Hi I am new to Fumaderm (I started on 01.04.14) for those of you unlucky enough to experience any of the side effects how long was it before they started? I'm wondering if my imagination has gone into overdrive!!

I have a quick question – does any of the women (most men don't have this problem) on this site have any magic solution for yeast infections? I am the unlucky recipient of a bacterial infection and now have a yeast infection in just about any place that has a fold in my body. To make things worse, I know have inverse psoriasis in several of those locations. Drying out the areas where the yeast infection occurs helps with that problem, but causes my inverse psoriasis to spread. I have been mixing antifungal creams with low dose corticosteroid cream without much luck.

This part may be too much info. Stop reading if you do not want to hear about the bacterial infection. I have postulates all over certain locations of my body. My GP said it’s a bacterial infection. I am ½ way done with my antibiotic and I have more postulates than before. I can’t see my dermatologist until the 21st, and I am ready for my Stelera injection. My dermatologist says to go ahead and take it, but not sure I am comfortable.

Following on from the European Commission, USA, Canada, and Scotland. England have decided Stelara will not be used for psoriatic arthritis. It works and I'm living proof of that, Boo Hiss to you England.

Stelara approved for Psoriatic Arthritis.

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Final draft guidance, from the National Institute for Health and Care Excellence, published today does not recommend ustekinumab (Stelara) for psoriatic arthritis.


Ustekinumab (Stelara) is not recommended within its marketing authorisation for treating active psoriatic arthritis, that is, alone or in combination with methotrexate in adults when the response to previous non-biological disease-modifying antirheumatic drug (DMARD) therapy has been inadequate.
   
People currently receiving treatment initiated within the NHS with ustekinumab that is not recommended for them by NICE in this guidance should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

The Committee concluded that ustekinumab is not a cost-effective treatment option for people who have not previously received TNF alpha inhibitors, for those cannot take them, or for those who have received TNF alpha inhibitors. In the economic analysis for people who have not previously received TNF alpha inhibitors (the ‘TNF alpha inhibitor-naive' population), ustekinumab was dominated by - that is, was more expensive and less effective than - adalimumab. In all other populations, including people who have previously received TNF alpha inhibitors (the ‘TNF alpha inhibitor-exposed' population) and people for whom TNF alpha inhibitors are not appropriate, the most plausible incremental cost-effectiveness ratio (ICER) for ustekinumab is likely to exceed £30,000 per quality-adjusted life year (QALY) gained.

Hello all, my name is stacey and I'm looking for some advice on being able to purchase coal tar paste like they use in hospitals, I was diagnosed from the age of 5yrs old and have suffered on and off since (I'm now 30) the only treatments that work for me is UVB treatment and coal tar paste, I used to as a child be taken into hospital for up to 5 weeks at a time and be slathered daily in the coal tar paste and had bandages put on over the cream, I'd also have UVB treatment 3times per week, I'm now a single mother of 4 and I'm unable to do so anymore, I'm struggling being able to get hold of coal tar paste from my local pharmacy can any one help with any links that I can purchase this miracle cream please xxxxxxxx I'm suffering at the moment with gut taste psoriasis but I also have the plaques my official diagnosis is chronic psoriasis xxx[/size][/b][/font]

Hi All,

I'd like to start by saying that I have never submitted anything online before but with recent events I feel that I need to share my experiences with you.

I'm a 41 year old male who has suffered from Psoriasis for 28 years. I have been prescribed everything from Steroid creams to Methotrexate. Even though the methotrexate worked a little, I wasn't happy taking such strong medication due to severe long term side effects like damaging your liver etc...

My partner fell ill and was very unwell for 18 months, tried various clinics, hospitals and medication but nothing worked for her. I suggested to her that maybe she should try alternative therapy so we visited a Chinese herbalist. 

She had a five minute consultation and was prescribed some simple vitamins, within a couple of weeks her symptoms improved significantly, she is now on the road to recovery. On the back of this I also visited the herbalist and explained the severity of my Psoriasis.

She told me to take Celedrin, Milk Thistle, Selenium, Multi Antioxident vitamins, vitamin D3 spray and some Chinese tablets called Shi Du Qing, all of which will help me with my liver as this was the cause of my Psoriasis.

