This is a meta-analysis of 59 studies with up to 18,666 cases and 50,724 controls which quantifies the level of cardiovascular disease risk factors in patients with psoriasis.

Objectives:
To quantify the level of cardiovascular disease risk factors in order to provide additional data for the clinical management of the increased risk.

Methods:
This was a meta-analysis of observational studies with continuous outcome using random-effects statistics. A systematic search of studies published before 25 October 2012 was conducted using the databases Medline, EMBASE, International Pharmaceutical Abstracts, PASCAL and BIOSIS.

Results:
We included 59 studies with up to 18 666 cases and 50 724 controls. Psoriasis cases had a higher total cholesterol [weighted mean difference 8·83 mg dL−1, 95% confidence interval (CI) 2·94–14·72, P = 0·003 (= 0·23 mmol L−1)], higher low-density lipoprotein cholesterol [9·90 mg dL−1, 95% CI 1·56–18·20, P = 0·020 (= 0·25 mmol L−1)], higher triglyceride [16·32 mg dL−1, 95% CI 12·02–20·63, P < 0·001 (= 0·18 mmol L−1)], a higher systolic blood pressure (4·77 mmHg, 95% CI 1·62–7·92, P = 0·003), a higher diastolic blood pressure (2·99 mmHg, 95% CI 0·60–5·38, P = 0·014), higher body mass index (0·73 kg m−2, 95% CI 0·37–1·09, P < 0·001), higher waist circumference (3·61 cm, 95% CI 2·12–5·10, P < 0·001), higher fasting glucose [3·52 mg dL−1, 95% CI 0·64–6·41, P = 0·017 (= 0·20 mmol L−1)], higher nonfasting glucose [11·70 mg dL−1, 95% CI 11·24–12·15, P < 0·001 (= 0·65 mmol L−1)] and a higher HbA1c [1·09 mmol mol−1, 95% CI 0·87–1·31, P < 0·001 (= 2·2%)].

Conclusions:
From a preventive medicine perspective, the weighted mean differences between cases and controls are significant, and therefore relevant to the clinical management of patients with psoriasis.

Source: NO LINKS ALLOWED

Thought this would be appropriate place for this question.

I have a problem, my psoriasis. It's reasonably bad. I have "paint brush psoriasis" covering my whole body with the plaque psoriasis on knees, elbows and scalp. I moisturise all the time probably 4-5 times a day with phototherapy treatment starting in a few days. My problem/question is;

The constant persistent f******g shitting ITCHING! ITCHING! ITCHING!!! To the point it's driving me wild, my psoriasis is so F'ing sore anyway but scratching that itch is all I can do, to the point I make myself bleed under the 'scab' so to speak..... I know this makes it worse.

Any ideas or known cures for itch relief would be very much appreciated before this happens

Cheers, Justin

Is it safe to drink alcohol whilst on medication for psoriasis ?

The Queen Mary University of London is working with King’s College London, the University of Manchester, Liverpool University and Newcastle University to develop a targeted approach to psoriasis treatment.

Quote:

---

The partnership – named Psoriasis Stratification to Optimise Relevant Therapy (PSORT) – also includes 10 pharmaceutical and diagnostics companies, the Psoriasis Association and NHS partners supporting healthcare of patients.

Professor Richard Trembath, Vice Principal for Health at Queen Mary University of London, Barts and The London School of Medicine and Dentistry, comments: “Stratified medicine is central to the progress of our healthcare and applying this approach to a condition such as psoriasis, where identifying the most effective treatment is difficult, is an area we can hopefully make a huge difference.

"Through this partnership we will use cutting-edge techniques to assess factors – such as drug levels in the body, genetic make-up, skin and blood differences – which may affect how successful various psoriasis treatments are for individuals. We believe this approach will lead us to better evaluate which treatment is right for different patient groups and people with psoriasis will receive tailored treatment which is ultimately more effective. This is an exciting project and we look forward to working with our partners and showcasing the expertise and knowledge Queen Mary has to offer.”

The Medical Research Council has invested £5 million in funding for this project and industry partners have contributed an additional £2 million. PSORT is also supported by the NIHR Biomedical Research Centre at Guy's and St Thomas' and King’s College London.

The study have been designed to ensure outcomes meet the needs of patients, the healthcare system and industry, as well as informing future medical research. The findings will also help scientists to understand the mechanics behind this difference in response from patients, and may improve treatment of other immune inflammatory diseases, such as arthritis and Crohn’s disease.

Hi, my name is justin I'm 27 from the uk.

Have had psoriasis that long I can't remember not having it. Usually just had plaque on my elbows and knees..... Until it disappeared for months on end..... Happy day!

