Monday, 18 April 2016

Psoriasis severity linked to work productivity, quality of life

By Lauren Biscaldi

Patients with severe psoriasis have a heightened reduction in quality of life (QoL) and work productivity, according to research published in Clinical and Experimental Dermatology.
As part of a recent survey conducted in the United States, dermatologists were asked to provide information on psoriasis patients' overall disease severity, symptom severity, and existing comorbidities. The patients completed QoL questionnaires – the EuroQoL 5-Dimension Health (EQ-5D) questionnaire, the Dermatology Life Quality Index (DLQI), and the Work Productivity and Activity Impairment (WPAI) questionnaire – and the researchers used multivariate regression to determine the relationship between variable outcomes and psoriasis severity.
Data from 694 patients were analyzed; 48% of patients had mild psoriasis, 46% had moderate psoriasis, and 6% had severe psoriasis. The most commonly reported symptom was scaling (82% of patients); participants also reported itching (73%) and pain (32%). Increased psoriasis severity was associated with an increase of symptoms and a reduced QoL and decrease in EQ-5D scores.
“WPAI scores increased with severity,” noted Neil J Korman, MD, PhD, of the Clinical Trials Unit at the University Hospitals Case Medical Center in Cleveland, Ohio. “It is important that physicians recognize the impact of severe disease on patients' lives and take steps to address this.”

http://www.clinicaladvisor.com/psoriasis-information-center/psoriasis-severity-affects-patients-quality-of-life/article/490195/

Sunday, 17 April 2016

Risk of aneurysm in the abdomen higher in psoriasis

By Emily Lunardo

A new study found that psoriasis patients are more likely to develop an aneurysm in the abdomen, compared to those without the autoimmune disorder. Although the risk is small, it is still important to note.
The researchers also found that the risk of an abdominal aneurysm increases with the severity of psoriasis. The reason for this connection, researchers speculate, may have to do with the role of inflammation in both conditions.
Lead researcher Dr. Usman Khalid said, “The association between [abdominal aortic aneurysm] and psoriasis has not been examined before, but we are not surprised by seeing a heightened risk in our study. Our results add to the evidence that there is an increased risk of various cardiovascular diseases in patients with psoriasis.”
Nearly 7.5 million Americans suffer from psoriasis, which is an incurable autoimmune disease. In an abdominal aneurysm, the main blood vessel that carries blood from the abdomen to the heart becomes enlarged. Because this condition can be symptomless it can lead to fatal outcomes without any warning.
The researchers analyzed 14 years of data from over 59,000 patients with mild psoriasis and 11,000 patients with severe psoriasis. The participants were followed until they developed an abdominal aneurysm, died, or until the end of the study.
Mild psoriasis patients were found to have a 20 percent higher risk of abdominal aneurysm, compared to people without psoriasis. Patients with severe psoriasis had a 67 percent higher risk of an abdominal aneurysm.
Khalid added, “More research is needed to explain the causal mechanisms. Nonetheless, our findings not only stress the need to treat the symptoms of the skin disorder, but also a regular evaluation of the risk factors that are associated with cardiovascular disease outcomes. Also, patients with psoriasis must be encouraged to change [an] unhealthy lifestyle and adhere to a daily program that will minimize the risk of cardiovascular problems.”
Unfortunately, taking the time to screen psoriasis patients for such conditions can be quite costly. Dr. Katherine Cox, a dermatologist at Houston Methodist West Hospital in Texas, explained, “We have known for a long time that psoriasis is not just a skin-deep issue. We’ve known there’s a cardiovascular risk issue with psoriasis. So, it’s not surprising to see now that it’s connected with [abdominal aneurysms] as well, especially since they share similar inflammatory pathways.”
“Being able to give [risk] numbers to patients makes it more real for patients,” Cox added. Abdominal aneurysms “are a silent killer. I’m not a cardiologist, but because a lot of people are asymptomatic for it, because they’re not looking for it, they may miss it,” Cox concluded.

http://www.belmarrahealth.com/risk-of-aneurysm-in-the-abdomen-higher-in-psoriasis/

Tuesday, 12 April 2016

Psoriasis and general bone loss linked, may help osteoporosis treatment research: Study