The vitamins weren't cheap at £80 for one months supply but I thought I'd give it a go.

I've been on the vitamins for 6 weeks now and can say that there has been between a 30-40% improvement and is improving still. There is very little flaking, no bleeding and have started to develop completely clear patches of skin in areas where the Psoriasis was extremely severe.

I have not changed my lifestyle at all, even though my doctor says that I need to give up smoking 20 cigarettes a day and still have a terrible diet, all I do is take the vitamins in the morning and again in the evening.

I'm not saing that this will work for everyone but it is definitely worth trying as all the vitamins are natural and not full of chemicals.

I wish you all well and hope that the treatment works for you as well as its worked for me

Hi,

I have only just joined today, and have already found answers to questions I had. Jiml has made me welcome, and has made it easier for me to get involved. I wish that I had found this forum earlier!

One of the reasons why I have joined this forum is because I would like to learn what others have found, as we can all benefit from a pooling of information.

I have had Psoriasis for most of my life, and it has got worse and improved periodically, as it does with most people. However, I have recently been diagnosed with PsA, which has changed how I feel about Psoriasis, and how I will deal with the other more recent symptoms that I am faced with.

Through the forum I hope to find other treatments as well as new ways of improving my quality of life in general.

In my short time on the forum I have been very impressed with the professional approach and wide range of topics. I look forward to learning so much more useful information.

Paul

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It has been reported that the Dermatology Department at Waterford Regional Hospital has closed its doors to all but urgent cases.

Several hundred thousand living in the south-east of Ireland currently rely on the services provided by the hospital.

However, according to Newstalk Radio, as of last week one of the specialist departments in that hospital shut its doors to all but urgent cases.

That is the Dermatology Department where people receive treatment for a variety of skin conditions, including psoriasis, eczema, scarring acne and even skin cancer.

The station reported that last week GPs in the region received a letter from one of the hospital's two Dermatology Consultants.

In it, he stated that the department is at crisis point and that a critical incident is waiting to happen.

Given that, they are unable to accept any new patients other than the most urgent cases involving suspected skin cancer.

Hi everyone,
It's one of those times when psoriasis is totally dominating my thoughts all the time. It is worse than it has ever been and I am getting to the point where I can't go swimming because I get stared at and don't even want to wear t-shirts. And the itching!! It is driving me crazy.
It is all over my back and my backside is covered and it itches a lot. It is gradually covering my arms and legs too. (And scalp)
Regarding lifestyle, I am about to start a new job which I am finding quite stressful. In the weeks leading up to my start date, I can feel myself getting more and more stressed. My work hours are 5am-1pm so tiredness is an issue too, perhaps, with P.
I have tried lots and lots of different creams etc in the past and my GP says she will send me to a dermatologist to look at the possibility of using a UV light treatment for it. Does this work?
I'm using dovobet at the moment but it isn't doing any good... Maybe my body has become immune to it?
I have read about using coconut oil.. Does this work? Do you ingest and put it on your skin?
I have also read about banana skins? Anyone tried these?
In terms of lowering stress, I am planning to do yoga when I start my new job and maybe have a massage more often (all costs money though).
Diet-wise, I'm seeing all sorts of recommendations online.. It is so hard to know what to do!
I know this is a really long post but it's one of those moments when P is just dominating my thoughts and I wondered if anyone has any suggestions?

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Celgene Corporation today announced that the U.S. Food and Drug Administration (FDA) has approved OTEZLA® (apremilast), the Company's oral, selective inhibitor of phosphodiesterase 4 (PDE4), for the treatment of adult patients with active psoriatic arthritis.

"OTEZLA works differently from other therapies approved for psoriatic arthritis through the intracellular inhibition of PDE4," said Philip Mease, MD, Director of the Rheumatology Clinical Research Division of Swedish Medical Center and Clinical Professor, University of Washington. "The approval of an oral therapy with a novel mechanism of action for patients with psoriatic arthritis offers a different approach to patient care."

The approval was based on safety and efficacy results from three multi-center, randomized, double-blind, placebo-controlled trials.