It is now back with vengeance and around 50% of my body is covered! I hide away from my wife, can no longer take the kids swimming. Had a little cry about it.

This is my first time seeking outside help but feel pretty low and desperate.

Thanks for listening

I'm pretty sure psoriasis is caused by a fungus. I notice that my skin gets worse during the winter. I believe it gets worse in the winter because I take longer hotter showers in the winter.

When I applied baking soda (which is an antifungal) to my psoriasis affected skin, I noticed that the skin would get sweaty. Could this be due to a fungus trying to fight the baking soda treatment, by creating a moist environment which they like?

I think you might also be able to make the argument that it is indeed a fungus, by
looking at the known treatments that are proven to work, and whether those treatments treat fungus' too. If not, then I am wrong.

If psoriasis is indeed caused by a fungus, then any anti-fungal should be effective against it.

Tea tree oil is a good antifungal. It's not that expensive. It smells ok. It's non irritating (I apply it undiluted to my skin).

Wikipedia says that a 10% tea tree oil cream is as effective as well as Tinactin (which is an antifungal) in treating athlete's foot: "a 10% tea tree oil cream works about as well as tolnaftate 1% cream" in treating symptoms of athlete's foot, although being less effective than clotrimazole or terbinafine."

If 10 percent is effective as an over-the-counter antifungul, then I would just use 100% tea tree oil, and apply it undiluted (I have done this many times without problems)

I think camphor oil is also an antifungal, but it does smell kind of bad and it's used in tiger balm for it's iceyhot properties. And there are other essential oils which are antifungals. But I would stick with tea tree oil...

I would get a 1oz NOW Foods Tea Tree Oil bottle from amazon. It's a good value, and the 1oz bottle has a built in dropper in the cap so you don't have to mess with a glass dropper. If you're going to buy more tea tree oil, I would either buy the NOW brand or from bulkapothecary.com which is cheap and good (but no built in droppers in the cap)

Stay away from people who say the essential oils can cure depression and stuff like that. If they say it cures everything... it doesn't

every time I google psoriasis an ad appears publicising this cream and it's apparently on sale in a large department store as well as drug stores. I don't know whether it's just a Spanish or international product, but with the English name i'm hoping that it is available elsewhere.
As usual with every winter, i'm now beginning to find new spots beginning to appear in various parts of my body and i'm hoping to use a less aggressive ointment to fight them this time around before they start to grow. So if anybody has any info on Blue Cap please let me know

My dermatologist is always telling me diet and exercise can help with psoriasis, so she will no doubt be reminding me after reading this study published in the British Journal of Dermatology

Quote:

---

Background:
Increased body mass index and weight gain are risk factors for psoriasis, and the prevalence of obesity in patients with psoriasis is higher than in the general population. Limited data exist regarding the role of diet in psoriasis. Here we assessed the impact of a dietary intervention combined with physical exercise for weight loss on improving psoriasis in overweight or obese patients.

Methods:
This study included 303 overweight or obese patients with moderate-to-severe chronic plaque psoriasis not achieving clearance after 4 weeks of continuous systemic treatment. They were randomized to receive a 20-week quantitative and qualitative dietary plan associated with physical exercise for weight loss, or simple informative counseling at baseline about the utility of weight loss for clinical control of psoriatic disease. The main outcome was any reduction of the Psoriasis Area and Severity Index (PASI) from baseline to week 20.

Results:
Intention-to-treat analysis showed a median PASI reduction of 48% (95% confidence interval, 33.3 to 58.3%) in the dietary intervention arm and 25.5% (95% confidence interval, 18.2 to 33.3%) in the information-only arm (P=0.02). Among secondary outcomes, PASI50 significantly differed between study arms (49.7% with dietary intervention vs. 34.2% with information only, P=0.006). The weight-loss target (a ≥5% reduction from baseline) was reached by 29.8% of patients in the dietary intervention arm compared to 14.5% in the information-only arm (P=0.001).

Conclusions:
A 20-week dietetic intervention associated with increased physical exercise reduced psoriasis severity in systemically treated overweight or obese patients with active psoriasis.

Hello all, I've now suffered psoriasis for around twenty years and have managed to get it down to lower legs and elbows. I now work in sunny Catalonia as a gardener and am still waiting for the sun and vitamin d to do their job and make the psoriasis go away but after fifteen years still no luck.
I've tried many things both prescribed, and natural remedies and up until now the only attempt with any success has been bath, Wrights coal tar soap, scrubbing brush followed by a moisturiser. Unfortunately I now live in a small house with a bath made for Hobbits so it's back to the drawing board.
Hoping to find some new ideas but more importantly just hear how others are coping with the day to day, glad to have found you

Thanks Yoyo for the welcome note. I realized I have psirosis few months back when my scalp becomes so itchy that it needs constant scratch. A visit to dermatologist confirms that it is not a typical dandruff problem. Besides scalp, there are few patches on my arm and neck. I am now using tea tree oil syampoo sometimes twice a day if the itch gets too unbearable. I try to avoid stress but it is quite hard to escape work stress.

