Higher weight increases risk of psoriasis

From medicalxpress.com/news

Studies have linked psoriasis and higher weight, but the causal relationship between the two has been unclear. What triggers what? Or could other underlying reasons explain the connection?

"Higher BMI may contribute to increased inflammation of the skin, which can exacerbate psoriasis, but it could also be that psoriasis leads to a person being less physically active and thus gaining weight," explains Mari Løset.
She is a medical doctor at the Department of Dermatology at St. Olavs Hospital and a postdoctoral fellow at the Norwegian University of Science and Technology's (NTNU) K.G. Jebsen Center for Genetic Epidemiology.
Løset is part of a team that been involved in a study of the causal relationship between BMI and psoriasis.
BMI stands for body mass index and is a measure of body fat content. It is calculated from a person's height and weight.
The observational study is a large collaboration among researchers from NTNU, England and North America. Some of the data being used are from the Health Survey in Nord-Trøndelag (HUNT) and the UK Biobank. Together, the analyses include data from 750 000 individuals.

Psoriasis is a chronic inflammatory condition of the skin, which causes a red, scaly rash. The cause of the disorder is probably multifactorial, involving both heredity and the environment.
Worldwide, two to four per cent of the population is affected by psoriasis. The incidence is particularly high in Norway.
"Self-reported data from two large population surveys in Norway indicate that six to eleven per cent of the population may be affected in this country," says Løset.
A study in the city of Tromsø has shown that the incidence of psoriasis was 4.8 per cent in 1980, but had increased to 11.4 per cent in 2008.
"Similar studies from other parts of the world substantiate the fact that the condition is increasing," says the postdoctoral fellow.
To investigate the causal relationship between BMI and psoriasis, the researchers used a method called Mendelian randomization. It is named after Gregor Mendel, who is known as the father of genetics.

According to Mendel's principles of inheritance, whether we inherit a certain variant of genes from our mother or our father is random. Genetic variants are randomly distributed, or randomized, between individuals.
"Mendelian randomization means that nature itself distributes individuals randomly into groups based on genes. This way, we can avoid the results being influenced by external factors," says Løset.
"Our understanding of how genes are related to disease is increasing at record speed, and in this study we used known genetic variants as markers for BMI and psoriasis," she adds.
By using Mendelian randomization, the researchers found that higher weight is a contributing factor to psoriasis. They observed that greater BMI increased the chance of getting the disease.
"We calculated that the risk increased by nine per cent for each higher whole number on the BMI scale," Løset says.

But the researchers are still uncertain about just how higher weight can lead to psoriasis.
"We still don't know enough about the mechanisms behind this connection. Fatty tissue is an organ that produces hormones and inflammatory signalling molecules, which could be a contributing factor," says Løset.
So far, not much research has been done on whether weight loss can cause psoriasis to disappear, although a few clinical studies suggest the possibility.
"Psoriasis is a very complex disease and we hope to study subgroups, especially individuals with severe psoriasis. The hypothesis is that we will be able to observe even greater links with higher weight," says Mari Løset.

https://medicalxpress.com/news/2019-04-higher-weight-psoriasis.html

9 Things You Think Could Be Arthritis—But Aren’t

From rd.com

Your joints are achy, stiff, and swollen. Run-of-the-mill arthritis might be to blame. But so could these other lookalike conditions.

Joint pain is extremely common. In one national survey, about one-third of adults reported experiencing it within the past 30 days. If your joints are giving you grief—and you don’t have a recent injury to blame—osteoarthritis (OA) is a likely cause. The condition, in which the joint becomes inflamed as the cartilage between the bones wears away, has more than 30 million Americans in agony, according to the Centres for Disease Control and Prevention, (the CDC). Even though the condition can’t be cured, OTC medications, prescription drugs, and surgery can ease the ache.

But OA isn’t the only health condition that can cause joints to become tender and stiffen. Before you reach for the ibuprofen, read on to see if you could be suffering from one of these conditions which can mimic arthritis pain.