"Patients and physicians have expressed their desire for a safe and effective therapy for psoriatic arthritis that has the potential to simplify patient management. Celgene is excited to be expanding our transformational science into the therapeutic realm of Inflammation and Immunology, with a new approach for patients with psoriatic arthritis," said Scott Smith, Global Head, Inflammation and Immunology, Celgene Corporation. "The FDA approval of OTEZLA is good news for patients and healthcare professionals who are looking for a different way to manage this disease."

OTEZLA® (apremilast) is expected to be available in the U.S. in March 2014 and will be dispensed through a comprehensive network of specialty pharmacies. For more information about OTEZLA distribution and the exclusive treatment support services (including reimbursement assistance and 24/7 nurse support), doctors and patients can contact Otezla SupportPlus™ at 1-844-4OTEZLA (1-844-468-3952) or visit [web]www.OTEZLA.com[/web] for more information.

The J&J biologic medicine, guselkumab, achieved the main goal of the Phase II study at all five dosing regimens tested by clearing or reducing the psoriasis to a minimal measure after 16 weeks of treatment in a far greater percentage of patients than in the group that received a placebo. It also appeared to be as good as or more effective than AbbVie's big selling Humira at four of the tested doses.

"The efficacy of guselkumab in the treatment of moderate to severe plaque psoriasis looks promising according to these Phase IIb study results," Dr. Kristina Callis Duffin, one of the study's investigators, said in a statement.

Results were determined using Physician Global Assessment (PGA) scores - a zero to 5 scale in which 0 indicates the disease has been cleared, 1 represents minimal disease and 5 indicates the most severe symptoms.

Guselkumab led to scores of 0 or 1 in as high as 86 percent of patients who received 100 milligrams of the drug every eight weeks, and in 83 percent of patients who were injected with 200 mg of the J&J medicine at the start of the trial and at week 4 and then every 12 weeks.

At the lower end, 34 percent of patients who got 5 mg of the drug to start and at week 4 and then every 12 weeks achieved PGA scores of 0 or 1. That was still deemed to be statistically significant compared with 7 percent for those who got a placebo.

In the Humira (adalimumab) group, 58 percent had scores of 0 or 1 after 16 weeks of treatment.

Results of the 293-patient trial, dubbed X-Plore, were presented at the American Academy of Dermatology (AAD) meeting in Denver. J&J has not yet said which of the treatment regimens would be advanced to larger, pivotal Phase III trials.

Guselkumab, which would be a follow-up treatment to J&J's Stelara, works by blocking interleukin-23, or IL-23, a protein that has been associated with chronic inflammation and is believed to play a role in psoriasis.

Morningstar analyst Damien Conover said the drug "is really under the radar right now." He currently sees sales reaching about $500 million several years after approval, but said estimates could change if later Phase III data were impressive.

In addition to the primary goal, significantly higher proportions of guselkumab patients achieved at least a 75 percent improvement in psoriasis as measured by the Psoriasis Area Severity Index (PASI 75) at week 16. Those results ranged from 44 percent of patients taking the lowest dose up to 81 percent at higher dosing regimens. That compared with 5 percent for placebo and 70 percent for Humira.

A 90 percent improvement was seen in as high as 62 percent of patients who got 100 mg of guselkumab every eight weeks.

The results remained consistent or showed additional improvement after 40 weeks of treatment, the company said.

After a year of treatment, serious adverse side effects were reported in 3 percent of those treated with guselkumab and 5 percent for Humira.

There were no cases of tuberculosis or opportunistic infections. One guselkumab patient reported a malignancy and there were three major adverse heart events, including one fatal heart attack, in patients with pre-existing cardiovascular risk factors, the company said.

Source: NO LINKS ALLOWED

Following on from Secukinumab V Enbrel Novartis announced today that a new phase IIIb head-to-head study of IL-17A inhibitor secukinumab (AIN457) versus Stelara® (ustekinumab) in moderate-to-severe plaque psoriasis has started patient enrolment.

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A total of twenty-five secukinumab abstracts, including two pivotal phase III convenience studies to be presented for the first time, will be unveiled at the 72nd Annual Meeting of the American Academy of Dermatology (AAD), taking place in Denver, Colorado, USA from 21-25 March 2014.

