Mediterranean Diet Cut Psoriasis Severity Over 16 Weeks

From conexiant.com

Dietitian-guided Mediterranean diet increases adherence and improves patient-reported psoriasis measures 

A 16-week Mediterranean diet program may reduce psoriasis severity compared with standard low-fat dietary advice.

In a randomized clinical MEDIPSO trial, researchers found that the patients who were assigned to follow the Mediterranean diet had greater reductions in Psoriasis Area and Severity Index (PASI) scores, with nearly half reaching PASI 75, whereas no patients in the control group achieved this outcome.

Nine of the 19 patients in the Mediterranean diet group achieved PASI 75, five achieved PASI 90, and two achieved complete clearance. Thirteen reached PASI 50 compared with two in the control group. The mean change in PASI was −3.4 points for the intervention group and 0.0 for the control group.

Patient-reported outcomes also improved among those who received the intervention. These patients reported an improved quality of life and sleep as well as lower anxiety scores compared with controls. Depressive symptoms didn't change significantly.

Metabolic results were mixed. The intervention didn't produce differences in weight, waist circumference, cholesterol, or apolipoproteins. However, patients assigned to the Mediterranean diet had reductions in lipoprotein(a) and haemoglobin A1c compared with controls. Mild infections occurred in both groups but weren't linked to diet, and no hospitalizations were reported.

“The Mediterranean diet may exert beneficial effects in psoriasis through multiple metabolic and molecular pathways relevant to chronic inflammation,” said senior study author Álvaro Gonzalez-Cantero, MD, PhD, of the Hospital Universitario Ramón y Cajal in Madrid, and colleagues.

The researchers enrolled 38 adult patients with mild to moderate psoriasis on stable topical therapy. The mean age was 46 years, and 25 of the patients were male. The patients were randomly assigned 1:1 to follow either a structured Mediterranean diet program or low-fat dietary advice. The intervention included counselling with a dietitian, educational materials, and a weekly provision of extra virgin olive oil. Controls received standard advice without counselling. Thirty-seven patients completed the study. The trial was conducted at a dermatology referral clinic in Spain between February 2024 and March 2025. The design was open-label with blinded evaluators.

Adherence to the Mediterranean diet increased in the intervention group. Scores on the er-MEDAS adherence scale rose more than six points higher compared with those of the control group. Greater adherence correlated with greater improvement in PASI, suggesting a dose-response relationship.

The researchers acknowledged several limitations. The small sample size limited the ability to assess subgroup effects or detect rare outcomes. The study was conducted at a single centre, which may have reduced generalizability. The 16-week follow-up period didn't capture long-term adherence or durability of improvements. Because the participants knew their group assignment, self-reported outcomes may have been influenced by bias.

Full disclosures can be found in the study.

Source: JAMA Dermatology

https://conexiant.com/dermatology/articles/mediterranean-diet-cut-psoriasis-severity-over-16-weeks/

Build a Stronger Body With Psoriatic Arthritis Workout

From healthcentral.com

Created in partnership with the pros from the Hospital for Special Surgery, HealthCentral’s exercise plan features 10 moves to support your joints—and your well-being, too 

You know the feeling—that moment when you wake up, get out of bed, and realize you ache from head to toe. Nothing can slow your morning momentum like joint pain, and if you’re one of millions of people living with psoriatic arthritis (PsA), chances are the last thing you want to do during a flare-up is exercise. But in fact, a gentle, well-planned movement program could be some of the best medicine in alleviating the symptoms of this chronic joint condition.

“People with psoriatic arthritis have intermittent flare periods that can make them question whether they should be pushing through pain or discomfort,” says Jonathan Yu, a doctor of physical therapy at Hospital for Special Surgery in New York City. “It is very important to empower people to get into a regular exercise regimen and figure out what type of exercises can be used to manage pain.”

To help you find and keep the upper hand on PsA pain, HealthCentral teamed up with the Hospital for Special Surgery, the leading orthopaedic hospital in the country, to customize 10 basic made-for-you strength moves that you can do—starting now.

