Psoriatic Arthritis Affects Men and Women Differently

From creakyjoints.org

New study suggests men and women experience psoriatic arthritis (PsA) differently, both in symptoms and response to treatment

Key Takeaways 

• Men and women experience psoriatic arthritis differently
• Women tend to have more pain and fatigue from their disease than men
• Men had more skin involvement

A new study found that men and women experience psoriatic arthritis differently. The researchers believe this information can help clinicians target treatment better. For example, women might need more treatment for pain and fatigue, and men might benefit from treatment targeting back pain and skin.

Researchers completed a systematic literature review of works published between January 1, 2015, and November 13, 2020, via MEDLINE, Embase, and the Cochrane Database of Systematic Reviews. They looked for observational studies on psoriatic arthritis that reported results separately by gender. The scientists excluded studies with less than 100 participants and interventional studies.

They included 27 different studies with participants who were, on average, between ages 41.9 and 58.3. Most of the participants were women, and researchers collected data on:

• Patient characteristics
• Demographics
• Disease outcomes
• Study design

Despite diagnosis occurring in similar numbers for men and women, there were distinct differences in symptoms. Some of the researchers’ findings included:

• Women had higher rates of peripheral disease, indicating they had higher counts of tender joints
• Men had higher rates of axial disease, with higher rates of ankylosing spondylitis
• Men had higher rates of plaque psoriasis
• Women scored worse in pain, fatigue, functional limitations, and work disability
• Women had poorer responses to treatment

The researchers found that their study could not give more information about how much the disease affected the participants. To know more, they would need to talk with each person. Because this study looked at other studies, they could not get more information from the people involved.

The scientists noted that their results do not detail self-reported functional impairment, pain levels, and the overall effect of the disease; interviews with each participant would be necessary. Since this study looked at previously conducted observational studies, it was impossible to dig deeper into participants’ answers.

“I think gender differences are becoming a key interest in rheumatology, and it’s clear that there is increasing evidence of differential disease presentation, impact, and response,” says Laura Coates. MBChB, MRCP, PhD, an NIHR Clinical Scientist, and lead author. “This study brought a great deal of data together to look for patterns across multiple studies and found a lot of consistency.”

“I think the main thing is that we have to treat everyone as an individual, and how we interpret outcome measures and plan trials should probably start to take sex or gender into account more.”

Gender Bias in Health Care

Much of the literature shows that psoriatic arthritis can affect both men and women, but women are more likely to experience pain, fatigue, and functional limitations. They are also more likely have a longer duration of symptoms before diagnosis than men. This is because their symptoms are often dismissed by doctors.

Gender bias in health care, which is still a problem today, may play a role.

A 2018 study found that doctors view men with chronic pain as brave, while they describe women with chronic pain as emotional or hysterical. A survey of physicians and dentists, also completed in 2018, found that health care professionals believe women exaggerate their pain.

Gender bias in health care can have significant consequences. Women whose symptoms are dismissed may avoid doctors, missing important health care check-ups. They may delay treatment until symptoms can no longer be ignored, which could be too late for effective treatment.

If you are experiencing symptoms of psoriatic arthritis, it’s important to see a doctor right away. Do not let gender bias prevent you from getting the care you need.

What This Means For You

Women with psoriatic arthritis are more likely to have fatigue and pain. But men are more likely to experience back pain and plaques on their skin. Both men and women can have trouble doing things they used to be able to do, and their symptoms can make it hard to work.

It’s important to get diagnosed and treated for psoriatic arthritis as soon as possible. A study published in 2021 found that if people wait even six months to get diagnosed, they might not respond as well to treatment.

“Unfortunately, it can take a while to get diagnosed,” says Amro Balki, MD, a rheumatologist. “But it might take longer for women, because they might get misdiagnosed before they see a rheumatologist.”