                                                                       Anut21ng Photo/Shutterstock

Fibromyalgia

Arthritis is often mistaken for fibromyalgia, according to the Arthritis Foundation. They share many of the same symptoms, like muscle pain, limited range of motion, and joint stiffness, especially in the morning. The difference? With fibromyalgia, the pain is often body-wide, while arthritis tends to be localized to a few joints, says Alexis Colvin, MD, an orthopedic surgeon at The Mount Sinai Hospital in New York City. If you’re still not sure whether your pain could be from fibro, check out these other fibromyalgia symptoms you might be ignoring.

Tendinitis

“Tendinitis and osteoarthritis can feel very similar,” says Dr. Colvin. “Pain, stiffness, and swelling are common symptoms in both.” Making distinguishing between the two even trickier? With both conditions, the pain doesn’t usually come from one event, but gradually increases over time, says Dr. Colvin. If you’re unsure what’s causing your joint to act up, see your physician. X-rays and MRI imaging can help doctors determine which condition is causing the pain, so they can help you find relief.

Rheumatoid arthritis

There are actually more than 100 different forms of arthritis and arthritis-related diseases, according to the Arthritis Foundation. And many have similar symptoms. “Rheumatoid arthritis, in particular, feels very similar to osteoarthritis, in terms of discomfort,” says Dr. Colvin. But while osteoarthritis is often caused by general wear and tear in a joint, rheumatoid arthritis (RA) is an autoimmune disease. One sign that your creaky joints might be due to rheumatoid arthritis: You have a close relative with the condition. “RA often runs in families,” says Dr. Colvin.

Lupus

Like rheumatoid arthritis, lupus is an autoimmune disease in which the body’s immune system turns on normal, healthy tissue, according to the Arthritis Foundation. The Lupus Foundation of America estimates that 1.5 million Americans have the chronic disease, which mainly strikes women between the ages of 15 and 45. In addition to the joint pain that can feel like arthritis, lupus also causes these other surprising symptoms. If you have more than four of them, call your physician, asap.

Carpal tunnel syndrome

You wake up and your hand is achy and tingly. Is it arthritis acting up, or something else? Carpal tunnel syndrome can cause pain, weakness, and numbness that runs from the forearm to the hand: These symptoms indicate that repetitive movements like typing or playing an instrument are pinching your carpal nerve, according to WebMD. Women are three times more likely than men to have carpal tunnel syndrome. The thumb, index, and middle fingers are usually the first to feel pain.

Lyme disease

In addition to a rash, fatigue, and overall malaise, Lyme disease—an infection caused by a type of bacterium carried by deer ticks—often causes achiness in the joints, according to the American Lyme Disease Foundation. “Many times people don’t know that they’ve been bitten by a tick,” says Dr. Colvin, so it’s easy to mistake the pain for arthritis. “If someone comes in with knee pain and swelling but no explanation, doctors can drain fluid, and test it for Lyme,” says Dr. Colvin. If the results are positive, they can prescribe antibiotics. And if your doctor suspects Lyme, she’ll probably also ask if you have any of these other silent symptoms of the disease.

Psoriatic arthritis

Psoriatic arthritis is an autoimmune disease that develops in around 30 percent of people who have the scaly skin condition psoriasis, according to the National Psoriasis Foundation. Usually, psoriasis develops first, with the joint problems coming later, but in some cases, joint pain can be the first system, notes the Mayo Clinic. Psoriatic arthritis can target any joint in the body, but people often notice their fingers and spine are the achiest spots. Psoriatic arthritis never goes away, but it can be managed with drugs and lifestyle changes.

Gout

Think you have arthritis in your hip or big toe? It might actually be gout, a form of inflammatory arthritis, says Dr. Colvin. The pain and swelling from gout occur when too much uric acid crystallizes in the blood, then builds up in the joints. The result: extreme pain in the joint that may come and go, according to the CDC. Fortunately, if your doctor diagnoses gout, she can prescribe medications to help keep symptoms in check, says Dr. Colvin. If you still need relief from gout, try these home remedies proven to ease the pain when it flares.

