10-20 pc women experience psoriasis during pregnancy

From sambadenglish.com

Hormonal changes caused during pregnancy can trigger the risk of psoriasis in about 10-20 per cent of women, said health experts 

New Delhi: Hormonal changes caused during pregnancy can trigger the risk of psoriasis in about 10-20 per cent of women, said health experts on Saturday.

Psoriasis is a commonly seen chronic autoimmune condition that causes skin inflammation, with thick, itchy, scaly patches, most commonly on the knees, elbows, trunk, and even the scalp. The common symptoms are red patches, rashes, scaling of the skin, dry and cracked skin, itching, and soreness. It is caused due to an overactive immune system that causes inflammation.

“Pregnancy is an exciting and life-changing phase for women. Though, it can often bring about various challenges for expectant mothers and one concerning problem is psoriasis. The hormonal fluctuations during pregnancy often lead to variations in immune response, which can trigger flare-ups,” said Dr Jisha Pillai, Dermatologist, Lilavati Hospital Mumbai. “Around 10-20 per cent of women may suffer from psoriasis during pregnancy. However, there will be no risk to the foetus due to psoriasis,” added Pillai.

Pillai noted that stress during pregnancy can also aggravate existing psoriasis and lead to the new onset of this condition. Moreover, changes in skincare routine and sensitivity to environmental triggers might position pregnant individuals at greater risk for outbreaks. Other trigger factors include smoking, secondhand smoke, alcohol, skin infections, cold weather, and certain medications.

Besides pregnancy hormones that can affect the immune system and skin, potentially altering psoriasis severity, changes in medicines can also work as potential triggers for psoriasis.

“Many psoriasis treatments are not recommended during pregnancy due to potential risks to the foetus. Women may need to discontinue certain medications, which can lead to flare-ups,” said Dr. Parinita Kalita, Associate Director, Obstetrics And Gynaecology, Robotic Surgery, Max Super Speciality Hospital. Women with more severe psoriasis before pregnancy may also have a higher risk of exacerbation, the doctor noted.

The health experts stressed the need to consult a dermatologist and an obstetrician to help manage psoriasis effectively during pregnancy. They must use products suggested by dermatologists only and avoid self-medication for managing symptoms of this condition.

“Women must report symptoms of psoriasis such as red patches, scaling of the skin, and itchiness without any delay for seeking timely intervention,” Pillai said. (IANS)

https://sambadenglish.com/miscellany/health/10-20-pc-women-experience-psoriasis-during-pregnancy-experts-7380099

How to get psoriasis under control

From krone.at

It's hard to imagine how much psoriasis affects patients' quality of life - especially if you are not affected yourself. But those affected should not despair, because the chronic skin disease and the associated symptoms can now be treated effectively 

There are many sad stories of fathers whose children are reluctant to hug them or of people who don't invite anyone home spontaneously because they can't vacuum up the flakes of skin scattered around their home so quickly. "Suffering from psoriasis is a huge burden on life," confirms Dr. Katharina Wippel-Slupetzky, a dermatology specialist in Vienna. "So it's all the more important to know that you don't have to put up with it. Although there is no cure for the skin condition, with the right treatment it is now possible to be symptom-free - and not have to be satisfied with a slight improvement in symptoms."

However, there is still a lack of knowledge about this non-contagious skin disease - even among young patients, the expert is surprised to learn. At first, they often know little about the unpleasant, itchy, rough and scaly patches on their bodies. These are often found on mechanically stressed areas such as the knees and elbows, but also on the scalp and sometimes on the palms of the hands, soles of the feet and in so-called inverse areas such as the genital area, armpits and anal folds. The joints are involved in up to 30% of cases.

Various triggers trigger the condition

"There is often a genetic background, even if only distant relatives are affected. This mainly affects psoriasis that occurs before the age of 40; in a third of cases, the disease develops before the age of 16. There is a second peak from the age of 40, usually in the 5th to 6th decade of life," explains the expert. Infections such as streptococci, but also smoking, alcohol, stress or some medications (certain drugs for high blood pressure) can trigger the outbreak of psoriasis.