What Makes Movement Potent for PsA

While small joints are commonly impacted with psoriatic arthritis, the condition also can affect the large joints in your hips, knees, and lower back. No matter where you feel the pain, being proactive as you follow your doctor-prescribed treatment plan is the key to relief.

“Untreated psoriatic arthritis can cause joint damage, loss of motion, continuous pain, and swelling,” cautions Theodore Fields, M.D., a rheumatologist at Hospital for Special Surgery in New York City. “But exercise helps maintain the full range of motion of joints in those with psoriatic arthritis, while also strengthening the surrounding muscles that support the joints.”

The National Psoriasis Foundation recommends exercise to reduce inflammation and stay limber. Indeed, according to research, resistance training was shown reduce disease activity in those with PsA. Not only that, but a study published in Clinical Rheumatology reported that exercising regularly helped PsA warriors experience less pain and fatigue, better mobility, improved endurance, and a better quality of life.

That boost in quality of life is an important benefit beyond being able to touch your toes. Research shows that exercise can also help treat depression, something that one review found can affect up to 51% of people with psoriatic arthritis.

The message: Moving more can help you feel better both physically and mentally.

Even if you’ve been living with PsA for a while, it’s never too late to start. “Regular exercise even can improve lost range of motion in joints, and increase level of overall function,” says Dr. Fields.

10 Moves for Healthier Joints

To be at your best with psoriatic arthritis, the American Arthritis Foundation recommends a weekly blend of strength-building, stretching, and low-impact cardio such as walking, cycling, and yoga. With this in mind, Yu created the perfect strengthen-and-lengthen plan for those with PsA.

“I chose these exercises because they are weight bearing, helping strengthen the major muscle groups of the body, while also improving dynamic balance and increasing range of motion,” says Yu. “Stronger muscles can help support and reinforce your joints, and strength training has an additive effect of loosening up the joints, which helps decrease stiffness.”

Yu recommends doing this workout three to five times per week (the routine takes roughly 15 minutes from start to finish), depending on your schedule and current physical condition. “If you have never exercised before, choose four or five of these exercises to do each day, and complete one to two sets per move,” says Yu. “If you have more experience with exercise, perform three sets of each move, and complete the entire program each time you work out.”

Begin each workout with five to 10 minutes of gentle activity such as walking or cycling on a stationary bike to prepare your muscles and joints for the task at hand. Once you’re finished, cool down similarly with a gentle cardio activity to help reduce your heart rate and return to normal.

Squats

Why they work: “Squatting is a daily activity in life, and we perform this motion when sitting and lifting, for example,” says Yu. The squat engages the large muscles in the lower body, such as the glutes, quadriceps, hamstrings, and calves. Strengthening these muscles helps support PsA-inflamed joints in your hips, knees, and ankles.

How to do them: Stand with your feet just outside shoulder-width apart with your arms at your sides or in front of you for balance. Keep your chest lifted and your focus in front of you as you push your glutes back, then bend your knees. Slowly squat down as low as you can, ideally until your knees and hips come level, with your thighs parallel to the floor. Pause briefly, then extend your knees and hips to return to standing.

Do three sets of 10 repetitions.

Forward Step-Up

Why it works: Not only does this move strengthen the large muscles of the leg (quads, hamstrings, glutes), it also challenges your balance and improves stability in your knees and hips, says Yu—essential for reducing strain on joints impacted by psoriatic arthritis.

How to do it: Stand facing a bottom step that is six to eight inches high. If you need help balancing, use a staircase with a railing, advises Yu. Place your entire right foot on top of the step (don’t let your heel hang off the edge), then straighten your right leg to stand on top of the step. Bring your left foot up to meet the right, then step back down with your right foot first, following with your left. Complete all reps on one side, then switch.

Do three sets of 10 reps per leg.

Bridge Hold

Why it works: Strengthening your glutes with moves such as this helps support your body in standing positions, while also improving posture and stability, according to Yu.

How to do it: Lie face-up on the floor with your knees bent and your feet flat on the floor spaced about a foot apart. Extend your arms along your sides with your palms facing down. Drive through your heels, squeeze your glutes and press your hips upward until your thighs form a straight line from your knees to your hips. Hold here for 10 to 30 seconds, then lower back to the start under control.