Hypothyroidism

Some people with a sluggish thyroid can experience arthritis-like joint pain and swelling—especially in the shoulders and hips according to the Mayo Clinic. Here’s why: As your metabolism slows down, fluid can build up in the joints, causing the achy symptoms. But it’s more likely that you’ll notice the condition’s other symptoms first, such as fatigue, hair loss, and increased sensitivity to cold. If you are diagnosed with an underactive thyroid, your physician can prescribe synthetic hormones to treat the small butterfly-shaped gland. Check out the best habits that will keep your thyroid healthy.

https://www.rd.com/health/things-that-arent-arthritis/

Help Me Understand Psoriasis vs. Eczema

From health.usnews.com

These two skin conditions are very similar, but knowing the differences helps with treatment

Psoriasis or eczema? These common skin conditions affect a total of about 40 million Americans each year. They result in similar symptoms – red, dry, itchy, cracked skin – but they are very different diseases, with different causes and, in more severe cases, different treatments. That’s why it is important for patients to receive a proper diagnosis, in order to receive the treatment that will best bring relief.

Eczema is by far the more prevalent condition. According to the National Eczema Association:

• 31.6 million people (10.1%) in the U.S. have some form of eczema.
• 18 million adults (7.2%) have atopic dermatitis, the most common form of eczema.
• 9.6 million (13%) children under age 18 have atopic dermatitis.
• Childhood eczema is more common among African-Americans, Asians or Pacific Islanders than whites or Hispanics.
• Adult eczema is most prevalent among multiracial populations than Hispanics or whites.
• Eczema is more common among women.

In contrast, the National Psoriasis Foundation says that:

• More than 8 million Americans have psoriasis.
• Psoriasis often begins between ages 15 and 25, but the condition can develop at any age.
• Psoriasis is more common among Caucasians than African-Americans.
• Psoriasis is more common in women, but men have more severe forms of the disease.

Differences Between Psoriasis and Eczema

Psoriasis is a chronic autoimmune disease. The immune system attacks the skin, causing red, scaly patches on the skin or scalp. There are several types of psoriasis, with plaque psoriasis the most common and making up between 80% and 90% of cases. Other types are called guttate, inverse, pustular and erythrodermic psotiasis.

Eczema, a skin inflammation, can be related to and triggered by allergies, asthma and skin sensitivities to touch, fabrics like wool or chemicals in household and personal products. It can also result from dry skin or chemicals in the environment that irritate the skin.

Neither psoriasis nor eczema is contagious, but both conditions tend to run in families.

Symptoms of Eczema and Psoriasis

Eczema and psoriasis symptoms look very similar, which makes it hard for the average person to tell one from the other. Specialists, though, can differentiate between the two. One clue is the patient's age. “Both can occur at any age, but eczema commonly presents in infancy or childhood, while psoriasis most commonly peaks in the 20 to 30 age group and again in the 50 to 60 age group,” says Dr. Mark Lebwohl, a professor and chair of the department of dermatology at Icahn School of Medicine at Mount Sinai Medical Centre in New York City.

Where the symptoms occur also is telling. “The distribution is different. Psoriasis typically occurs on the back of the elbows and front of the knees, while eczema occurs in the inside folds of joints and the neck,” Lebwohl says. Eczema also generates a liquid that can ooze and crust over, whereas psoriasis rarely oozes, he says.

Treatments for Eczema and Psoriasis

Though each disease has differing underlying causes, they are treated similarly. “We don’t always cure them, but we can help control and manage the diseases,” says Dr. Seemal R. Desai, clinical assistant professor of dermatology at the University of Texas Southwestern Medical Center and a member of the American Academy of Dermatology board of directors.

First-line treatment for mild to moderate cases of both eczema and psoriasis is topical therapy, usually a corticosteroid cream. For more severe cases of psoriasis, there are a host of new medications, both injectable and oral, to treat autoimmune diseases like this. They target the specific immune cells that are behaving dysfunctionally, with Humira being a common, heavily advertised example of this kind of injectable medication. “Patients always think pills are safer than injections, but in this day and age injections are much safer,” Lebwohl says. “They attack just one small part of the immune system, where pills attack a larger portion of that system.”