"We are pleased to announce the start of CLEAR, our global phase IIIb head-to-head psoriasis study of secukinumab versus Stelara at the 2014 AAD annual meeting, which will provide further evidence regarding the benefit IL-17A inhibitor secukinumab brings to patients," said Tim Wright, Global Head of Development, Novartis Pharmaceuticals. "We initiated this study following the positive results from the phase III FIXTURE study, which showed secukinumab was significantly superior to Enbrel in clearing skin, and we look forward to presenting additional new phase III data from our specialty dermatology portfolio at AAD."

About the CLEAR phase IIIb head-to-head study of secukinumab versus Stelara
CLEAR (Comparison to assess Long-term Efficacy, sAfety and toleRability of secukinumab vs. ustekinumab), the new 52-week, multicenter, randomized, double-blind study, is the second head-to-head phase III study initiated with secukinumab, and will compare the long-term safety, tolerability and efficacy of secukinumab versus Stelara, a current standard-of-care therapy, in patients with moderate-to-severe plaque psoriasis. The target enrollment for this global phase IIIb study is approximately 640 patients with sites in 25 countries across North America, Europe, Asia and Australia.

The primary endpoint measured at Week 16 is at least 90% reduction in the severity of psoriasis symptoms (redness, thickness and scaling) and the extent of skin affected by the disease, known as Psoriasis Area and Severity Index (PASI) 90. PASI 90 is considered the best evidence of efficacy and is therefore a more robust measure of the extent of skin clearance compared to the standard efficacy measures used in most psoriasis clinical studies.

The CLEAR study follows the pivotal phase III head-to-head FIXTURE study, which showed secukinumab was significantly superior to Enbrel® in clearing skin. Enbrel is a current standard-of-care anti-TNF-alpha medication approved to treat moderate-to-severe plaque psoriasis, and results from the FIXTURE study were first announced in October 2013

Hi my name is Pam,
I am having what I think is psoriasis. I am finding small patches of red itchy scaly patches of skin here and there, and am battling very thick patches of it all over my scalp.
I live in Po-Dunk, and have not told my Dr. about this yet. If I sneeze he wants to send me in for every invasive test known to western medicine.
Really, I am just in the last few days figuring out what is going on.

I had the scalp issue before many years ago, and remember finding a tar shampoo that I used diligently and it did eventually go away. But it is back with a vengeance.

The small patches, (The biggest one is approaching the size of a dime) are popping up here and there, and am finding more everyday.
I am so frightened I am afraid to share this new discovery with anyone in my life.
~Pam~

For a large portion of my life I had my psoriasis treated with various topical steroid ointments and creams,which were quite effective at reducing the plaques. I was told by my doctors and dermatologist that one of the side effects was skin thinning, but being foolish I just wanted to be rid of the scales. I used them on and off for many years. I just kept putting in for repeat prescriptions and without question they were prescribed. I found after a few years that the slightest knock on my legs would rip the skin open. I used to be very self conscious about my psoriasis, and as an engineer I was constantly banging my legs, when out on sites and often excused myself and went to the privacy of my van to roll up my trousers to reveal blood pouring out so I got to carrying a roll of tube gauze with me and steri strips to repair the damage.
When I stopped using steroid creams it seemed as if my skin recovered a bit. But I still have to be careful, and was wondering if others have had the same experience or worse. Or was I just unlucky

This is my first time on this forum and I hope someone has some suggestions for me.
I have been diagnosed with Postulate Psoriasis on the bottom of my foot. I, of course, have tried the steroids and only helped until I quite using them.

Has anyone found a natural treatment that has helped.

Calcipotriol/betamethasone dipropionate ointment most commonly know as Dovobet / Daivobet / Taclonex is studied for effectiveness and safety in pediatric patients with mild to moderate plaque psoriasis.

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Background:
Psoriasis in children has a significant negative impact on the quality of life (Qol) and effective treatment can improve this. The two-compound ointment calcipotriol 50 μg/g and betamethasone dipropionate 0.5 mg/g is an effective treatment option for moderate to severe psoriasis in adults.

