19, your healthcare professional will advise what modifications may be needed.

The COVID-19 vaccine is recommended for people with psoriasis. It, and standard infection-prevention precautions, are the best way to avoid COVID-19.

A Word From Verywell

The COVID-19 pandemic has proved to be a challenging time for people managing serious illnesses like psoriasis. But having psoriasis in the middle of a pandemic doesn’t mean you should fear going out, going to your doctor’s office, or getting infusion therapies.

Preventing COVID-19 can be as simple as getting vaccinated and practicing good hygiene. These practices might seem tiresome, but they are the most important tools you have for reducing your chances of getting sick and for keeping psoriasis managed.

Frequently Asked Questions

Should I get a COVID-19 vaccine if I have psoriasis?

You are probably wondering if it is safe for you to take the COVID-19 vaccine. The answer is yes for most people with psoriasis. Both the International Psoriasis Council and the National Psoriasis Foundation recommend that people with psoriasis take the vaccine.

According to the International Psoriasis Council on COVID-19, “there is no evidence that vaccines affect psoriasis onset or severity.” 

The National Psoriasis Foundation recommends people with psoriatic disease, who have not previously had problems with vaccination, receive the “mRNA-based COVID-19 vaccine as soon as it becomes available to them based on federal, state, and local guidance.”

If you have any concerns about taking the vaccine or worry you might have adverse skin effects from the vaccine, talk to your doctor. They are the best source of information about the vaccine, and they can offer advice based on your unique health situation.

Is the COVID-19 vaccine effective for people with psoriasis?

Research has found one in 10 people with autoimmune diseases, including psoriasis, may not be properly protected against COVID-19.

Additional research suggests that people using systemic medications, such as methotrexate and Rituxan (rituximab), might respond poorly to the vaccine, but these findings are still in the early stages. 

None of the research confirms or suggests that people with autoimmune diseases should avoid vaccination. In fact, the American College of Rheumatology recommends that all people with rheumatic and autoimmune diseases get vaccinated. 

They note that even if vaccines do not offer full protection, they are still a benefit to the public. This is because even partial protection can guard against severe symptoms, life-threatening complications, and death from COVID-19.

Is COVID-19 more dangerous for people with psoriasis?

Even though people with psoriasis have a higher risk for infection, no evidence to date has found that COVID-19 might be more dangerous for them in comparison to others without the condition.

What the research does show is that having other risk factors, including older age and serious medical conditions, adds to the risk for a more severe illness or complications from COVID-19. 

Your doctor is the best resource when it comes to questions and fears you may have about your risk for COVID-19. You should always reach out to your doctor if you think you might have COVID-19 or if you experience new or changed psoriasis symptoms.

How high is my risk of being exposed to COVID-19 if I come in for psoriasis treatment?

COVID-19 has made treating serious health conditions like psoriasis more challenging, but even so, you still need to communicate with your doctor and attend regular appointments.

Even in a pandemic, you can go to inpatient appointments because your doctor and their staff are doing everything to keep you safe when you come to their offices.

Precautions being taken include limiting the number of people coming in and out of their spaces, practicing masking, creating ways to physically distance, screening for COVID-19, disinfecting frequently touched surfaces, and sanitizing stations for staff and patients.

If you don’t feel like coming into your doctor’s office or you are not feeling well, you have the option of telemedicine. That way, you can still meet with your doctor and get treatment using various videoconferencing technologies in real time, including Zoom and FaceTime.

Studies have found that people with psoriasis who received treatment via telemedicine had similar outcomes to people who saw their dermatologists in person.

https://www.verywellhealth.com/psoriasis-and-covid-19-5190781

Finger psoriatic arthritis: Symptoms and treatment

From medicalnewstoday.com

Psoriatic arthritis (PsA) is a chronic condition that occurs in people with psoriasis. Psoriasis is an inflammatory disease that affects the skin and nails and can also affect the joints. Finger PsA may cause pain and swelling in one or more finger joints.

In most cases, psoriasis occurs in early adulthood, with one-third of people going on to develop PsA after the age of 30. A milder form of psoriasis can also develop later in life, but typically, this form does not cause arthritis. 

Once PsA develops, it can start to damage the bones after a few months, so it is important to seek medical advice and treatment for the condition.

In this article, we will look at PsA in the fingers, including the symptoms, treatment, and management.

How does PsA affect the fingers?