Another treatment option is phototherapy, “a modified tanning treatment, which is indicated for both eczema and psoriasis,” Dr. Desai says. Ultraviolet light acts as an immunosuppressant on the skin. “Think of high-beam lights on your car. You flash the light to scare off an oncoming car. UV light is similar. There is a specific wavelength of light that scares away immune cells,” he says. Sunlight has the same effect, but it also includes the harmful wavelengths that cause burning. Phototherapy delivers just the one wavelength needed to treat the diseases.

“If you think you have one of these conditions, see a dermatologist early,” Desai recommends. “Even the best general practitioner, this is not their area of expertise. Don’t wait until your skin is so scaly and thick it causes scratching and bleeding.” He has a particular warning for people of color, who he says are underserved and often come in later in the disease process. “See a dermatologist who specializes in treating people of color,” he says.You can find a practitioner and learn more at www.skinofcolorsociety.org.

Self-Treatment for Eczema and Psoriasis

Both doctors recommend patients take good care of their skin, with emollient-rich moisturizing creams and lotions. “Scratching makes small tears in the skin, which can cause infection. An emollient can seal some of those cracks,” Desai says.

For those with psoriasis, losing weight can also be helpful. “The treatments work better if the patient loses weight,” Lebwohl says.

Practicing good general health habits also helps your skin:

• Eat a healthy diet.
• Drink more water.
• Drink alcohol only in moderation.
• Don’t smoke.
• Exercise.

https://health.usnews.com/conditions/psoriasis/psoriasis-vs-eczema

How to Find Real Relief for Dry Skin

From consumerreports.org

These tips can help you break the itch-scratch cycle

We tend to think of itchy skin as an annoyance that grows more common with age, not as a serious health concern. And common it is: A study of more than 300 seniors in Mexico found that 1 in 4 complained of chronic itch.
But itchiness can lead to lost sleep or depression, especially when scratching an itch seems to only make it worse. And itchy skin isn’t just challenging on its own—it can sometimes indicate an underlying medical problem.

The good news is that simple home remedies can often help relieve it, and doctors can help treat more serious cases.
“I really try to get my older patients out of the mindset that dry, itchy skin is something normal that they have to live with,” says Ilana DeLuca, M.D., Ph.D., a clinical assistant professor of dermatology at George Washington University. “You don’t have to just grin and bear it.”

Why Age Is a Factor

For most people, the diagnosis is simple: xerosis, the medical term for dry skin. Xerosis is often exacerbated in the winter by the dry air from home heating systems, but it’s common in seniors year-round.
Later in life, our bodies lose the ability to regenerate the fats and proteins that contribute to a healthy outer layer of skin, says Adam Friedman, M.D., a professor and the interim chair of dermatology at George Washington University. As a result, the skin loses its natural buoyancy and can become drier, rigid, and cracked.

Eczema and Psoriasis

Another common cause of itching is eczema, an umbrella term for several conditions that cause swollen rashes. Older adults with eczema may notice severe skin cracking on the lower legs.
Psoriasis, which is associated with autoimmune problems, can also lead to significant itching. Outbreaks frequently—but not always—occur on the elbows, knees, lower back, and scalp. Psoriasis shows up in red patches covered by a thick crust of dry and cracked skin, which will typically peel off in big white pieces.
Your doctor should be able to diagnose eczema or psoriasis with a physical exam.

Simple Tips for Relief

Small changes in your routine can help you manage itchiness and alleviate xerosis on your own. DeLuca says these steps should work for nine out of 10 people with itchy skin.
Wash with a mild soap. Common soaps can leave your skin itchy and dry. Try a gentle cleanser that’s free of dyes and perfumes.
Cool it with the showers. Washing your skin too frequently can dry it out, so avoid showering more than once a day. You may also want to try lukewarm showers; hotter water can wash away substances in skin that help it retain moisture.
Use a humidifier. This tip is especially useful in winter, when heated indoor air can make dry skin even drier.
Ice the itch. If you need immediate relief—and you’re tempted to scratch—Friedman says that icing the itchy area is a good quick fix.
Chlorinate your bath. Adding just a quarter-cup of bleach to 40 gallons of warm bathwater has been found to be an effective means of combating eczema. But be careful not to use too much.
Use moisturizer effectively. Moisturisers work primarily by locking in moisture your skin already has. So Friedman suggests using one right after you get out of the shower or bath. Wearing gloves or socks for a half-hour after application can also help, he says.
Talk to your doctor. If you’ve tried all of these suggestions and you’re still itching, it might be time to see a dermatologist, says DeLuca. Psoriasis and eczema, for example, can often be treated with topical steroids or narrow-band UVB light therapy. These help some patients, but ongoing steroid use can thin out the skin and light therapy can be time-consuming.
A doctor can investigate other possible causes of unrelenting itchy skin, such as kidney, liver, or thyroid problems. In very rare cases, itching could even be a sign of certain cancers, such as lymphoma. Allergies and medications (particularly opioids) can also make you itchy.