Complete three 10- to 30-second holds.

Standing Hip Abduction

Why it works: Your hip abductors are muscles that lift your leg to the side. They help you maintain balance and stabilize you when standing on one leg. “The abductors also work when you step to the side, and when you get into and out of a car,” says Yu.

How to do it: Stand next to a wall, a sturdy pole, or another stable surface with your feet hip-width apart. Place your left hand on the wall for balance and shift your weight into your left leg. Keeping your right leg straight and your hips level, slowly lift your leg up and to the side as high as you can without tipping or leaning over. Pause briefly, then lower your leg to the start. Complete all reps on one side, then switch.

Do three sets of 12 to 15 reps on each leg.

Bed Hip Stretch

Why it works: Anyone with psoriatic arthritis will attest to the stiffness that results from sitting for long periods of time. Tightness in the hips, hip flexors, and lower back makes simply standing up a painful endeavour. This stretch helps release the muscles in those areas, working to alleviate pain and stiffness. “The psoas is the only muscle in the hip that has attachments into the lower vertebrae, so you get a two-for-one stretch here,” says Yu.

How to do it: Lie face-up along the left side of your bed. Dangle your left leg over the edge so you feel a stretch in the front of your left hip and lower back. Hold and breathe, relaxing as much as possible, for five to 10 seconds. Lift your leg back onto the bed, rest briefly, then repeat. Complete all reps on one leg, then switch sides and repeat.

Do three sets of 10 five- to 10-second holds per leg.

Standing Resistance-Band Row

Why it works: If your job involves spending the day in front of a computer, you also likely spend a good deal of that time slouching. This can lead to pain in your neck, shoulders, and upper back, exacerbating the battle with PsA. This exercise strengthens the muscles surrounding your shoulder blades, improving posture and alleviating pain.

How to do it: Secure the centre of a resistance band around the doorknob on the outside of a door, then close the door tightly to hold it in place. Grasp an end in each hand with your arms extended straight in front of you and your palms facing in toward each other. Stand with your feet hip-width apart and your knees slightly bent for balance. Keep your chest lifted and your arms in close to your sides as you drive your elbows back behind you. Imagine squeezing a pencil between your shoulder blades to help target the right muscles. Pause briefly, then slowly extend your arms to return to the start.

Do three sets of 15 to 20 reps.

Resistance-Band Shoulder Extension

Why it works: This exercise helps strengthen the muscles that support your scapulae as well as your mid-back. The better your posture, the less back and shoulder pain you will have, according to Yu.

How to do it: Secure the centre of a resistance band around the doorknob on the outside of a door, then close the door tightly to hold it in place. Grasp an end in each hand with your arms extended in front of you at shoulder height, and turn your palms downward to face the floor. Keep your arms straight and your chest lifted as you slowly press the band down toward your legs in a smooth arc. When your hands come just to the outside of your thighs, pause briefly, then slowly return to the start.

Do three sets of 15 to 20 reps.

Forearm Plank

Why it works: The stronger your core—the abdominal and lower back muscles around your midsection—the better your posture and body mechanics, relieving unnecessary tension around PsA joints that are trying to compensate for bad form.

How to do it: Get on your hands and knees, then place your elbows on the floor underneath your shoulders. Extend your legs behind you one at a time, then lift your hips so your head, hips, and heels are aligned. Tighten your abs, squeeze your glutes and press down into the floor through your elbows to help maintain this position. Hold and breathe for 30 to 45 seconds.

Complete three 30- to 45-second holds.

Calf Raise

Why it works: Your ankles are an oft-forgotten joint, but they can be negatively impacted by psoriatic arthritis, just like the rest of your body. This move simultaneously stretches your ankles while strengthening your calves and feet.

How to do it: Stand next to a wall or face a countertop with your feet hip-width apart and your toes pointing forward. Lightly place your hand(s) on the stable surface for balance, if needed. Keep your legs straight as you raise your heels off the floor and lift up onto your toes. Pause briefly at the top, then lower back to the start.

Do three sets of 15 reps.