By Dr. Victor Marchione

Psoriasis and general bone loss have been found to be linked and studies suggest it may help osteoporosis treatment research. Researchers from the Genes, Development and Disease Group found that psoriasis patients experience higher levels of bone loss as a result of the disease. Their findings, published in Science Translational Medicine, described the molecular communication that is established between the inflamed skin and loss of bone mass. The research unveiled a possible treatment for psoriasis with already available drugs that could benefit bone health, too.
Psoriasis is an autoimmune disorder that affects two percent of the world’s population. Manifested as inflammation and scaling of the skin, psoriasis increases a person’s risk of developing a type of metabolic syndrome by predisposing them to obesity, cardiovascular disease, and diabetes.
First author and researcher Özge Uluçkan said, “We have detected that psoriasis causes the widespread and progressive loss of bone tissue. There is no active destruction of the bone. On the contrary, during the bone regeneration cycle, bone is not formed at the necessary speed to replace what is being lost and, therefore, patients’ bone mass reduces over time.”
Previous research found that in animal models the skin generated large amounts of the cytokine IL-17, which activates cellular inflammation response to damage. IL-17 travels through the blood and ends up in the bones where it blocks osteoblasts (cells responsible for bone formation) – just like it occurs in osteoporosis, arthritis, and myeloma. The mice were treated with IL-17 blockers, and normal function was restored along with bone formation.
When specialized CT scans were administered in psoriasis patients and healthy individuals, the researchers found that psoriasis patients had greater bone loss, which was correlated with higher levels of cytokine IL-17A in blood.
Uluçkan explained, “Treating psoriasis patients with IL-17 blockers — some already on the market — could have a beneficial effect on the loss of bone tissue, unlike other compounds that might only affect skin inflammation.”
“IL-17 has become a focus point for the investigation of the immune system. Its deregulation is not only related to psoriasis, but also to other diseases, such as rheumatoid arthritis, inflammatory bowel disease, and multiple sclerosis. Some of these have been linked to loss of bone tissue, as in the case of inflammatory bowel disease, found in 70% of cases. It would be interesting to study whether IL-17 is responsible for this secondary effect,” Uluçkan concluded.

http://www.belmarrahealth.com/psoriasis-and-general-bone-loss-linked-may-help-osteoporosis-treatment-research-study/

Wednesday, 6 April 2016

5 Reasons to Choose Home Remedies for Psoriasis Treatment

By Maria Calire

There are a number of products and decisions for sufferers of psoriasis out there. You can find many choices to eliminate psoriasis such as topical agents, medication, systemic agents, or home remedies. All methods can help you curing the skin problems, however, you will be disappointed if you find the wrong way you cannot cure it permanently. You are wondering which preferences will be suitable for you, home remedies or other therapy.
Why you should choose home remedies over the opposite selections, we have 5 main reasons to discuss. First, home remedies are not expensive cost and you can get effectively at an equivalent time. If you realize the natural herbs and products around the home can help treating your psoriasis, you never want to spend much money on creams or medications.
What the second reason from natural home remedies can give you is that you can follow the best process and method in your own home with natural ingredients you can find to help you treat psoriasis according to the therapy. You can just gently rub lotion after showers and drink herb tea, or you can choose to have a bath with oatmeal, or changing diet, with the natural remedies there are many ways for treatment you can choose.
The third main reason you can find that there are not visit from the doctor. You maybe have or do not have health's insurance, and even with the insurance; a doctor's visit is often expensive. If you have time you can go to the doctor but if you do not have enough time, home remedies are a good way to save time for treatment.
The next reason is that a small number of side effects with natural home remedies. Side effects of the prescription medications severely affected parts of the body in case you use too much for long time. Home remedies are safer than for the result they have very little side effects to no side effects. Your purpose is to cure psoriasis rather than adding other diseases procession to the body.
The final reason is that you can control the time treatment and there is nothing to lose much, you are responsible for your treatment and creating the natural remedies your own, if the system you are following don't work well, you can stop using them immediately and your money will not run out of the wallet.
Psoriasis makes you losing confidence and difficulties in contact with others, it is not fun to have and the outbreaks can be unbearable, however, there are many things you can do to help yourself alleviate the symptoms and Home remedies are the best way to treat all Major causes of psoriasis permanently.

http://ezinearticles.com/?5-Reasons-to-Choose-Home-Remedies-for-Psoriasis-Treatment&id=9342717