Objectives:
To prospectively study the effectiveness and safety of calcipotriol/betamethasone dipropionate ointment in pediatric patients with mild to moderate plaque psoriasis in daily clinical practice and to investigate the influence on Qol.

Methods:
Data were obtained from a prospective longitudinal pediatric psoriasis registry, called Child-CAPTURE. Severity was assessed by the Psoriasis Area and Severity Index (PASI) and body surface area (BSA). The Children's Dermatology Life Quality Index (CDLQI) was used to assess Qol. Visual Analogue Scores (VAS) for pain and itch were used. For safety data the number of (serious) adverse events was recorded.

Results:
Seventy-three patients (mean age 10.8 years, range 3-18) were treated for a median time of 35.0 weeks (range 1.0-176.0). At week 12, mean PASI decreased 15.4% (from 5.2 to 4.4), BSA barely changed, and median CDLQI decreased significantly from 5.5 to 4.0. VAS pain and itch declined. At week 24, mean PASI decreased to 4.3 (17.3%). No related serious adverse events were observed.

Conclusions:
In this daily clinical practice study in pediatric psoriasis, calcipotriol/betamethasone dipropionate ointment initially improves mild to moderate psoriasis and then maintains its effect. In addition, it improves Qol, with few adverse events.

This article published in The British Journal of Dermatology sets out to to better understand the mechanism of action of Enbrel (etanercept) by examining very early changes in the lesional skin of psoriasis.

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Background:
Anti-TNF-α therapy has made a significant impact on the treatment of psoriasis. Despite being designed to neutralize TNF-α activity, the mechanism of action of these agents in the resolution of psoriasis remains unclear.

Objectives:
To better understand the mechanism of action of etanercept by examining very early changes in the lesional skin of psoriasis patients responding to etanercept.

Methods:
20 chronic plaque psoriasis patients were enrolled and received 50mg etanercept twice weekly. Skin biopsies were obtained before treatment and on days 1, 3, 7 and 14 post-treatment. Skin mRNA expression was analysed by QRT-PCR and microarray; cytokine and phosphoprotein levels were assessed using multiplexed bead arrays.

Results:
In etanercept responders, we observed no significant changes in IL-17A, IL-22 and IFN-γ mRNA or protein in the first week of treatment; however, there was a 2.5-fold down-regulation of IL17RC mRNA (p<0.05) after day 1, accompanied by decreased ERK1/2 phosphorylation. Transcriptional analysis revealed genes suppressed by etanercept significantly overlapped with IL-17A-induced genes, and a marked overlap was also observed between the genes suppressed by etanercept and by the anti-IL17A therapy ixekizumab. Finally we show that TNF-α enhances the expression of IL-17RC and shRNA inhibition of IL-17R expression abrogates synergistic gene induction by TNF and IL17A.

Conclusions:
These results suggest that the early responses of psoriasis plaques to etanercept may be due to decreased tissue responsiveness to IL-17A due to suppressed IL17RC expression in keratinocytes, blunting the strong synergy between TNF-α and IL-17, which contributes to the maintenance of psoriasis lesions.

This article published in The British Journal of Dermatology assesses whether methotrexate use increases the risk of developing fibrosis.

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Background:
Methotrexate is an effective treatment for psoriasis but concerns regarding the development of liver fibrosis prevent optimal use.

Objectives:
To assess whether methotrexate use increases the risk of developing fibrosis.

Methods:
Searches were performed on MEDLINE, Embase, the Cochrane database and Clinical Trials Register from inception until September 2013 for studies including at least two liver biopsies in people with psoriasis. Double extraction using predefined data fields was performed. RCTs and observational studies were considered. Statistical analysis was performed using Review Manager 5. Quality of observational studies was assessed using a study quality bias checklist.

Results:
Eight observational studies met the inclusion criteria (N=429). The pooled risk difference (RD) of developing significant liver fibrosis was 0.09 (95% CI: -0.03, 0.20). The RD for developing ‘any fibrosis’ was 0.22 (95% CI: 0.04, 0.41). The RD for cirrhosis was 0.04 (95% CI 0.02, 0.07). There was no clear association between cumulative dose of methotrexate and fibrosis. Obesity, diabetes and alcohol use were under reported. The quality of included studies was weak and the degree of selection bias means the results are not generalisable to all patients with psoriasis taking methotrexate.