Single-Leg Balance

Why it works: Balancing on one leg might sound simple, but doing so engages and strengthens dozens of smaller muscles in your hips, knees, and ankles, thereby improving dynamic balance, strengthening your lower body, and in turn easing joint strain.

How to do it: Stand next to a wall or countertop (for balance, if needed) with your feet hip-width apart and your arms at your sides or your hands on your hips. Shift your weight into your left leg and maintain a slight bend in your left knee as you lift your right foot off the floor. Hold as long as you can with the goal of balancing for 20 to 30 seconds. Replace your foot and repeat on the other side.

Do three sets of 20 to 30 seconds on each leg.

Making Exercise Work for You

Psoriatic arthritis affects people in different ways, so you may have to tailor this workout to meet your specific needs on a day-to-day basis. “For example, when there is a marked flare in a particular joint, people with psoriatic arthritis should limit exercise [in that area] until they can calm the inflammation down, but they can still exercise with other parts of the body,” says Dr. Fields.

Don’t be afraid to take longer breaks between exercises or dial back the intensity at any time, if needed. The goal is to move your body, no matter how slowly or carefully you do it, and any exercise is better than none. Ultimately, your goal is to be physically active most days of the week, with the target of accumulating 150 minutes weekly to reap the full spectrum of benefits that exercise can provide.

While 150 minutes might seem like a lot, if you break it down into smaller, bite-sized chunks it becomes instantly manageable. For example, if you take a 15-minute walk each morning you’re already more than halfway there! Add in this strength/stretch program most days per week, and you’ve reached your goal—and then some.

https://www.healthcentral.com/condition/psoriatic-arthritis/build-a-stronger-body-with-psa-workout 

Psoriasis Triggers: How Your Environment Can Cause Flare-Ups

From msn.com

Psoriasis is a complex condition that affects millions, but its exact causes remain a mystery. While genetics play a significant role, environmental factors often act as the triggers that bring psoriasis to the surface.

W​eather Conditions

For those predisposed to psoriasis, life can be symptom-free until a specific environmental trigger, like cold or extremely dry weather, sets off a flare-up. Extremely dry weather is also one of the most common psoriasis triggers. That's because cold, dry weather can strip moisture from the skin, weakening its protective barrier and making it more prone to irritation. The lack of humidity in winter air, combined with indoor heating, dries out the skin further, exacerbating inflammation and scaling.

R​educed sunlight exposure during colder months can also decrease natural vitamin D levels, which play a role in regulating skin cell growth and immune responses, potentially worsening psoriasis symptoms. 

O​ther Concerns

It's not just weather —factors like smoking, alcohol consumption, and even exposure to air pollution can all impact your skin.

Smoking tobacco, or being exposed to secondhand smoke, not only increases the risk of psoriasis but also may increase the severity of the disease. Heavy alcohol consumption can increase inflammation in the body, which can trigger psoriasis. Alcohol can also dry out skin that's already prone to dryness and flaking. And high exposure to air pollutants has been linked to an increased risk of severe psoriasis, research shows.

Flares of psoriasis are common after the use of certain medications, including lithium, high blood pressure drugs, and antimalarial drugs. Infections, like strep throat or even skin infections, can send the immune system into overdrive, worsening psoriasis symptoms. Injury to the skin, such as a cut, bug bite, or a severe sunburn can increase the chances of a psoriasis flare-up.

Understanding these triggers is crucial for managing psoriasis effectively. By knowing more about how your environment and habits might be affecting your psoriasis, you can keep tabs on common triggers and keep flare-ups at bay. Always consult with your doctor before making changes to your psoriasis treatment strategy.

https://www.msn.com/en-ca/health/other/psoriasis-triggers-how-your-environment-can-cause-flare-ups/ar-AA1pxcLY?apiversion=v2&noservercache=1&domshim=1&renderwebcomponents=1&wcseo=1&batchservertelemetry=1&noservertelemetry=1

Psoriasis Medication Side Effects

From everydayhealth.com 

Major advancements in psoriasis treatments in the past two decades have given people living with the autoimmune condition a wide range of options for controlling symptoms. There are more than a dozen systemic treatments alone, which include some of the newer medications like Janus kinase (JAK) inhibitors.