Hello.... again....


Things have been crazy since I last posted......

I can't remember if I got back to you guys on the plan but I definitely have Psoriatic arthritis, apparently very little skin involvement, but several joints and enthesis is where I am now...... after a big fight with the insurance company, Humiar was approved for me......

I started Humira last week and the 5th day after the injection I developed a severe cellulitis in my elbow.....We are hoping it is not in the joint..... the big concern was whether it was bursitis and also there is a concern about MRSA....... I have been loaded up with antibiotics and the plan is to restart the Humira after I finish 2-3 weeks of antibiotics......

Even in this short time, with the Humira and a job change where I am able to move around more, I was starting to feel better..... now my right arm is so swollen and painful that I can hardly do anything.......


I am hoping this is just a small setback.....

I will post pictures as soon as I figure out how to do is..... Cellulitis is a possible side effect of Humira and mine started with pain.... well when you have different pains all the time, it is hard to know when it is something to worry about, I ma glad that I called right away and have a great Doctor since she said one more day would probably put me in the hospital for IV antibiotics......so i want everybody on Humira to know about it........

Hi everyone!

I am Rini from India, new on this forum .Psoriasis affected me at a very young age. I had taken homeopathic treatment but it it didnt help me a great deal. M not takin any treatment now...i only apply dipsalic that to occasionally.. my P isn't bad but as its winter now..chances of flare up is somethin which is botherin me :(

Hello,
I have only had psoriasis for the last seven years and my first time on a forum.
Just about to start 3rd course of phototherapy. It has been really difficult to manage/control, though consultant is really good. For all those who are perhaps using Dead Sea salt, I thought I would let you know what my consultant had to say. He was involved in extensive research into the affect of Dead Sea salt and the results were it has no effect on psoriasis whatsoever. He also said why pay for sea salt if you believe salt works, just use table salt as cheaper! It appears there is still a lot to learn about psoriasis and a lot of new treatments. I have so far refused to use anything but topical and phototherapy treatments even though I am currently experiencing my worst outbreak yet! However I don't let it stop me doing anything, I even went to work in bare feet, because the psoriasis meant wearing shoes was agony, thank goodness we had a great summer!
Glad to have found you.

Hi All,
My name is Ali and have suffered from Psoriasis for over 25 Years. I am interested to find out whats been working for other Psoriasis sufferers.

Ali

Some folks have recommended that I read Healing Psoriasis: The Natural Alternative. I like the idea of using natural remedies instead of medicines. It looks like it has good reviews, but I wanted to see if anyone here has read it and if it worked??? Thanks!

The screening for latent tuberculosis infection (LTBI) is mandatory in patients with psoriasis prior to starting on tumour necrosis factor (TNF) blockers, and this study published in The British Journal of Dermatology suggests Fluctuations of IFN-γ release may occur in patients with psoriasis treated with TNF antagonists.

Quote:

---

Objectives:
To investigate the longitudinal changes of interferon (IFN)-γ response to Mycobacterium tuberculosis-specific antigens by serial QuantiFERON-TB Gold In-Tube (QFT-GIT) testing in patients with psoriasis during long-term anti-TNF therapy. The direct in vitro effect of adalimumab on IFN-γ secretion was also evaluated.

Methods:
In total, 148 patients with psoriasis designated to start anti-TNF treatment were enrolled. We performed a tuberculin skin test at screening, and QFT-GIT at baseline and serially for 24 months after TNF antagonist onset.

Results:
At screening, QFT-GIT was positive in 22·3% of the patients, negative in 73·6% and indeterminate in 4%. The IFN-γ response following isoniazid therapy declined and became QFT-GIT negative in 8% of 26 patients with LTBI; in 69% of subjects with LTBI the QFT-GIT remained persistently positive with a significant increase of IFN-γ levels during the follow-up, even if no cases of active tuberculosis were found. Variations of IFN-γ levels were observed also in 7% of 27 patients without LTBI who switched to positive QFT-GIT after 12 or 18 months of biologic therapy, suggesting a new occurrence or reactivation of LTBI. In vitro data showed that in the presence of adalimumab the IFN-γ levels were significantly reduced in a dose-dependent manner (P < 0·05).