https://www.consumerreports.org/medical-conditions/find-real-relief-for-dry-skin/

Dealing with children's psoriasis

From gulfnews.com/uae/health

                                                                Image Credit: iStock

Like adults, children too get red scaly patches and plaques on elbows, knees and scalp; but unlike grown-ups, children’s face and even eyelids can get affected 

With ground-breaking treatment options being discovered at a rapid pace, life for psoriasis patients has taken a turn for the better over the past decade and a half.

We now know that psoriasis is not just a skin disease. Chemicals and cells involved in the inflammation have been found to be not only responsible for red scaly patches and plaques on the skin but also joint swellings, pain and many other problems.

An inflammatory systemic disease, psoriasis is often associated with diabetes, heart disease, joint swellings, inflammatory bowel disease, depression and even cancer. It affects about 2.5-3 per cent of the world population; that is about 125 million people regardless of age, gender, ethnicity and socio-economic status. About one third of adult patients develop the disease in their childhood.

Like adults, children too get red scaly patches and plaques on elbows, knees and scalp; but unlike grown-ups, children’s face and even eyelids can get affected, says Dr Srikumar Goturu, Specialist Dermatologist and Medical Director at Dr Joseph’s Polyclinic in Karama.

Paediatric psoriasis can be difficult to diagnose. Irritations that look like a diaper rash but doesn’t respond to treatment may be psoriasis. Teardrop-like scaly patches that appear on the body after a throat infection can be psoriasis too.

“The management of paediatric psoriasis is more important as it is well established that children with psoriasis commonly become obese, develop blood pressure, diabetes and high cholesterol, and are also more likely to have ischemic heart disease, arthritis and even inflammatory bowel disease, not to mention the psychosocial impact,” explains Dr Goturu.

About 19 per cent of the affected children get psoriatic arthritis — pain in their joints — compared to 30 per cent of the adults with psoriasis.

“Good treatment is a combined effort of a dermatologist, paediatrician, rheumatologist, nutritionist, psychologist, counsellor, the parents and the child,” he adds.

Various studies have discovered that the cost of caring for psoriasis patients can be more than the cost of treating heart attacks, cancers, or even serious road traffic accidents.

“Recent advances in our understanding of psoriasis and the many new medications that are available have revolutionised the management of the disease,” he says. The US National Psoriasis Foundation has declared complete cure of psoriasis as a goal. Although that seems difficult at the moment, it is possible to control psoriatic disease to almost 100 per cent nowadays, explains Dr Goturu.

Creams, lotions and shampoos are the first line of treatment. If the condition is severe, phototherapy is used.

Amber Clinics provides all the treatments licensed in Dubai. The most modern — the biologic treatment — has been in use for four years. “When pioneering biologic treatments for paediatric psoriasis are used judiciously, they can vastly improve the quality of life of the child as well as the family.

“We have an excellent protocol for the treatment of the disease and have been using all the recent medications with good outcomes as borne out by our patients.”

