Hello .my name is mark.north London.
I've had psoriasis for 25 years..
Would be good to talk to people who understand.

I know Fumaderm has the side effect of hot flushes - but im boiling and feel very itch ( like prickly heat ) is this normal????

Hi all. I had a very bad week full of bad flares. Friday night I simply couldn't take it any more. the plaques on my stomach and back were as thick as pancakes. My scalp and face were not. My next Dr appt is not until end of sept. I went to the ER and they put me on a 14 day taper of prednisone, some hydroxizine for the itch and naprosyn (prescription nsaid) for the back pain at L4-L5 which had come on suddenly and gotten worse over the last 5 days (i was questioning psoriatic arthritis). I was in a panic. Not knowing if I had now come down with shingles in addition to psoriasis ??? I didn't know what was going on but it was bad. My torso was on fire. Inflammed, itchy and very painful. My blood work was normal accept for being anemic which I find odd given the amount of healthy eating i have been doing last several weeks, in addition to supplments. My back xray showed no significant findings.

I had huge relief from the prednisone after 1st dose. pancake thick plaques were completely flat and redness is 90 percent gone after 3 doses and my skin is practically clear. I know prednisone is not a long term treatment but i am thankful to have short term relielf.

Best of all, I am able to get in to see a new (and hopefully) better dermatologist on Tuesday instead of waiting until September. The ER doc called on my behalf and insisted they squeeze me in. So, while I am not ready to give up on the hope that this can be brought under control through diet alone, I also realize that I can no longer suffer while I wait for my leaky gut to repair itself. I'm a bit depressed but in so much relief that I'm willing to go on methotrexate or whatever the dr. deems appropriate at this point given topical steroids did nothing for me.

and how has your weekend been, all?

I feel like I'm losing my mind. My arms, legs, face don't itch at all. My scalp, which used to be the worst, barely itches. My back itches a lot and my stomach - holy hockeysticks - It's driving me crazy. I am taking antihistamines to try and quiet the itch down but they don't seem to do much. I don't understand why some body parts that have plaques don't itch and others itch like crazy. No lotion or cream seems to keep my skin moist and every one of them burns when applied to my stomach.

This affliction is new to me so I'm still trying to understand the ins and outs. Bear with me!! I honestly don't even know for sure if I was correctly diagnosed. My dermatologist looked only at my elbow, not any other body part, didn't take a biopsy, didn't ask me any questions at all. I was in and out of his office in 5 mins after saying I think I might have psoriasis (after waiting months for an appointment). He threw 3 prescription creams at me and a few weeks later when I insisted he see me again because my scalp was on fire and the lesions on my body had tripled in size and in number, he threw a few more different steroid prescriptions at me and referred me to another dermatologist that I'm waiting months to get to see.

I don't know how people deal with this affliction without jumping out the window. I'm about ready to. Even if I wanted to go back to using the steroid topicals I would have to practically cover my entire torso and upper arms. Doesn't seem like a real good idea to have my body absorbing that much steroid.

What do you folks think????

Does anyone have any ideas on how to put lotion, etc on the places I can't reach in the middle of my back? I live alone

hi my name is Jessica and I have a friend that has severe psoriasis all over his body and we got onto the subject of me cooking for him and he told me to look up psoriasis diet so I did, I have a few friends that have it only a little so I started looking into what it is and what I can cook for him and what is beneficial to aid in not causing flare ups, I don't look at him as he expects me to or thinks im going to I don't judge by looks as I have weight issues and have had all my life and get judged for my looks with tattooes and lots of piercings. but I think if I can get more insight from people that have had to deal with ridicule and being shunned I can honestly be not just a friend but maybe more and find out what I can do to ease his symptoms. so any info or suggestions will greatly be appreciated

Hi folks,
new to this site but was wondering if anyone else has experienced my problem?