Conclusions:
Fluctuations of IFN-γ release may occur in patients with psoriasis treated with TNF antagonists. The clinical use of repeated blood tests and the correct interpretation of individual IFN-γ changes could be useful in identifying possible cases of LTBI reactivation or newly acquired tuberculosis infection during long-term anti-TNF treatment.

This study published in The British Journal of Dermatology evaluates the association between Epicardial fat thickness (EFT) and Carotid intima–media thickness (CIMT) in patients with psoriasis.

Quote:

---

Background:
Carotid intima–media thickness (CIMT) is a potential indicator of subclinical atherosclerosis in patients with psoriasis. Epicardial fat thickness (EFT) is proposed as a new cardiometabolic risk factor.

Objective:
To evaluate the association between EFT and CIMT in patients with psoriasis.

Methods:
This was a cross-sectional and observational study; 65 patients with psoriasis and 50 age- and sex- matched control subjects were included. Data about echocardiographic EFT, CIMT, anthropometric measurements and metabolic profile were obtained.

Results:
The EFT and CIMT were significantly increased (7·3 ± 0·5 vs. 6·5 ± 0·5 mm, P < 0·01; 0·74 ± 0·11 vs. 0·60 ± 0·07 mm, P < 0·01, respectively) in patients with psoriasis compared with the controls. EFT was significantly correlated with CIMT (r = 0·69, P < 0·01). In a multiple linear regression model in which EFT was independently associated with psoriasis (β = 0·45, P < 0·01), age (β = 0·33, P = 0·01), CIMT (β = 0·50, P < 0·01), body mass index (β = 0·25, P = 0·01), high-sensitivity C-reactive protein (β = 0·32, P < 0·01) and duration of disease (β = 0·34, P = 0·03).

Conclusions:
We demonstrated that EFT and CIMT are increased in patients with psoriasis, and that echocardiographic EFT is closely correlated with CIMT in patients with psoriasis. The echocardiographic assessment of EFT may have the potential to be a simple marker of subclinical atherosclerosis and increased cardiovascular risk in patients with psoriasis.

This study published in The British Journal of Dermatology looks at the relationship between serum levels of endocan and both cardiovascular risk and disease activity in patients with psoriasis.

Quote:

---

Background:
Psoriasis vulgaris is an inflammatory disease characterized by epidermal hyperproliferation, leucocyte adhesion molecule expression and leucocyte infiltration. Psoriasis is associated with an increased risk of cardiovascular disease. Endothelial dysfunction is widely regarded as being the initial process in the development of atherosclerosis. Human endothelial cell-specific molecule-1 (endocan) is a novel human endothelial cell-specific molecule. Previous studies suggested that endocan may be a novel endothelial dysfunction marker.

Objectives:
To investigate the relationship between serum levels of endocan and both cardiovascular risk and disease activity in patients with psoriasis vulgaris.

Methods:
A total of 29 patients with psoriasis vulgaris and 35 control subjects were included in the study. Endocan, high-sensitivity C-reactive protein (hsCRP) and carotid artery intima–media thickness (cIMT) were measured in all subjects.

Results:
Serum endocan levels were significantly different between the two groups (P < 0·001). In patients with psoriasis, serum endocan levels correlated with Psoriasis Area and Severity Index, hsCRP and cIMT (r = 0·477, P = 0·009; r = 0·484, P = 0·008; r = 0·408, P = 0·02, respectively).

Conclusions:
Circulating endocan may represent a new marker that correlates with cardiovascular risk as well as the severity of disease in patients with psoriasis vulgaris. Endocan may be a surrogate endothelial dysfunction marker and may have a functional role in endothelium-dependent pathological disorders. Whether endocan levels could become a treatment target merits further investigation.

Hello just a quick update. I've been on MTX now for about 4/5 weeks and at first I noticed my skin was clearer but now looks very red and noticeable. As for the pain for Psa it's no different but I know it's only early days still. I get very sleepy the day after taking MTX and I'm still taking my folic acid 4 days after. I am still going for fortnightly blood tests which they struggle getting blood out of me (I don't like to part with anything lol) I have got a rheumy appointment at the end of November so hopefully they may up my dose and change my bloods to every 4 weeks.

Hello,
I have had psoriasis for nearly 50 years. It started as a tiny patch on my scalp and at various times in my life it has covered my body so badly that I have been hospitalised for 4-weeks at a time. I have tried dithranol, Betnovate, UVA, PUVA and now I am on my second course of Neotigason which I have been taking 20mg daily for 15 years. I am not absolutely clear but it is manageable and the summer sunshine helps so much. My last liver test showed some raised levels so I might be looking for an alternative treatment. I'm hoping to chat on this forum and find out about the latest treatments and what you all think about them. If I can share my experiences of my life with psoriasis and the treatments I've had to help others, then that is a bonus. Nette