Effects of paediatric psoriasis

1. Low quality of life; 2. Disruption in family and social relationships; 3. Interferes with play and sport; 4. Affects normal development

How it affects adults

1. Embarrassment and isolation; 2. Low quality of life; 3. Anxiety and depression; 4. Associated problems such as hypertension, obesity, diabetes and metabolic syndrome; 5. Joint swelling and pains; 6. Absenteeism and job loss; 7. Sexual issues and marital problems; 8. Diet and lifestyle; 9. Networking

Lending a helping hand

Launched six months ago at Dr Joseph’s Clinic Karama, the Psoriasis Support Group provides patients a platform to understand the disease better. “Our main aim is to empower psoriasis patients through education and support,” says Dr Srikumar Goturu. “The interactive group offers an effective platform for patients to enhance their quality of life.” The unsightly appearance of the plaques, irritation and pain as well as the long-standing nature of the disease usually isolate patients. Discussions with their doctor about shared problems and concerns enhance understanding of the disease, which relieves emotional burden and anxiety. The patients recognise that they are not alone. To enrol in the Psoriasis Support Group, call 04 337 8828 or email docsrikumar@gmail.com

PATIENTS REVEAL THEIR PSORIASIS JOURNEY

“Diagnosed with psoriasis 12 years ago, I’d learned to accept the plaques on my body and adopted a dress code that concealed them. Over the years I’ve tried to understand the triggers and changed my lifestyle for better. I’ve been managing the condition on my own. However, things changed drastically two years ago, when a pain in the knuckle started to increase gradually, making it almost impossible to carry out simple daily tasks. I was then diagnosed with psoriatic arthritis. Although I learnt a lot about my condition and how to deal with it on the net, denying medication due to the high cost associated with the biologics vaccination worsened my condition. A year later when I couldn’t manage the pain anymore, my doctor, Srikumar Goturu, suggested trying a cheaper alternative oral drug. It turned out to be a lifesaver. Today I’m a happier person and try to give back by working closely with the doctor on the Psoriasis Support Group, helping people with similar issues.”

Deepa C.

“I was diagnosed with psoriasis eight years ago. I found it difficult to deal with the disease in the initial days. I met a lot of doctors and was advised different medications. I met Dr Srikumar Goturu about 18 months back. Things have improved drastically since. As the treatment was very expensive, he guided me to different charitable institutions for my medication. Being part of the Psoriasis Support Group has also helped me immensely. Sharing our experiences with each other gives us the feeling that we are not in this alone.”

Rakesh Singh

https://gulfnews.com/uae/health/dealing-with-psoriasis-1.1554023364709

What to know about psoriatic arthritis jaw pain

From medicalnewstoday.com

Psoriatic arthritis can affect any joint in the body, including the jaw. The condition can cause jaw pain, teeth grinding, and other dental issues such as tooth loss.

Psoriatic arthritis (PsA) is an autoimmune condition. It causes joint pain, swelling, and stiffness.
PsA causes inflammation that attacks healthy joints and tissue, leading to painful symptoms.
In this article, we look at how PsA can affect the jaw. This includes jaw-related symptoms, complications, treatments, and how to relieve jaw pain.

PsA and jaw pain

PsA can affect the temporomandibular joint (TMJ), or jaw joint, in the same way as other joints in the body.
Recent research suggests that jaw pain may affect up to 35 percent of people who have PsA.
One study states that psoriasis and PsA play a significant role in TMJ disorders. These TMJ problems can include:

• clicking or making other sounds when using the jaw
• pain when moving the jaw
• misalignment of the jaw
• teeth grinding, or bruxism

People who have jaw pain from PsA may experience symptoms that make it difficult to chew, eat, drink, speak, and sleep.
Many current treatments can help control inflammation and the immune system's involvement, allowing many people with PsA to lead active lives and stay healthy.

Can PsA cause dental problems?

PsA mainly affects the joints, but it appears to have a link to gum disease and dental problems, too.
One 2013 study found that people with PsA had more severe gum problems than those who did not have the condition. Gum disease can lead to chronic bad breath, changes in bite, and, in severe cases, tooth loss.
A more recent study suggests that the inflammation in PsA could lead to gum inflammation. However, researchers need to explore this further to fully understand the link.
People with PsA have a higher rate of TMJ problems, which can lead to tooth damage from grinding and clenching. A dentist may prescribe a bite splint that a person can wear over the teeth to protect them from damage.