But psoriasis treatments include many “old-school” medications as well, mainstays of therapy that have been around for decades. The one thing that all these options have in common? Side effects, which can range from mild to bothersome, and in some cases, a risk of serious adverse events.

Keep reading to learn what you need to know about the most common side effects from the most used psoriasis treatments.

Topical Corticosteroids and Skin Side Effects

Topical corticosteroids are among the most commonly prescribed treatments for psoriasis because they reduce inflammation, redness, and irritation, says Susan Massick, MD, an associate professor of dermatology at the Ohio State University in Columbus.

But if they’re used too frequently or for too long, they can cause skin atrophy, or thinning of the skin, says Dr. Massick.

Topical corticosteroid overuse can also lead to:

• Noticeable blood vessels (telangiectases)
• Hypopigmentation (light-coloured skin)
• Easier bruising
• Delayed wound healing
• Acne breakouts
• Stretch marks (striae)

“This can happen with low-potency topical steroids when used for prolonged periods of time, or with higher-potency topical steroids when applied in more sensitive areas, such as the face, armpits, groin, or genitals, or if used for prolonged periods of time,” she says.

Massick recommends working with your medical provider to limit the length of treatment to short-term or intermittent use and avoid prolonged or continuous treatment times.

“Your dermatologist will tailor what type of topical steroid depending on how severe your disease is and what areas need to be treated, with lower-potency topical steroids reserved for the delicate areas of the face, armpits, breasts, and genital areas, and with higher-potency topical steroids more appropriately reserved for places like your arms, legs, hands, feet, and trunk — and not to be used on the face,” says Massick.

Vitamin D Analogues and Sun Sensitivity

Medications like calcipotriene (also called calcipotriol), a synthetic form of vitamin D, are often paired with topical steroids to treat psoriasis. They’re generally well tolerated and don’t directly cause sun sensitivity, though using sun protection and wearing protective clothing and a hat are precautions worth taking, according to Massick.

You should also avoid sunlamps and tanning beds while using topical vitamin D analogues.

Retinoids and Skin Irritation

In psoriasis, keratinocytes (the type of cell that makes up most of the epidermis, the outermost layers of the skin) build up faster than normal, leading to the thick patches on the skin known as plaques.

Topical retinoids such as tazarotene (Fabior, Tazorac, Avage) treat psoriasis by reducing the overproduction of keratinocytes; promoting normal differentiation, or maturation, of keratinocytes; and exerting anti-inflammatory effects.

But patients do notice signs of skin sensitivity like redness, dryness, peeling, and irritation, especially when first starting treatment, says Massick.

“I recommend starting low and slow: Start with using the product two to three times a week to get acclimated to any potential irritation, and then increase the frequency as long as you’re not experiencing skin irritation,” she says.

Topical retinoids increase sun sensitivity, meaning you’ll sunburn more easily, so it’s important to practice excellent sun protection when using a topical retinoid: Stay out of the sun as much as possible, and apply sunscreen before going outside.

Coal Tar and Skin Irritation

Topical coal tar has been used to treat psoriasis for decades. Indeed, it may be the first known therapy for psoriasis, with use dating back to 1900. It is used less frequently today because newer treatments come with fewer side effects and less hassle, says Massick. 

“While coal tar can reduce inflammation by slowing the rapid skin cell turnover — the hallmark of plaque psoriasis — it also has a very pungent smell and can stain clothing, bedding, and towels,” she says.

Coal tar can also cause skin irritation in some people, especially when used in higher concentrations or on sensitive skin, says Massick.

For people who find that coal tar is a good way to manage psoriasis, they can limit skin irritation by using a lower concentration or using it on alternating days.

Biologic Medications and Infection Risks

Psoriasis is an autoimmune disease; the immune system is triggered and activated as if there were harmful invaders attacking the body. Sometimes topical therapies aren’t enough to control inflammation, and systemic therapies — drugs that address the root cause — are needed.

“Biologic medications target specific components of the immune system’s response and inflammatory cascade that trigger the psoriasis inflammatory pathway. These medications can block specific targets, such as IL-17, IL-23, and TNF alpha, all of which play key roles in psoriasis,” explains Massick.