Once you’re diagnosed, it’s important to see your rheumatologist regularly so they can help you manage your condition.

https://creakyjoints.org/about-arthritis/psoriatic-arthritis/psa-symptoms/psoriatic-arthritis-men-and-women/ 

When You Have Psoriasis, Change Is a Constant

From everydayhealth.com

By Howard Chang

Over time, your relationship with psoriasis has likely had its ups and downs.Evgeniy Shvets/Stocksy

I started writing this blog, the Itch to Beat Psoriasis, 15 years ago. That was also the year Apple announced the first iPhone, NASA launched the Phoenix Mars lander, and J.K. Rowling published the final book in the Harry Potter series.

I had a lot of psoriasis back then. Early biologics didn’t help me as much as I’d hoped they would. I couldn’t tolerate the stomach upset from methotrexate any longer. I feared continuing cyclosporine treatment because it had the potential to damage my kidneys.

I felt alone with psoriasis, too. In my hope to connect with others I came across a couple of psoriasis blogs on a website called HealthTalk. By the end of the year, I had published my first blog post there, which would eventually lead to the Itch to Beat Psoriasis.

This is what I wrote to conclude that first entry: “I hope this blog can be a tool to contribute in a small way to the need to connect and communicate about that part of our lives that so often stays under wraps: psoriasis.”

Since launching my blog, my relationship with psoriasis has changed in some ways but not in others. Consider how your relationship with psoriasis has changed over time and what your hopes are going forward.

My Psoriasis Treatment Has Evolved, and So Has My Self-Care

Over the past 15 years, psoriasis research has advanced the understanding of psoriasis as an immune-mediated disease. In tandem, innovative biologic treatments have become more effective and convenient. I can testify to an improvement in my overall quality of life as a direct result.

At the same time, I’ve changed my assumptions about what these drugs can accomplish. I once expected my prescription medications to do all the work of quelling my skin inflammation. I figured that if I popped a pill, and regularly injected my biologic, I’d be fine no matter what else I did.

That meant stressing my body and mental health to the limit. I worked long hours, often not taking a day off for weeks. I regularly deprived myself of sleep to get as many tasks completed as possible. I knew I needed to exercise but didn’t prioritize it. If my psoriasis flared, I took more medicine — even if that meant a greater chance of adverse effects.

I’ve since changed my lifestyle to complement my medications. Three years ago, I faced burnout and took an extended break from my work. I realised quickly that I had to find a more sustainable job. My employment now is much less stressful and affords me more time to care for my health. Additionally, I have more capacity to improve my diet and sleep habits while striving to exercise daily.

Ask yourself: As treatments have advanced, have you changed how you manage your psoriasis, both through medications and lifestyle?

It’s Gotten Easier to Make Psoriasis Connections 

The ability to connect with other people living with psoriasis has increased dramatically since I started blogging. In those early years, many people shared how alone they felt before they read the blog and took the opportunity to discuss their own experiences living with psoriasis.

The advent of the smartphone and social media has further transformed the way we connect. Before that, I had never met another person with psoriasis until after high school when I received treatment in a day-care clinic. I rarely met others living with the condition outside of medical settings. But virtual spaces have allowed us to find each other in ways we never imagined.

I embraced the opportunity to make friends and join online groups. I met friends from around the country and world who are within reach virtually if I ever need their advice or support. I later served as a National Psoriasis Foundation Social Ambassador, volunteering to blog and post on social media to further the group’s initiatives.

Ask yourself: In what ways have electronic tools enhanced your journey with psoriasis, especially in managing your health?

I Won’t Stop Looking Forward to a Psoriasis Cure

Despite these two important ways my relationship with psoriasis has grown, one aspect has not changed: my wish for clear skin. The other night I looked at the clear skin on my wife’s arm and for a moment wished I, too, could have an arm without psoriasis. 

It’s not that I don’t accept living with psoriasis. I have good skincare routines and treatments. I like my dermatologist and enjoy good medical care. I’ve grown in self-acceptance and confidence through the hard work of facing emotional trauma caused by my condition.