Controlling complicated psoriasis

By Cheryl Guttman Krader

Dermatologists and their patients have benefited immensely from the expanded armamentarium of treatment options for plaque psoriasis. Nevertheless, they may still be challenged by patients with coexisting systemic diseases or other psoriasis phenotypes.
Speaking at the 40th annual Hawaii Dermatology Seminar (Waikoloa, Hawaii, February 2016), Kristina Callis Duffin, M.D., M.S., offered ideas for managing a variety of individuals who she described as presenting with “situations not covered in textbooks or cases you call your friends about”.
Complexity from comorbidities
Patients with endstage renal disease and severe psoriasis comprise one challenging group because treatment with methotrexate and cyclosporine is contraindicated for them. Dr. Duffin notes that none of the biologics are eliminated through the kidneys and so any—etanercept (Enbrel, Amgen/Immunex), adalimumab (Humira, Abbvie), infliximab (Remicade, Janssen), or ustekinumab (Stelara, Janssen)—could be used without dose adjustment. As a caveat, however, patients with kidney failure will require particularly close monitoring for infection as it is a risk associated with both their renal disease and treatment with a biologic.
Options for biologic therapy in a patient with multiple sclerosis (MS) are more limited, however, because MS is a contraindication to use of an anti-TNF agent. Dr. Duffin said phototherapy is her first choice for managing a patient with MS whose psoriasis requires more than topical medications. In addition, she has used methotrexate safely, although she cautioned there have been rare reports of optic neuritis in patients on methotrexate.
Should a systemic agent be required, one might consider the interleukin-12/23 antagonist, ustekinumab, or dimethyl fumarate (Tecfidera, Biogen IDEC).
“Ustekinumab was evaluated as treatment for relapsing-remitting MS in a phase 2 trial, and its findings should provide some reassurance about prescribing ustekinumab for patients with MS,” says Dr. Duffin. She is associate professor of dermatology, University of Utah, Salt Lake City.
“Although it was not helpful, it was safe as it did not worsen MS clinically or radiographically.”
The rationale behind using dimethyl fumarate off-label relates to the fact that it is approved for the treatment of MS in the United States while fumarates are available in Germany as a treatment for psoriasis. Patients treated with dimethyl fumarate should be monitored for lymphopenia and told that side effects include nausea, diarrhea and flushing, Dr. Duffin says.
Patients who develop psoriasis while being treated with an anti-TNF agent for inflammatory bowel disease (IBD; Crohn’s disease, ulcerative colitis) present a conundrum considering that these biologic agents are used to treat psoriasis. Dr. Duffin said she has had good success using ustekinumab to “kill two birds with one stone” in these individuals.
“Ustekinumab is approved for psoriasis, and results of Phase 3 clinical trials demonstrate it was effective compared with placebo for improving Crohn’s disease in patients who had been refractory to anti-TNF therapy,” she said.
“I now have a series of ten patients switched to ustekinumab after developing psoriasis while on an anti-TNF for IBD, and they have all done well from the standpoint of controlling both their cutaneous and bowel disease.”
Challenging phenotypes
For Dr. Duffin, getting guttate psoriasis under control can involve a two-pronged approach that addresses the infectious component and the skin disease. She said that if a patient with guttate psoriasis has recurrent streptococcal pharyngitis, she collaborates with an infectious disease specialist about whether to place the patient on an antibiotic regimen or consider tonsillectomy.
Topical modalities are her first-line treatment for the psoriasis, although narrowband UVB phototherapy or traditional systemic therapy with cyclosporine or methotrexate are considered for individuals with a more extensive area of involvement.
If these approaches fail, Dr. Duffin suggests considering ustekinumab. She reported her personal experience using it in three patients with good results. Two patients achieved prolonged remission after one and three doses, respectively.
The biologics are also something dermatologists might consider for patients with palmar-plantar psoriasis who failed conventional therapies, whether their disease is pustular or non-pustular. Based on her experience again, Dr. Duffin cautioned that there is no one biologic that stands out as being the agent of choice in this situation, and she added that she has occasionally seen palmar-plantar disease worsen in rare patients started on a biologic.
The presence of another skin disease, particularly contact dermatitis or eczema, as a mimicker or comorbidity is also something to consider in patients with palmar-plantar psoriasis, she said.
If it is determined that the patient has psoriasiform dermatitis with coexisting psoriasis and contact dermatitis or eczema, apremilast (Otezla, Celgene) may be a rational choice as this agent has been reported effective for treating both contact allergy and eczema.
“Apremilast is in development as a possible treatment for eczema and may eventually be approved for that use. In the meantime, management of patients with psoriasis and features of eczema or contact dermatitis may be a good niche for this new agent,” Dr. Duffin says.
On the topic of pustular psoriasis, Dr. Duffin also cautions against using oral or intramuscular corticosteroids for treating plaque psoriasis considering the many patients she has seen who develop a severe pustular flare when given a systemic corticosteroid.
Dr. Duffin says there are situations where she considers an oral corticosteroid for psoriasis management, but they are used with certain caveats:
  • Plaque psoriasis flares due to oral corticosteroid dose reduction and only if the patient has been started on another systemic agent, such as cyclosporine, methotrexate, or a biologic
  • Psoriatic arthritis flares using a low dose for a short course
  • Palmar-plantar psoriasis flares as a last resort
  • Pustular psoriasis of pregnancy if cyclosporine and other therapies are not working or contraindicated.
http://dermatologytimes.modernmedicine.com/dermatology-times/news/controlling-complicated-psoriasis