Because these medications work by suppressing part of your immune system, they are considered immunosuppressants, she says.

Any suppression of your immune system can increase your risk of infection in general.

“This includes infections such as the typical upper respiratory viral and bacterial infections, such as influenza (flu) and COVID-19, and, in rare cases, more serious infections like tuberculosis,” says Massick. 

“Prior to starting therapy with any of the biologics, your doctor will screen you for chronic infections, including HIV, tuberculosis exposure, and hepatitis B and C, and will continue to monitor you during your treatment course,” she says.

JAK Inhibitors and Blood Clots

JAK inhibitors are oral drugs that can help with chronic inflammatory conditions, including psoriasis.

“These are the new kids on the block, one of the newer classes of medications that are effective in chronic inflammatory conditions, such as eczema and psoriasis. JAK inhibitors work by targeting specific inflammatory signalling pathways within cells that lead to inflammation,” says Massick.

While JAK inhibitors have been shown to be effective, they do carry potential serious risk of internal, or systemic, side effects, including increased risk of infection, bone marrow changes with low white counts, blood clots, heart-related events, and increased risk of cancer, she says. Not every patient will experience these side effects; some risks can depend on an individual's medical history and risk factors, says Massick.

As a class, JAK inhibitors have a black box warning that includes an increased risk of blood clots. Studies have shown that the risk is higher in people with other risk factors for clotting, and the risk is higher in people who take higher doses.

“A blood clot, such as a deep venous thrombosis (DVT), can cause swelling or pain where the clot forms, most commonly in the lower legs, developing as localized calf redness, swelling, and pain. If the clot travels to the lungs, this can cause a pulmonary embolism, causing shortness of breath and much more severe complications,” she says. A pulmonary embolism is a medical emergency.

Because of this risk, prescribing JAK inhibitors requires careful consideration to ensure that the severity of psoriasis outweighs the potential risk of these more serious side effects, says Massick.

JAK Inhibitors and Skin Cancer

“JAK inhibitors are associated with increased risk of non-melanoma skin cancers particularly in conjunction with other risk factors for skin cancer like age, fair skin, and history of skin cancers and sunburns,” says Massick.

The data has been mixed, but some studies have shown an increased risk of skin cancers in people taking JAK inhibitors for autoimmune conditions, including psoriasis.

“In terms of counselling, I do choose very carefully who I will offer these treatment options to and have frank discussions regarding potential side effects and long-term effects of these newer systemic therapies. While efficacious in terms of disease control, they are not without their risks,” says Massick.

The Takeaway

• Psoriasis treatments can control symptoms, but each treatment has potential side effects to weigh against benefits.
• Topicals like corticosteroids, vitamin D analogues, retinoids, and coal tar mainly cause skin issues such as irritation, thinning, or staining, which can often be managed by adjusting the dosage.
• Biologics and JAK inhibitors target immune pathways for stronger control but can raise the risk of serious infections; JAK inhibitors may also increase blood clot and cancer risk in certain people.
• Work with your dermatologist to choose, monitor, and adjust your psoriasis treatments to balance effective symptom control with safety.
• 
  
• https://www.everydayhealth.com/skin-conditions/psoriasis-medication-side-effects/
  

Finding Community—and Herself—Through a Psoriasis Diagnosis

From healthcentral.com

Student and advocate Alina Vue shares the challenges and triumphs of living with generalised pustular psoriasis and psoriatic arthritis 

Between early morning classes and late night study sessions, no one ever said college was easy. But for Alina Vue, a 25-year-old student based in Westminster, CO, it’s been especially tough juggling classes and not one, but two forms of psoriasis. “This is my second attempt at college; I was in my second year before I took my hiatus,” shares Vue, who is currently studying communications at Front Range Community College.

Vue was just two years old when her mother first noticed splotchy rashes on her skin. “At first, they thought it was just baby eczema. That’s pretty common with the kids in my family,” says Vue, who is Hmong American. So her parents did as most would: moisturized her skin well and sought to reduce irritation via home remedies.