But still, I allow myself to daydream about clear skin on hopeful days. If the advancements in medical science lead to a cure for psoriasis, I will be ecstatic beyond belief. I won’t stop looking forward to a cure until there is one.

Indeed, I’m crossing my fingers that it’ll be within the next 15 years.

https://www.everydayhealth.com/columns/howard-chang-the-itch-to-beat-psoriasis/when-you-have-psoriasis-change-is-a-constant/

How to Identify and Treat Psoriasis on Your Feet

From healthline.com

When psoriasis develops on your feet, it can cause uncomfortable itching or soreness that makes tasks like walking difficult.

Psoriasis, an autoimmune skin condition, usually causes itchy and scaly rashes but can also cause pus-filled blisters. It most commonly develops on your:

• knees
• elbows
• scalp
• trunk

Psoriasis can affect many other parts of your body, such as your feet. In a 2020 studyTrusted Source from Denmark, researchers found the soles of the feet were the fourth most common hard-to-treat area.

Mild psoriasis on your feet can be managed with home remedies such as moisturizers, but more severe psoriasis may need prescription medications.

Read on to learn more about the signs of psoriasis on your feet and how it can be treated.

Types of psoriasis that can affect your feet

Psoriasis is divided into subtypes depending on its features. Several types can develop on your feet.

Plaque psoriasis

Plaque psoriasis is the most common type of psoriasis. It makes up about 90% of cases. It’s also known as psoriasis vulgaris. Vulgaris is the Latin word for “common.”

Plaque psoriasis on your feet causes similar symptoms as when it develops on other parts of your body. It’s characterized by raised patches of dry and scaly skin. These patches tend to be itchy or sore.

Palmoplantar psoriasis on feet

When plaque psoriasis occurs on the palms of your hands or soles of your feet, it’s referred to as palmoplantar psoriasis. In a study of people with psoriasis, 15% of them were found to have palmoplantar psoriasis.

Localised pustular psoriasis on feet (also known as palmoplantar pustular psoriasis)

Palmoplantar pustular psoriasis is a rare form of psoriasis that causes pus-filled blisters to form on your palms or the soles of your feet. It’s much more common in women between the ages of 40 and 69 who smoke.

Nail psoriasis

Nail psoriasis is when psoriasis also causes nail symptoms. According to the American Academy of Dermatology Association, nail symptoms usually start years after psoriasis develops on your skin. They may include:

• grooves
• blood beneath the nail
• lifting of the nail from the nailbed

Guttate psoriasis

Guttate psoriasis causes small red and scaly spots to form on your skin. These spots often resemble raindrops and generally form on your:

• trunk
• upper arms and legs
• face
• scalp

Guttate psoriasis has also been reported in case studiesTrusted Source on the soles of the feet. It’s usually triggered by infections, particularly strep throatTrusted Source.

Erythrodermic psoriasis

Erythrodermic psoriasis makes up about 1% to 2.25%Trusted Source of cases of psoriasis. It causes redness over at least 75% of your body’s surface. It can also lead to fluid retention in parts of your body, such as your feet and ankles.

Erythrodermic psoriasis requires immediate emergency medical attention to prevent severe complications such as heart failure or hypothermia.

Acropustulosis

Acropustulosis is a rare form of psoriasis that causes a painful rash on the soles of your feet or palms of your hand. The rash may contain small, reddish, flat bumps that turn into blisters.

Acropustulosis is most common in infants but can affect anybody.

Symptoms of psoriasis on feet

Psoriasis can cause similar symptoms on your feet as on other parts of your body. Psoriasis on the feet can be mild, only affecting a small area of your feet, to severeTrusted Source, which affects your quality of life. Symptoms usually flare up for a few weeks to a few months and then go into remission for months to years. 

Plaque psoriasis can cause:

• red and inflamed patches covered in whitish-silver scales
• itching and burning
• pain
• dry and cracked skin
• pitted and thick nails

Plaque psoriasis patches tend to be pink or red on people with light skin and violet or dark brown on people with darker skin.