It is common for PsA to affect smaller joints, such as those in the fingers. Often, the condition affects the joint closest to the nails.

People who develop PsA in the fingers may experience:

• pain and swelling
• difficulty bending the finger
• reduced range of motion
• misshapen finger joints
• white or silvery patches on the skin that may itch
• pitted or indented nails

PsA typically affects joints asymmetrically, which means it may develop in one hand and not the other. The symptoms can range from mild to severe and may progress, decrease, or remain the same for long periods of time.

The condition often affects the area of the hands closest to the nails, causing swelling that resembles gout. 

In the later stages of PsA, the spaces between joints may narrow or completely disappear due to a loss of cartilage.

Can PsA affect just one finger?

Yes, people can have PsA symptoms in just one finger, or just in one hand, according to the Arthritis Foundation. 

PsA affects everyone differently. Doctors are not sure what causes it or why some people with psoriasis develop joint problems where others do not.

However, it is likely that a combination of genetic and environmental factors plays a role.

Can PsA cause trigger finger?

Trigger finger, also known as tenosynovitis, occurs when a pulley in the hand becomes inflamed. Each finger has a sheath, or “tunnel,” of tissue that acts like a pulley, holding tendons in place as they move. If this part of the finger thickens, the finger will become stuck in a bent position.

Tenosynovitis can occur in many places around the body, but it most frequently occurs in the hands, wrists, and feet.

A 2018 study suggests that in people with PsA, these pulleys are thickened, which could result in PsA-related trigger finger.

However, trigger finger does have other causes, including infections. Sometimes, infections that cause the condition are serious and spread quickly.

That is why it is important to seek guidance from a doctor if a person develops trigger finger, especially if redness and swelling are present.

Diagnosis and treatment of finger PsA

When diagnosing PsA in the fingers, doctors will begin by taking a medical history.

If an individual already has psoriasis or if their family has a history of the condition, this may help determine the cause of finger pain and swelling.

Next, doctors may examine the hand. They will look for:

• inflammation and swelling in the joints
• inflammation in places where tendons attach to bones
• difficulty moving the fingers, including trigger finger
• nail changes
• skin changes
• skeletal disorders in other parts of the body

Doctors may also order imaging tests, such as radiography, ultrasonography, and MRI scans.

Treatment for PsA may entail:

• corticosteroid medication or injections
• nonsteroidal anti-inflammatory drugs (NSAIDS)
• disease-modifying anti-rheumatic drugs
• anti-tumour necrosis factor agents

Doctors choose treatments based on the severity of a person’s symptoms. Some people may only need NSAIDs or to take medications during flare-ups, while those with more advanced PsA may need more intensive treatment.

In some cases, surgery may be necessary to address damage.

Not all of these drugs are suitable for everyone. That is why doctors will take into account any other medical conditions a person has, any medications they are taking, their individual response to different treatments, and risk of side effects.

Tips for living with PsA in the fingers

Living with PsA can be challenging, particularly if it inhibits movement in the hands.

People can look after the health of their joints and manage the symptoms of PsA by trying:

• hot and cold therapies, which can ease pain and swelling
• stretching and flexibility exercises to improve the health of the joint
• an anti-inflammatory diet that contains plenty of fruits and vegetables
• avoiding things that worsen inflammation, such as tobacco, alcohol, saturated fat, and sugar
• reducing sources of stress, which can aggravate PsA flare-ups
• learning relaxation techniques to relax the muscles, slow breathing down, and boost mental well-being

It is important to look after the health of other joints in the body, even if they have not become affected by pain and swelling. Regular low-impact exercise, such as walking or swimming, can improve health without placing strain on the joints.

It is also advisable to protect the skin if a person has psoriasis on the affected joint. People can do this by:

• taking warm, but not hot, baths or showers
• using colloidal oatmeal, Epsom salts, or Dead Sea salts in the bath
• applying moisturizers after getting the skin wet, particularly ones that contain aloe vera, zinc, or jojoba
• wearing rubber gloves to protect the hands while washing the dishes or cleaning
• using unscented products to avoid skin reactions

If a person struggles to move their finger much or if PsA affects multiple joints, they may benefit from consulting an occupational therapist. These are medical professionals who can help a person adapt their home and learn how to use assistive devices so that everyday tasks become easier.