Home remedies for PsA and jaw pain

There are some home remedies that can help relieve jaw pain, clicking, grinding, and any other symptoms that affect the jaw.
Medical treatments can tackle the underlying causes of PsA symptoms to prevent joint damage and stop the condition from progressing.
People should not rely on home remedies alone to treat PsA, however. This is because even if symptoms are mild, the condition can still cause permanent damage to the joints.
To relieve PsA-related jaw pain at home:

Apply ice or heat

Many people find that applying a moist heat pack is effective for relieving jaw pain and stiffness. Ice packs can also soothe pain and reduce swelling and inflammation. However, avoid leaving an ice pack on for more than 10 minutes at a time.

Adopt a jaw-friendly diet

People with PsA that affects the jaw may wish to temporarily switch to a jaw-friendly diet when their symptoms flare up.
A jaw-friendly diet includes foods that are soft or liquefied to give the jaw a chance to rest and heal.
Tips for adopting a jaw-friendly diet include:

• avoiding chewy and crunchy foods, such as crusty breads, chips, and chewy meats
• opting for cooked instead of raw vegetables and fruits
• making smoothies with fresh vegetables and fruits
• eating soups

Rest the jaw

A jaw that is inflamed from PsA may be less painful when a person gives it time to rest. Some ways to rest the jaw include:

• avoiding chewing gum
• being mindful of chewing habits, such as biting the nails or chewing on pens, that can stress the jaw
• taking time away from activities that require extensive talking, such as lectures and meetings
• avoiding cradling a phone between the face and shoulder, as this can stress the neck and jaw muscles

Reduce stress

High stress levels can cause a person to grind their teeth and clench their jaw more often. Using relaxation techniques such as meditation, yoga, and deep breathing can help reduce tension in the jaw.
Reducing stress can also help with other PsA symptoms, as stress can cause psoriasis and PsA flares.

Seek physical therapy

Practicing specific exercises, with the guidance of a physical therapist, can help relieve PsA symptoms in the jaw and other joints.
Research has found that physical therapy can help with TMJ symptoms and jaw joint pain.
Physical therapy for the jaw may involve jaw movements, stretches, and correcting the positions of the body and head.

Exercise

Physical activity can help reduce stress and improve sleep. The National Psoriasis Foundation recommend exercise as a way to relieve PsA symptoms. Regular exercise keeps the joints and tendons loose and reduces inflammation.

Treatments

Inflammation and an overactive immune response cause most PsA symptoms, including those in the jaw.
Because of this, doctors will usually treat PsA-related jaw pain by reducing one or both of these.
Below are some treatment options for PsA, including jaw-related symptoms:

• Take nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, aspirin, and naproxen, for temporary pain and inflammation relief. Ask a doctor before taking NSAIDs for prolonged periods of time.
• Ask a doctor about corticosteroid injections, which can quickly reduce swelling and pain. A clinician will usually administer these in-office.
• Take prescription inflammation medicine. Some newer oral medicines, such as tofacitinib and apremilast, can help control inflammation that causes PsA.
• Take disease-modifying anti-rheumatic drugs, which prevent inflammation-causing chemicals that result in the clinical findings seen in PsA.
• Ask a doctor about biologics. Scientists make these agents from living cells in a laboratory. A person takes biologics by injection or infusion. These drugs target certain cells or proteins in the immune system that cause PsA.

Diagnosis

There is no single test for PsA or TMJ problems. However, a clinician will use a combination of medical tests, a person's medical history, and a physical exam to determine whether a person has PsA and which joints may be affected.
Diagnostic tests for PsA and jaw involvement may include:

• blood tests, which can help rule out other types of arthritis, such as rheumatoid arthritis
• X-rays of the jaw and other joints, though these do not usually detect early-stage PsA
• MRI scans
• a skin exam to look for rash or silvery scales, which are signs of psoriasis
• a physical exam of the jaw
• medical history and family history, because PsA can be genetic

Other symptoms of PsA

PsA is related to psoriasis, a skin condition that causes a scaly rash. About 30 percent of people who have psoriasis also develop PsA. As a result, many clinicians will check for PsA when a person experiences psoriasis and joint pain together.

However, doctors cannot always diagnose PsA based on skin symptoms alone. Some people develop PsA without having psoriasis. In 85 percent of people with PsA, the skin symptoms come before the joint symptoms.
PsA is different from other forms of arthritis. Many types of arthritis can cause joint pain and stiffness, but PsA has its own unique symptoms.
Studies show that two particular symptoms can be tell-tale signs of PsA: enthesitis and dactylitis.