“But it kept getting worse,” Vue explains. One day, her skin not only turned really red, but felt very hot to the touch. Worried this was far beyond eczema, her mother rushed Vue to the local emergency room in Green Bay, WI. There, a doctor quickly recognized the symptoms of generalized pustular psoriasis (GPP), which include inflamed skin, fever, fatigue, nausea, weight loss, itching, muscle weakness, headaches, and the tell-tale painful pus-filled white and yellow bumps.

“I vividly remember being very itchy,” Vue says. “I’m glad that I was diagnosed, because it is a pretty severe experience. My mom was my champion. She was clear that something was wrong.”

While the National Psoriasis Foundation estimates that 2% to 3% of the population has one of the five types of psoriasis, only about 1%of those cases are GPP. The low prevalence is one of the reasons Vue likes to share her story. “People tend to think psoriasis is just a skin thing, and it definitely relates to the skin, but it’s an autoimmune disease, so it’s definitely more than what they think it is. It’s inflammatory, so it can lead to organ issues, I’ve had swollen feet, I’ve lost a lot of weight unexpectedly. It’s an all-around intense health issue separate from the skin itself,” Vue says.

Finding the Pattern

By the time Vue was old enough to start kindergarten, her health was locked into a pattern: a massive flare each winter, followed by recovery each summer. “I would have this dual experience throughout the year of like, ‘Ah, everything’s fine!’ and then come my birthday in September, things would start getting worse again. I have a lot of memories of not being able to do recess because I lived in a very cold climate. I did a lot of activities in bed because it was very hard to move around,” Vue says.

By the time Vue reached third grade, her condition had gotten more severe, leading her mother to homeschool her for a year. “That was one of the worst bouts of my psoriasis because it was just so hyper-aggressive. It was a tumultuous time and I was very sedentary,” remembers Vue.

She filled her days drawing and writing poetry with a cousin. She credits her father with the inspiration to put pen to paper. “My father is a pastor, and he used to write sermons all the time, so words were a big part of my childhood. But I also didn’t know how to tell people things, and writing was a more accessible tool for me to express myself,” says Vue.

These days, she’s tapping that tool for school. The severity of her conditions has meant that she hasn’t yet been able to work a job, but she’s excited to put her talent to good use after graduation. “I love film and design, and I would love to be in the film industry as a graphic designer or social media marketer, or even in spaces where I can talk about movies and fashion and art,” she says.

Adding a Diagnosis

Vue returned to school for fourth grade, but not before being thrown for another loop. In late 2009, when she was nine, she noticed a new pain. “I was struggling with swollen ankles,” she says. But her inflamed joints didn’t seem like a big deal until she was hospitalized for two weeks for her pustular psoriasis. “I was very sick. I remember being in the hospital and in the midst of it all, doctors recognized that I also had the presentation of psoriatic arthritis,” she says.

Psoriatic arthritis is an autoimmune condition in which the immune system doesn’t just attack the skin, but it goes after the joints, tendons, and ligaments, leaving pain, swelling, and stiffness in its wake. About one in every three people with psoriasis will develop this painful condition (2.4 million people in the United States alone), though it is usually diagnosed between the ages of 35 and 55. Studies estimate that about 15% people with this condition have not yet been diagnosed.

If left untreated, psoriatic arthritis can cause permanent joint damage. That’s definitely a concern for Vue, who says the condition has always felt undertreated, with doctors mostly relying on the medications for her GPP to treat both. “I'm trying to see a rheumatologist right now,” she shares.

Experimenting With Treatments

Middle school is tough for everyone, but it hit Vue especially hard. At the start of sixth grade, she experienced a flare so bad it put her back in homeschool.

Courtesy of Alina Vue

“I had a very hard time walking because the pain was aggressive. So I was sitting all the time, mostly at a table doing my homework. But after a month or so, the skin behind my knees started closing up, and then my legs started atrophying,” Vue shares. Unable to straighten her legs or walk on them, she was hospitalized again, and it took two months of physical therapy to get her back on her feet. “It was a very trying time.”

It was also a time of experimentation. Like most chronic illnesses, psoriasis can be treated with many types of medications. And like most chronic illnesses, it can be tough to land on the right, unique combination that will facilitate a person’s best life.