Other potential causes

There are other conditions that can cause symptoms similar to those of PsA. If a person does not have psoriasis, the cause of finger swelling may be something else.

Some examples of conditions that could result in finger joint inflammation include:

• osteoarthritis
• gout
• rheumatoid arthritis
• reactive arthritis, which occurs as a response to infection in another part of the body
• ankylosing spondylitis, which causes inflammation and fusion of bones in the spine
• trigger finger

When to contact a doctor

If a person suspects they have psoriasis or PsA, they should contact a doctor for diagnosis and treatment as soon as they can.

Without treatment, the symptoms may continue or get worse over time. PsA can also cause damage to bones, which is irreversible.

Additionally, people should seek guidance from a doctor if they have any other unexplained symptoms, such as:

• pain or swelling elsewhere in the body
• morning joint stiffness
• fatigue
• fever or hot flashes
• general malaise, or feeling of being unwell

These could be signs of other conditions that resemble PsA.

Summary

Finger PsA causes pain and swelling in the finger joints. It can affect just one finger or one hand. While PsA occurs in people with psoriasis, doctors do not know the exact cause of the condition.

Doctors can diagnose PsA with the help of physical examination and diagnostic and medical imaging tests.

Treatment can depend on how severe the symptoms are but may include a combination of medications and diet or lifestyle changes.

https://www.medicalnewstoday.com/articles/finger-psoriatic-arthritis

Targeting a skin protein may reduce the severity of psoriasis, study reveals

From news-medical.net

Results from a Michigan Medicine study reveal that targeting a protein found in the skin may reduce the severity of psoriasis.

Interferons play a major role in activating the body's response to viral threats, but they have also been detected in the lesions of many psoriasis patients at abnormal levels. Psoriasis is an autoimmune disease that causes overproduction of skin cells and impacts nearly 30 million people in the world.

Using a model that mimics psoriasis in mice, researchers found that changing the levels of interferon kappa, a protein made by skin cells, altered the severity of inflammation and production of cell signalling molecules, called cytokines, that induce inflammation characteristic of psoriasis. Investigators found more psoriasis-like inflammation when more interferon kappa was present, while decreasing interferon kappa levels reduced disease.

The findings, published in the Journal of Investigative Dermatology, suggest using therapies to modulate interferon states may limit inflammation in psoriasis patients.

The research team induced psoriasis in mouse models, splitting them into groups with interferon kappa at low, normal or elevated levels. The overexpressed protein alone didn't induce the disease, but it primed the skin for the inflammatory response that followed.

"This work shows how the context of the skin environment can shape inflammatory responses." said Mehrnaz Gharaee-Kermani, DVM, M.P.H., Ph.D., lead author of the study and a senior research lab specialist at Michigan Medicine. "It will be exciting to see how this can be applied in clinic."

The research team is conducting further studies to understand the role of interferon kappa in psoriasis patients through their Taubman Institute-sponsored study at Michigan Medicine and in partnership with Johann E. Gudhonsson, M.D., Ph.D., receiving funding through the National Psoriasis Foundation. Several treatments are used against the disease, but there is no cure.

A few current psoriasis drugs inhibit interferons, but many that are more specific are still in the trial phase. Coupled with the study's findings, personalized medicine will be paramount as physicians attempt to treat this disease, Kahlenberg said.

"Until now, treatments have been tested by studying a drug in hundreds of patients, lumping the average of them all together and targeting the average of those patients," Kahlenberg said. "As any patient who has been on these medications will tell you, this trial–and-error approach wastes patient time and money trying to get control of the disease. Understanding a patient's background level of interferon might help us target things within that person to make their disease better faster and stay in remission."

https://www.news-medical.net/news/20210812/Targeting-a-skin-protein-may-reduce-the-severity-of-psoriasis-study-reveals.aspx

Does Psoriasis Spread? Here’s What You Need to Know

From greatist.com

Written by Leandra Beabout

Medically reviewed by Susan Bard, MD

Some rashes are contagious AF. But a psoriasis rash isn’t just any old rash. Here’s the lowdown on how psoriasis spreads (and how it doesn’t).

Repeat after us: Psoriasis 👏 is 👏 not 👏 contagious. 👏 Not now, not ever.

A psoriasis flare-up can spread to different parts of your body, but it can’t spread to a different person.

Here’s the scoop: Psoriasis is propelled by your immune system, which is why most docs and researchers file it under “autoimmune diseases.” Basically, the inflammation erupts from *inside* your body, not in response to a single outside irritant.