Tuesday, 5 April 2016

5 foods you should NOT eat if you suffer from psoriasis

By Tania Tarafdar

If you have been suffering from psoriasis, and no medication seems to be working, you might want to pay attention to your diet. Well-known nutritionist Priya Kathpal advocates avoiding these foods to prevent psoriasis flare-ups.
Junk foods: It contains refined starches and sugar and is high in saturated fats and trans fats that can promote inflammation. Plus it is high in calories and have microscopic nutritional value, so it is best you steer clear of them.
Dairy products: Diary products contain the inflammatory compound arachidonic acid. They also contain the protein casein that can lead to inflammation.
Citrus fruits: Ingesting citrus fruits may result in allergic reaction that may cause your psoriasis to flare. So, it is best you eliminate citrus fruits like oranges, lemon, and grapefruit from your diet that are common allergens.
Red meat: It contains polyunsaturated fat that can easily lead to inflammation and worsens the symptoms of psoriasis. Also, avoid processed meats such as sausage.
Alcohol: It also triggers outbreaks by causing inflammation. So it is best that you totally cut out alcohol if you suffer from psoriasis.
 

Saturday, 2 April 2016

What to Do After Finding Out You Have Psoriasis

By Maria Calire

Most of the people do not realize they have psoriasis because they do not think this skin disease is more common. If you see your skin had some problem you should do some online research or get diagnosed by a dermatologist for finding out you have psoriasis or not.
When you get your diagnosis result that confirmed you have psoriasis, do you feel worried and sad about it? And do you think which options you must do now for treating it?
3 things you need to do after finding out you have psoriasis
The first thing you will do is remember the time you have the skin problem and find out what causes this disease. Figuring out the cause of your disease may be difficult. There is no one trigger of psoriasis and not everyone has the same source. Outbreaks can be caused by genetics, lifestyle, stress, the food you eat, the climate or medication.
You do not know which method will help you cure for psoriasis immediately, but if you can determine what brings on the outbreaks you can help yourself to stop the frequency.
Second thing, It's a good idea to write down the daily activities and keep it carefully when you receive the first diagnosis of psoriasis. It may take time at the beginning, but in the long run it would be helpful for your treatment.
When you look at the log of daily activities as well as seeing the outbreak happen, you can analyze a little what the main triggers of your skin disease. Time after time, you will discover the source of your psoriasis so that you can then take steps to avoid them.
Finally, If you feel an outbreak coming on you should find a relief as soon as possible. Do not scratch or rub heavily if you want to bleed. The relief can be found by applying the fragrance-free moisturizer to the skin. Take a mineral bath or olive oil. Use baking soda powder to paste and slather on the sore spots or wrap it wet.
You can gently rub Aloe Vera on the sore spots to ease the pain and inflammation. Lotion many times throughout the day is the most important activity you should do regularly to keep the skin is moisturized. It will help you prevent outbreaks and relieve the patches, dry areas.
Figuring out you have been diagnosed of psoriasis is the first step, since then you need to do something to help yourself relieving the disease momentarily. Moreover, you should find the right method to cure your psoriasis to get back the normal and healthy life.

http://ezinearticles.com/?What-to-Do-After-Finding-Out-You-Have-Psoriasis&id=9349107