The appropriate treatment for this unpleasant skin condition is discussed with the doctor.

(Bild: stock.adobe.com/B. BOISSONNET)

Sometimes very emotional or stressful phases of life also cause the condition. "A great deal has improved in terms of treatment in recent years," says Dr. Wippel-Slupetzky. "There are now various good local therapies such as creams and sprays. Irradiation with UV light, some immunosuppressive tablets such as methotrexate and those that block inflammatory messengers also help. However, drugs called biologics have revolutionized therapy. These inhibit inflammatory messengers in the body."

The way these drugs are administered is also advantageous, explains the expert: "Depending on the active ingredient, injections or infusions are administered. The frequency ranges from every few days to several times a year. This makes everyday life easier, as the application takes less time. However, basic skin care should be maintained." Of course, the doctors discuss which therapy would be best together with those affected.

"The rough rule of thumb is that if more than 10 percent of the skin is affected, systemic therapy is recommended, i.e. the entire organism is treated, be it with UV radiation, tablets, injections or infusions. If so-called 'upgrade criteria' are present, such as the infestation of visible areas such as the face, hands, severe nail infestation, but also involvement of the genital area, these therapies are also used for skin involvement of less than 10 percent." It is also important to consider the patient's individual circumstances in order to select the most suitable therapy for them.

Psoriasis often affects more than just the skin

Psoriasis is much more than just a skin disease, as it affects the entire body. Those affected have a higher risk of cardiovascular disease, for example. Sometimes the joints are also affected, which is referred to as psoriatic arthritis. "30 percent of psoriasis patients develop this disease, but the skin does not necessarily have to be affected first," says Dr. Wippel-Slupetzky. "In general, nail, scalp and intimate areas are strong warning signs for the possible development of psoriatic arthritis. Skin symptoms and joint complaints that occur together should therefore always be linked and shown to a specialist."

According to the expert, patients should: "Take care of your health: go for a check-up, don't smoke and ideally don't drink alcohol or only drink a little. It is also important to aim for a normal weight, as abdominal fat in particular produces inflammatory messengers that fuel psoriasis. You should eat a Mediterranean diet with fish, olive oil and lots of vegetables."

https://www.krone.at/3577493

Can Vitamin D Help With Psoriatic Arthritis? Here’s What Experts Say

From healthcentral.com 

Research has found people with psoriatic arthritis tend to be low in this essential vitamin—but the jury is out on whether a supplement can help

Psoriatic arthritis, an autoimmune disease fuelled by out-of-control inflammation, can cause symptoms like joint pain, fatigue, and swelling from head to toe, so it's no surprise that people might be looking for ways to get relief. And one option that has gotten some attention is vitamin D, which some consider to be one of the best supplements for psoriatic arthritis.

But in reality, the relationship between psoriatic arthritis and vitamin D is—as with a lot of supplements —a tricky one to figure out, since the science behind it is still unclear. What might be driving the correlation? Vitamin D is one of the most promising vitamins for psoriasis (a related but still separate condition that appears on the skin), so there’s reason to be optimistic. So, do psoriatic arthritis supplements like vitamin D merit a spot in your medicine cabinet? Here’s what the experts say.

The Relationship Between Vitamin D and Psoriatic Arthritis

The connection between vitamin D and psoriatic arthritis is more complicated than it seems. Vitamin D, for reference, benefits your body on several fronts. “It’s important for bone health and has roles in the immune system and in maintaining skin health,” says S. Louis Bridges, Jr., M.D., a rheumatologist and physician-in-chief and chair of the Department of Medicine at the Hospital for Special Surgery in New York City.