Palmoplantar pustular psoriasis can cause:

• tiny blisters filled with yellow pus
• scaly skin
• painful cracking
• bleeding

About 10% to 25% of people with palmoplantar pustular psoriasis also have plaque psoriasis.

Psoriatic arthritis

About 20%Trusted Source of people with psoriasis also develop psoriatic arthritis. Psoriatic arthritis can affect any of your joints but often occurs in your:

• knees
• ankles
• hands
• feet

Symptoms can include:

• swollen and tender joints
• stiffness in the mornings
• swollen fingers or toes
• lower back pain

What causes psoriasis on your feet?

Psoriasis develops when your immune system attacks healthy skin cells. It’s not clear why this happens, but a combination of genetic and environmental factors likely play a role.

People with family members with psoriasis are at an elevated risk of developing it too. In a 2020 study, researchers found 31.9% (444 of 1,393)Trusted Source of people with psoriasis had a family history.

The most common gene associated with palmoplantar psoriasis is HLA. People with a version of this gene called HLA-Cw6 seem more susceptible to developing psoriasis.

Symptoms often develop when genetically susceptible people are exposed to certain triggers.

Triggers vary between people but often include:

• stress
• certain foods
• alcohol
• excess sunlight
• cold and dry weather
• obesity
• smoking
• some medications
• infections
• skin injury
• hormone changes

The majority of people with palmoplantar psoriasis are current or former smokers. It’s been hypothesized that activated nicotine receptors in sweat glands could trigger an inflammatory reaction that leads to psoriasis.

Psoriasis on feet pictures

Here are some images of different types of psoriasis on the feet.

VIEW ALL

Plaque psoriasis on a foot. | 2Ban/Shutterstock

How to treat psoriasis on your feet

Psoriasis doesn’t have a cure, but a combination of home and medical treatments can help relieve flare-ups and symptoms.

Home remedies

Home remedies might be all you need to treat mild psoriasis. The following remedies may help ease your symptoms:

• warm baths
• oatmeal baths
• aloe vera to soothe irritation
• emollient creams to lower itching and scaling

Making lifestyle changes may help reduce flare-ups. Some habits you can adopt include:

• maintaining a moderate weight
• avoiding smoking and reducing alcohol intake (quitting can be difficult, but a doctor can build a cessation plan that works for you)
• eating a balanced diet
• keeping your skin moisturised
• tracking your symptoms with a diary
• minimising stress
• exercising regularly

Over-the-counter treatments

Some over-the-counter medications may help ease your symptoms. These include:

• coal tar to lower itchiness and flaking
• hydrocortisone creams or ointment to lower inflammation
• moisturizers to keep your skin hydrated
• salicylic acid products to soften scaly skin
• anti-itch creams

Medical treatment

A doctor may prescribe you stronger medications if you have moderate or severe psoriasis. Some of these medications include:

• apremilast
• biologic drugs
• cyclosporine
• methotrexate
• retinoids
• prescription topical steroids

A doctor may also recommend you try light therapy to treat pain and itchiness. This treatment involves exposing your skin to ultraviolet light in a controlled way to lower symptoms.

When to contact a doctor

It’s a good idea to visit a doctor any time you develop an unknown rash or skin lesion. A doctor can help you determine if it might be a sign of psoriasis or another condition.

The National Psoriasis Foundation recommends seeing a dermatologist if:

• your symptoms are flaring up or getting worse
• treatments recommended by your primary care doctor aren’t working
• you’re interested in trying treatments such as biologics, oral medications, or phototherapy

How do doctors diagnose psoriasis on your feet?

A primary care doctor may be able to diagnose psoriasis based on the appearance of your skin if you have typical symptoms. They may refer you to a dermatologist if your condition is severe or if they aren’t sure if you have psoriasis. They may refer you to a rheumatologist if you have signs of psoriatic arthritis.