What’s causing that inflammation? It’s essentially friendly fire from your immune system. Your immune system is responding to a trigger and lashing out at the wrong guys (your skin cells). This attack shows up as rashes and plaques on different parts of your body.

So when a psoriasis flare spreads, it’s not because you accidentally touched your arm to the plaque on your leg. It means your immune system is still misguided, but in a new location.

Psoriasis can spread differently depending on the type:

• Plaque psoriasis. These scaly, raised patches of skin can crop up all over your body. They most often occur on the scalp, knees, and elbows.
• Guttate psoriasis. These tiny pink bumps are scaly. They spread fast along your arms, legs, and torso. Some folks also get flare-ups on their face and scalp.
• Inverse psoriasis. These raw, red patches spread in your body’s folds — e.g., your butt, armpits, and groin.
• Erythrodermic psoriasis. These bright red patches look like burns and spread quickly all over your body. A flare-up can also cause uncontrollable shivering and ankle swelling. 🚨PSA: This type of psoriasis is super rare, but it can be life threatening. If you’re experiencing symptoms of erythrodermic psoriasis, get to the emergency room! 🚨

Can you keep psoriasis from spreading?

Maybe! You can definitely take steps to help.

Treat it, stat

Notice the first signs of a flare-up? Start giving your skin a little TLC! Like most other rashes, psoriasis is more likely to dig in its heels when you don’t treat it.

Start by keeping the area clean and makeup-free. Then, you can move in with soothing home remedies or medications.

Figuring out your most effective treatment(s) is a process of trial and error. It’s best to get help from a doctor or dermatologist who specializes in psoriasis.

Avoid triggers

Kinda goes without saying, right? But if you feel a flare-up coming on, now’s the time to baby your skin, eat nutritious foods, and do what you can to dodge common triggers like sunburn, bug bites, and stress.

Infections and illnesses can be triggers, too, so take steps to protect yourself from those whenever possible.

Try not to scratch

Resist the urge! Scratching can contribute to spreading. It can also lead to infection — and infection = a longer-lasting flare-up.

The faster you calm the eruption, the lower the chance that it will spread.

Can’t stop the itch? Hydrate your skin as much as possible.

What’s triggering your psoriasis flare?

Science isn’t exactly sure what causes psoriasis. It seems to be a combo of genetics, environmental triggers, and your immune system going rogue against your skin cells.

If you’re genetically predisposed to psoriasis (gee, thanks, fam), you’ll prob experience your first flare-up because of an environmental trigger.

Here are some common culprits:

• stress
• cold weather
• UV exposure
• skin injuries (everything from sunburn and bug bites to tattoos and vaccine jabs)
• certain meds (such as lithium, antimalarial drugs, and beta-blockers)
• infections (There’s a documented link between strep throat and guttate psoriasis.)
• alcohol
• smoking

Even folks with a tried-and-true treatment protocol can get flare-ups. There’s just no way to control *everything* around you — and trying to control everything would be a lot of stress. (Go figure.)

Most psoriasis flare-ups start as a small itchy patch that spreads pretty quickly. Scratching it won’t speed up the spread, but it could lead to irritation and infection.

Common psoriasis treatments to try

There’s currently no cure for psoriasis (ugh), but there are heaps of at-home and medical treatment options. Most aim to soothe inflammation and keep flare-ups from spreading.

If you’re frustrated by a psoriasis flare-up that just won’t quit, keep looking for options to fight it. Most people try several treatments before landing on one or two that work for them.

Topical treatments

The most basic treatments on the market? Lotions and potions.

• Fragrance-free moisturiser. It’s vital to keep your skin hydrated so it can heal quickly. Bonus points for soothing moisturisers that reduce the urge to scratch!
• Corticosteroid creams and gels. Steroid creams like hydrocortisone are considered safe and effective for most folks. They can soothe itching and speed up your skin’s natural healing process. Just remember to use them sparingly, because long-term use can cause skin thinning.
• Tar soap. People have used tar soap to quash psoriasis flare-ups for ages. Just review the potential side effects and use it for only a few weeks at a time.
• Salicylic acid. Soaps and gels with salicylic acid can help gently exfoliate flaky plaques away. But these products can be *too* exfoliating at times, so use a gentle solution and run any questions or reactions by your dermatologist.
• Aloe vera. This skin care classic won’t cure your flare-up, but it certainly can soothe the itch.