Enthesitis

Enthesitis is inflammation in areas where tendons or ligaments attach to bones. This can cause new bone to form, similar to a bone spur.
It can also cause pain, stiffness, and swelling. Enthesitis often affects the heels, bottoms of the feet, fingertips, elbows, knees, hips, and the spine.
The pain from enthesitis may be focused on an area next to the joint rather than the joint itself.

Dactylitis

Dactylitis causes swelling, inflammation, and pain in an entire digit (finger or toe). This symptom can cause severe pain and may make it difficult or impossible to move the affected digits.
Dactylitis normally affects one or a few digits, but not in a symmetrical pattern. This means that it can affect one side of the body and not the other.

Other signs

Other signs of PsA include:

• spondylitis, wherein PsA affects the joints in the spine, pelvis, or neck
• fatigue
• joint stiffness, especially in the morning
• pain, throbbing, and stiffness in one or more joints
• nail changes, such as crumbling, pitting, or a nail fungal infection
• uveitis, which is inflammation within the eye that causes redness and pain, affects about 7 percent of people with PsA

Outlook

PsA symptoms, including those that affect the jaw, can be painful and disruptive to a person's daily life. However, following an effective treatment plan for PsA can help a person get relief and, in many cases, achieve remission.
The Arthritis Foundation say that up to 60 percent of people with PsA can achieve remission with proper treatment. Remission means that there is very little disease activity in the body. However, it does not mean that a condition is cured, or that a person can stop taking their medications.
People with PsA must take their medications indefinitely, as their doctor prescribes, to keep their condition under control and achieve the best possible quality of life.

https://www.medicalnewstoday.com/articles/324751.php

How to Reduce Your Risk of a Stroke With Psoriasis

From healthcentral.com

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Skin and stroke: not typically relatives. But increasing evidence shows a connection between psoriasis – a chronic skin condition that causes dry and itchy patches of skin – and a higher risk of stroke and other cardiovascular disorders, according to an article published in Cureus. The researchers suggest that the chronic inflammation associated with psoriasis is also central to strokes and other cardiovascular diseases. However, even with an increased stroke risk there are still things you can do to stay as healthy as possible.

Why stroke and psoriasis might be related

After an extensive review of the evidence, the authors of this latest study believe that those of us with psoriasis are more likely to have increased cardiovascular risk factors such as hypertension, diabetes, and obesity compared to the general population. The risks are even higher if we have severe psoriasis and psoriatic arthritis. In two different studies of psoriatic arthritis that were included in the review, death was more likely than in the control groups, and cardiovascular disease was the leading cause of death.The authors of the review believe there may be a variety of reasons psoriasis and stroke are related. One reason is that severe psoriasis is associated with an increased prevalence of metabolic syndrome, a chronic inflammatory state. The inflammation that is present with psoriasis is also linked to elevated levels of C-reactive protein, which is an independent risk factor of cardiovascular disease. Psoriasis is also associated with other health risks such as obesity and an increase in cholesterol levels that could lower the quality of life.

How to lower your risk

The good news is that stroke is largely preventable by lowering your risks. This can be done by what is referred to as Life’s Simple 7. These anti-stroke behaviours include not smoking, being physically active, maintaining a healthy body weight, eating a healthy diet, controlling blood pressure, cholesterol, and blood sugar.
If you are living with psoriasis, you should also go a step further by making sure that your psoriatic disease is being treated as well as possible. The inflammation that you see on your skin begins below the skin, so you want to make sure that you are treating the inflammation throughout your body. These latest findings led the study investigators to suggest that psoriasis should be treated systemically with methotrexate or biological drugs to reduce stroke risk.

You may also want to talk to your doctor about measuring and determining your overall stroke risk. Your doctor can determine if you are at low, moderate, or high risk of stroke. If you are at a high risk of stroke due to a variety of risk factors, you may want to discuss therapeutic interventions directly related to stroke prevention with your doctor.

https://www.healthcentral.com/article/how-to-reduce-your-risk-of-a-stroke-with-psoriasis