In some cases, a small skin sample called a biopsy may be taken to confirm the diagnosis.

Takeaway

Psoriasis can develop on any part of your body, including your feet. Symptoms can range from mild to severe. Some people have soreness that may lead to disability.

There’s no cure for psoriasis, but a number of treatments can help you manage your symptoms. If you have mild psoriasis, a doctor may recommend home remedies and over-the-counter treatments. They may recommend prescription medications or light therapy if your symptoms are more severe.

https://www.healthline.com/health/psoriasis/psoriasis-on-feet?slot_pos=article_5&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2023-04-04&utm_term=s:hl_n:pso&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e#diagnosis

12 Ways to Treat Psoriasis at Home

From healthline.com

You may be able to manage mild psoriasis symptoms at home with supplements, moisturisers, or other home remedies. What works for one person may not work for another, so it’s important to find what works for you and the symptoms you’re experiencing.

Treating psoriasis

Psoriasis is a recurring autoimmune disorder that affects more than 7.5 million AmericanTrusted Sourceadults.

It tends to appear pink or red, usually with silvery-white scales, on those that have fair to light skin tones. On medium skin tones, it may look salmon-coloured with a silvery-white scale, and on darker skin tones, it could look violet and the scale grey. Or it can also appear dark brown and difficult to see.

Even though it affects your skin, psoriasis actually begins inside your body in your immune system.

Psoriasis is a condition where your T-cells, a type of white blood cell, can become overactive to produce other immune markers that can cause an inflammatory reaction on the skin. The reaction on the skin shows up in the form of silvery-white scale, depending on the skin ton

Even though there’s no cure, many treatments exist to ease the symptoms of psoriasis. Here are 12 ways to manage mild symptoms at home.

1. Take dietary supplements

Dietary supplements may help ease psoriasis symptoms from the inside.

Fish oil, vitamin D, milk thistle, aloe vera, Oregon grape, and evening primrose oil have all been reported to help ease mild symptoms of psoriasis, according to the National Psoriasis Foundation.

Check with your doctor before taking supplements to make sure they don’t interfere with other health conditions you may have or medications you’re taking.

2. Prevent dry skin

Use a humidifier to keep the air in your home or office moist. This can help prevent dry skin before it starts.

Moisturizers for sensitive skin can keep your skin supple and moisturized.

3. Try aloe

Aloe vera has been shown in some cases to reduce redness and irritation caused by psoriasis. A 2010 studyTrusted Source found aloe vera gel cream to be slightly more effective in improving psoriasis symptoms compared to 0.1 percent triamcinolone acetonide, a steroid cream used to treat psoriasis.

More research is needed to show for sure if aloe vera can improve symptoms of psoriasis. However, the risk of trying aloe vera gels or creams is low, so it may be worth a try.

4. Avoid fragrances

Most soaps and perfumes have dyes and other chemicals in them that may irritate your skin. They can make you smell great, but they also can inflame psoriasis.

Avoid such products when you can, or choose those with “sensitive skin” labels.

5. Eat healthfully

Diet may play a role in managing psoriasis.

Limiting red meat, saturated fats, refined sugars, carbohydrates, and alcohol may help reduce flare-ups triggered by such foods.

Cold water fish, seeds, nuts, and omega-3 fatty acids are known for their ability to reduce inflammation. This can be helpful for managing psoriasis symptoms.

Olive oil may also have soothing benefits when applied topically to the skin. Try massaging a few tablespoons on your scalp to help loosen troublesome plaques during your next shower.

6. Soak your body

A lukewarm bath with Epsom salt, mineral oil, milk, or olive oil can soothe the itching and infiltrate scales and plaques. Oatmeal baths can also be very helpful and soothing for plaque psoriasis.

Be sure that the water is not hot. Hot water can cause more irritation.

Moisturize immediately after your bath for double benefits.

7. Get some rays

Light therapy involves exposing your skin to ultraviolet light under the supervision of a doctor.