Phototherapy

Step into the light! Phototherapy is a treatment that involves exposing your skin to ultraviolet (UVB) light. And no, we’re *not* talking about your neighbourhood tanning salon!

This treatment works by dialling down inflammation and skin cell production. It can be super helpful for stopping the psoriasis spread, but it does have drawbacks. Too much phototherapy could increase your risk of skin cancer and contribute to signs of aging in your skin.

Phototherapy for psoriasis will require a visit to the doc. The experts can help you figure out the best light equipment and schedule if you want to bask in the rays at home.

If you’re digging your results from phototherapy, your doctor might also recommend supplemental treatments like laser therapy and PUVA, which combines phototherapy with a medication called psoralen.

UV rays are always available from the sun, but phototherapy for psoriasis requires some fine-tuning. Definitely talk with your doctor before using sunlamps or other non-prescription lights.

Oral medications

Topical treatments not cutting it? Your doctor or dermatologist can help you explore prescription medications for psoriasis.

A few common options:

• antibiotics (to combat underlying infections that may trigger flare-ups)
• acitretin (a systemic oral treatment)
• cyclosporine (another systemic med)
• methotrexate (yet another systemic)
• apremilast (to reduce inflammation)

Systemic medications help dial down your immune system’s overreaction to environmental triggers.

Biologics

Biologics are drugs administered through an injection or IV. They work like systemic meds — by targeting your immune system’s hyper-reactivity.

Heads-up: Dermatologists won’t just give you biologics because you ask for ’em. These heavy-duty injectables are usually reserved for folks with moderate to severe plaque psoriasis.

A few common biologics on the scene:

• adalimumab (Humira)
• risankizumab-rzaa (Skyrizi)
• certolizumab (Cimzia)
• ixekizumab (Taltz)

Alternative therapies

Is stress one of your main psoriasis triggers? There’s help for that.

Some people living with psoriasis swear by these alternative measures:

• acupuncture
• meditation
• talk therapy

Bottom line

Psoriasis doesn’t spread the same way a contagious rash would. A psoriasis rash is caused by an immune response that’s triggered by something in your environment, so it isn’t possible to pass this rash to another person.

But it can spread across your body as your immune system attacks more healthy skin cells. That’s why it’s important to identify your triggers and find a treatment that can help ease your symptoms.

https://greatist.com/health/does-psoriasis-spread

The One Ingredient a Dermatologist Is Begging You To Stay Away From if You’ve Got Psoriasis

From wellandgood.com

Treating psoriasis can be tricky business. While there are a number of effective options out there—like topicals, UV light, and biologics—according to Mona Gohara, MD, a board-certified dermatologist based in Connecticut, successfully getting rid of flare-ups is just as much about what you don't do to your complexion as what you do to it.

Psoriasis is characterized as an inflammatory skin condition that shows up in scaly patches that occur primarily on "high-pressure" areas, like your scalp, elbows, and buttocks (though it's worth noting that these patches can show up anywhere). In the latest episode of Dear Derm, Dr. Gohara breaks down exactly what goes into a solid psoriasis-fighting routine. To avoid flare-ups, she suggests staying away from anything that might cause irritation to the skin, and one of the main culprits, according to her, is fragrance.

"Fragrances, as much as we love them, can act as skin irritants in many situations," says Dr. Gohara. "So particularly when we have inflammatory skin conditions, such as psoriasis we want to make sure that the skin barrier remains intact and isn’t irritated so it can do its job in fortifying our skin and keeping it protected from further inflammation."

A note to this end: Some beauty products contain "masking fragrances" that are added to formulas to disguise chemical scents. This means that even products that say "unscented" on the label can contain fragrance. To ensure that you're reaching for a bottle without fragrance, make sure your formula says that it's fragrance free.

In addition to watching out for rogue scents, you'll also want to take a discerning eye to the sudsy formula you use to clean your face and body. "When we scrub our skin with harsh soaps or cleansers or rub really hard, it makes room for psoriasis to come out more," says Dr. Gohara. To avoid this, she recommends using oil-based cleansers because they effectively remove makeup, dirt, and grime without needing to rub skin too hard, which means they'll help you avoid friction and irritation.

https://www.wellandgood.com/skin-psoriasis-treatment/