Research has found that vitamin D deficiency was especially common among people with PsA—and that the lower their vitamin D levels were, the more disease activity, indicated by a higher DAPSA (Disease Activity in Psoriatic Arthritis) score, they experienced. DAPSA is a measurement of PsA severity that takes into account the joints affected, pain levels, and levels of C-reactive protein, which is an inflammation marker.

But it’s unclear whether low vitamin D levels are the cause or the result of inflammation, according to Dr. Bridges. “When there is inflammation, serum levels of vitamin D decrease,” says Dr. Bridges. “Low levels of vitamin D are associated with a variety of inflammatory states.” In other words, it’s like which came first—low vitamin D, which contributes to the uptick in inflammation and DAPSA, or the inflammation, which stifles the levels of vitamin D? It’s hard to say.

Should You Take Vitamin D to Treat Your Psoriatic Arthritis?

Taking vitamin D could be helpful if you have psoriasis alongside your PsA. “Oral vitamin D supplementation may have some benefits in psoriasis,” says Dr. Bridges, though he notes that most research focuses on the efficacy of topical creams applied to plaques (versus oral supplements). “They work by slowing down the rapid skin cell turnover associated with psoriasis and have immunomodulatory effects.”

As for psoriatic arthritis, vitamin D may help ease symptoms—in theory. But “there are no studies that definitively show this, and much more work is needed,” says Dr. Bridges. “We also need studies to understand the role of vitamin D in the development and treatment of PsA, and the differences in vitamin D metabolism between patients with PsA compared to psoriasis without arthritis.”

What are the Best Sources of Vitamin D?

Sunlight is the primary source of vitamin D. “Vitamin D is made or synthesized in the skin from its precursor, a type of cholesterol,” says Shailendra Singh, M.D., a rheumatologist at White County Medical Center in Searcy, AK. “When you're exposed to the sunlight, that vitamin D precursor is formed in the skin—and once that is formed, that is converted into its active form in the liver and the kidneys.” But if you don’t spend a lot of time outside, then sunlight alone might not be enough to make the amount of vitamin D you need.

If that’s the case, you’ll need to get it from your diet—and, ideally, you should be eating your vitamin D rather than taking it through a supplement, according to Dr. Singh. “There are several foods which are enriched in vitamin D,” he says. “Most of the milk available in the market is enriched with vitamin D, as are yogurt and cheese.” You can also find vitamin D in fatty fish and fish liver oil.

How Much Vitamin D You Need With Psoriatic Arthritis

Besides infants, most people need 15 micrograms (mcg) of vitamin D a day, according to the National Institutes of Health (NIH). (A cup of milk has 2.9 mcg, while three ounces of salmon and trout each have over 14 mcg.) Even if you have psoriatic arthritis, that’s all our experts recommended. “I do not recommend routine vitamin D supplementation to treat psoriatic arthritis,” says Dr. Bridges.

The Risks of Too Much Vitamin D

Because it can increase calcium absorption, taking too much vitamin D can lead to hypercalcemia—literally, excessive calcium—which in turn leads to nausea, vomiting, and kidney stones. And while too much vitamin D alone can lead to kidney failure, it's extremely rare, according to the NIH. Really, it only tends to become a problem if you’re taking a lot of different vitamins, according to Dr. Singh. “Overdosing on vitamin D is very, very difficult,” he says.

And, even when you take it in an over-the-counter supplement, “that vitamin D needs to be activated inside the kidneys and in the liver to become active vitamin D—and our body will only produce as much active vitamin D as it needs,” he says. The rest gets excreted out.

Talk With Your Doctor

If you’re curious about supplementing with vitamin D, talk to your doctor—but manage your expectations accordingly. If your doctor checks your vitamin D levels and they’re low, they might recommend a supplement, says Dr. Singh. And if they’re normal, then supplementing with vitamin D won’t add any extra benefit for your psoriatic arthritis. And remember, it’s not a cure-all, and should at most be part of an overarching treatment plan overseen by your doctor.

https://www.healthcentral.com/condition/psoriatic-arthritis/psoriatic-arthritis-and-vitamin-d