Vue is no exception. She’s been on several topical medications, most notably triamcinolone, a corticosteroid that she used for four years and discontinued because it thinned her skin and sensitized it. She’s taken oral systemic medications, including immunosuppressants cyclosporine (“tasted horrible and didn’t change anything”) and methotrexate (“actually made me more itchy”), with little success. She also tried UV light therapy, but that just “made me feel like a cupcake in a display case.”

It wasn’t until 2010 that Vue’s doctors introduced biologics, which are injected or IV-infused medications that target relevant portions of the immune system, rather than smothering the entire thing. She started with Humira (adalimumab), an injectable that worked for a year before abruptly stopping. Then she moved to IV infusion Remicade (infliximab)for a year until it triggered anaphylaxis, her body developing antibodies against the medication and her throat closing up.

Seeing her child gasp for air brought Vue’s mom to a breaking point. Vue moved to virtual school (where she stayed through graduation), and they took two years off medications, trying ultimately unsuccessful home remedies, including some from their Hmong culture like eating eucalyptus leaves for their anti-inflammatory properties.

Testing Genetics

By age 16, Vue was ready to try medications again, starting with injections of Stelara (ustekinumab), which blocks the IL-12 and IL-23 proteins in the immune system. Again, it worked for a year before failing, throwing 17-year-old Vue into yet another flare.

Lucky for Vue, her doctor had a new plan. “She asked if we’d be okay with doing genetic testing to see if there’s a specific mutation causing my psoriasis, because there are certain medications that specifically target that, which would make it easier for recovery,” Vue says. “I said, ‘Yes!’ and they found my specific mutation and the right medication for me.”

It turned out, Vue has a mutation of the IL36RN gene, which makes a protein called interleukin 36 receptor antagonist (IL-36Ra). Researchers have linked this mutation (along with more than a dozen others) to GPP, as it reduces the amount of the protein in the skin of people like Vue, clearing the way for uncontrolled inflammation.

That led them to try Taltz (ixekizumab), a biologic that works by blocking interleukin-17A (IL-17A), another inflammation-causing protein linked to GPP. While Taltz is marketed as a medication for psoriatic arthritis and the more common plaque psoriasis, researchers have found that it can successfully treat GPP, too.

More than that, the autoinjector works for Vue, effectively putting her GPP into remission for seven years. “It really worked well, but my mom and I were wary, because so many things stopped working at the one-year mark,” she says. “But then it kept going, and I haven’t experienced a lot of major side effects. It’s the longest I’ve ever gone without a flare. Sometimes I’m still surprised, but I’m so glad.”

Still, Taltz, plus a skincare regimen of vitamin D topical cream and CeraVe, is not perfect. It hasn’t helped with her psoriatic arthritis as hoped, and as an immunosuppressant, it can open users up to infection. Vue got a taste of that in 2024, when a combination of summer heat and an infection she caught during an unmasked Mother’s Day photo shoot triggered her first GPP flare since starting Taltz. That touched off a new pattern; it flared again summer of 2025.

Sharing Her World

Courtesy of Alina Vue

While she’s in a good place now, Vue doesn’t shy away from sharing the highs and the lows of living with psoriasis. She was diagnosed with major depressive disorder in 2024, but notes that the online psoriasis community has been pivotal to finding her footing.

“Psoriasis has significantly affected my mental health. Even though I grew up with very supportive people, it still felt like I was always in a bubble and separate from everyone,” she shares. “But seeing other people in the community talking about it and knowing that I wasn’t the only one with these intense feelings made me feel like I could carry less weight. Hearing them say, ‘This is who I am, and it’s okay,’ made me feel more confident and safer in the world.”

Ultimately, her experience with psoriasis has taught her some important lessons beyond what she could pick up in a classroom. “It’s difficult, but it’s also a beautiful opportunity to understand ourselves and each other,” she shares. “I have learned so much about my own humanity. There is so much beauty to be had from just witnessing other people’s journeys and being witnessed back.”

https://www.healthcentral.com/condition/psoriasis/finding-community-and-herself-through-psoriasis-diagnosis