Ultraviolet light can help slow the growth of skin cells triggered by psoriasis. This therapy often requires consistent and frequent sessions. Sitting in the sun for 10 to 15 minutes can also help reduce plaques.

However, too much sunlight and tanning beds aren’t the best options as they can also increase your risk of skin cancer.

Light therapy should always be done under the supervision of a doctor.

8. Reduce stress

Any chronic condition like psoriasis can be a source of stress, which in turn can worsen psoriasis symptoms.

In addition to reducing stress whenever possible, consider incorporating stress-reducing practices such as yoga and meditation. 

9. Avoid alcohol

Alcohol is a trigger for many people who have psoriasis.

A study in 2015 found an increased risk of psoriasis among women who drank nonlight beer. Those who drank at least five nonlight beers per week were nearly twice as likely to develop psoriasis compared to women who didn’t drink.

10. Try turmeric

Herbs are commonly used to treat many conditions.

Turmeric has been found to help minimize psoriasis flare-ups. It can be taken in pill or supplement form, or sprinkled on your food.

Talk to your doctor about the potential benefits for you.

11. Quitting smoking

Avoid tobacco. Smoking may increase your risk of psoriasis.

If you already have psoriasis, it can make your symptoms more severe.

12. Maintain a healthy weight

Being overweight or obese puts you at a greater risk of developing psoriasis. Obesity is also associated with more severe psoriasis symptoms. StudiesTrusted Source have found that losing weight can help improve these symptoms.

Here are some tips for losing weight:

• exercise on a regular basis
• cut back on refined carbs
• eat plenty of vegetables and protein

The takeaway

There isn’t a single answer for keeping the symptoms of psoriasis at bay. What works for one person may not work for another.

Some treatment options may have negative side effects for preexisting conditions other than psoriasis.

While these remedies for psoriasis may help with mild cases, prescription therapy is required for more severe cases. Talk to your doctor before seeking treatment on your own.

A dermatologist can treat the thick, red, scaly patches of skin (also known as plaques) from psoriasis. They can also treat other parts of your body that moderate to severe psoriasis may affect, such as your scalp and nails. Consider checking with your dermatologist when you experience a flare or worsening symptoms.

Nearly a third of people with psoriasis develop a condition called psoriatic arthritis. This can cause swollen, stiff, or painful joints. A rheumatologist can determine if you have psoriatic arthritis and prescribe treatments to control your symptoms. This type of doctor specializes in treating arthritis and other musculoskeletal disorders.

Psoriasis has been linked to other health conditions, such as lymphoma, heart disease, diabetes, and high blood pressure. A primary care doctor can help you find ways to reduce your risk of other conditions and improve your overall health. They can also screen you for early warning signs of psoriasis complications and refer you to a specialist, if necessary.

While psoriasis has no cure, it can be treated with a variety of prescription medications (like immunosuppressive drugs) and over-the-counter drugs (such as topical ointments). A pharmacist can provide information and tips on following your treatment plan and can make sure your medications are safe to take together. They can also answer questions or address concerns about your medications.

Stress has been shown to be a trigger for psoriasis flares. A psychologist, licensed professional counselor, or clinical social worker can help you develop personalized ways to manage stress. Self-care techniques — such as breathing exercises, journaling, meditation, yoga, and stretching — can also help you ease stress.

Cutting back on foods that trigger psoriasis flares can help reduce symptoms. A dietitian can help you develop a nutritious eating plan that may potentially reduce inflammation in the body. They can also help you maintain a healthy weight to avoid obesity and reduce your risk of psoriasis-related complications, such as diabetes and heart disease.

https://www.healthline.com/health/psoriasis/treat-symptoms-home?slot_pos=article_1&utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=psoriasis&utm_content=2023-04-04&utm_term=s:hl_n:pso&apid=39239719&rvid=058431b717dcfa59c0cdd27cd0a9313769e8b3dd4ad59d88efd0ded7ddb4774e