Conclusions:
High quality, population based studies that consider potential confounders common in the psoriasis population taking methotrexate are justified to better predict the subset of patients at risk of liver fibrosis. In this highly selected population, methotrexate use contributes to the development of ‘any’ fibrosis without clear evidence of risk stratifiers.

Hello!

I have been lurking around here for quite some time so I figured I'd introduce myself.

I'm 24 and live in the great state of Wisconsin. I have had scalp psoriasis for about 3 years now. Currently it covers about 40% of my head as well as around my ears. I saw a dermatologist about 2 years back who prescribed me Clobox. This cleared me up while I applied it regularly but I eventually discontinued using it about a year back because I read about the harmful side affects of prolonged use of topical steroids. I am still using another prescription called Protopic around my ears. I actually have not seen anyone on this site that has used it but after reading up on it a bit I found out that it is sort of a new drug on the market and has been prescribed for many different skin conditions. I use a small amount about 3-4 times a week before I go to bed and notice that the scaling/ redness around my ears goes away but comes back if I don't use it for a few days. As for my scalp, I use a coal tar shampoo twice a week and an organic tea tree/ peppermint oil shampoo the rest of the time (from Trader Joes, such an awesome store!). I also have been recently been using baking soda mixed with the shampoo and have noticed that I don't scale as much (if at all). The redness is still there, but it seems to help with the itching as well. Sometimes it helps with the raised edges but notice that I'll still flair up if I'm stressed out. I am planning on seeing another Dermatologist sometime soon (now that I am on my own insurance) and was wondering what some of you have to say about a first time consultation. What have you done to work with your doctor to get the best results at treating your psoriasis?

Now on to the fun stuff.

I am an avid disc golfer, weight lifter, runner and bass player. I like to stay active and try to keep positive although psoriasis sometimes makes me a bit self conscious. I used to hate getting haircuts but I have found a place that I feel comfortable at. I usually talk about psoriasis with them and how I'm working on treating it and have started to realize that people who cut hair have seen everything under the sun when it comes to scalp and hair health.

That's me in a nutshell, I'm really happy to find a forum like this that is so welcoming and has so much knowledge to share with those of use that are still learning!

-Eric

I have (almost) beat this thing in two months after years of visiting a dermatologist with little luck. I am not against doctors or endorsing any product. What I did was in desperation and it worked in just over two months. I am 99 percent clear on my shins which is where the problem area was. This story is about what I did. I truly believe the key was keeping the area moisturized and natural sun when you can. The pictures should be accessible at the link below.

The Mixture:

I started out with putting liquid Vitamin D, cocoa butter petroleum jelly generic from Wal-Mart and Turmeric on the bad area. I would apply the triple combination the morning with rubber gloves and wrap with cling wrap over the mixture and an ACE style bandage to prevent the staining of clothing. I wore the bandage all day long. I cleaned the area at the end of the day with Dermarest Psoriasis Skin Treatment and added MG217 after cleanup and before the lamp. I also took up to 200mg Zinc and around 10,000 UI Vitamin D orally a day. I took half of both in the morning and the other half at bed time.

The lamp:

I bought two reptile bulbs, REPTISUN 10.0 UVB bulbs (48 inch 36 watt) and put them in a 32 watt 48 inch fixture from Lowes. I would put my legs (uncovered) under this light for at least an hour. Sometimes more sometimes less.

I did both treatments least 5 days a week during winter as it was easy to cover up with long pants. It took some time learning the securing the bandages so they would stay all day. I ultimately used safety pins. On the weekends I would apply MG217, liquid vitamin D and sometimes diaper rash ointment from Wal-Mart. I would get under the lamp as often as possible.

Last week I stopped with the petroleum/turmeric/bandage thing and went to just the MG217 and diaper rash cream and I can see its coming back. Next week I will go back to the petroleum/turmeric/bandage on Monday and Tuesday then lay off and see if it keeps in check. More later.
David