I have been on Stelara now for 18 months and it's a brilliant drug, I've gone from 75% body coverage to ZERO!!!
However, over the last 6 months, I have had 2 teeth snap, and, I've always had extremely strong teeth, also, 2 crowns that had been in place for 10 years or so, came lose as the roots developed cracks!
has anyone else experienced teeth problems whilst using this drug?

Here is a piece of news that may be the answer to finally differentiate between psoriasis and eczema, this could have a huge impact on early treatment for both patients.

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In many patients it is not easy to differentiate between the chronic inflammatory skin diseases psoriasis and eczema. Researchers at the Helmholtz Zentrum München and the Technical University of Munich (TUM) have now developed a procedure based on a skin analysis that enables an exact diagnosis to be made.

In some patients, the chronic inflammatory skin diseases psoriasis and eczema are similar in appearance. Up to now, dermatologists have therefore had to base their decision on which treatment should be selected on their own experience and an examination of tissue samples. A team of researchers at the Helmholtz Zentrum München and the Technical University of Munich (TUM) have now analyzed the molecular processes that occur in both diseases and discovered crucial differences. This has enabled them for the first time to gain a detailed understanding of the ways in which the respective disease process occurs. Building on this knowledge, the scientists, led by Dr. Stefanie Eyerich and Prof. Dr. Kilian Eyerich as well as Prof. Dr. Fabian Theis, have developed a diagnostic procedure which in practice enables psoriasis and eczema to be reliably differentiated from one another on the basis of only two genes.

“Both diseases have a highly complex appearance, which often varies widely from one patient to another,” says Dr. Stefanie Eyerich, who heads the Specific Immunology working group at the Institute of Allergy Research (IAF) at the Helmholtz Zentrum München. “This has led previous attempts to compare their molecular signature to fail.” In this study, the researchers identified 24 patients who were suffering simultaneously from psoriasis and eczema and in each analyzed at the molecular level the characteristic differences they demonstrated between psoriasis and eczema compared to clinically unremarkable skin.

“We were thus able to drastically reduce random genetic or environmental influences and gain a detailed picture of the development of these two diseases,” explains Prof. Fabian Theis of the Institute of Computational Biology (ICB) at the Helmholtz Zentrum München.

In recent years, many new specific treatments have been developed for psoriasis and eczema. However, in each case, these are only effective for one or other of the two diseases. And they are very expensive: one such treatment generally costs several tens of thousands of euros per year, per patient. The ability to make an exact diagnosis therefore has a considerable economic impact.

If it cannot be clearly determined on presentation which of the two diseases is involved, the newly developed diagnostic tool will help to differentiate them. It involves a test which compares samples of diseased and healthy skin and is concluded within one day. The researchers have now filed a patent application for it.

The procedure, moreover, marks the first step towards the introduction of personalized medicine also for chronic inflammatory skin diseases. “Whereas this is practiced increasingly in oncology, for example in the form of mutation analyses and the subsequent decision in favor of the best individual treatment option, it is not common in the case of inflammatory skin diseases,” says Kilian Eyerich of the Clinic and Polyclinic for Dermatology at the Technical University of Munich.

The researchers plan to purse this path with a view to characterizing even more precisely the molecular processes involved in inflammatory skin diseases and combining them with clinical information, such as the choice of certain treatments. In this way, their goal is to determine the best possible treatment option for each individual patient.

This is an early view before publication and it looks at the Clinical factors affecting quality of the response to Stelara (ustekinumab) for psoriasis.

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Ustekinumab has demonstrated efficacy for psoriasis. However, it is known that approximately 30% of patients have shown insufficient response.

The aim of the current study is to clarify the specific clinical factors that could be associated with response to ustekinumab treatment. We reviewed the medical records of all patients who were treated with ustekinumab. The Psoriasis Area and Severity Index (PASI) score was calculated, and the efficacy was evaluated at week 0 and week 16. The relationship between clinical efficacy and the patients’ background was investigated. The patients, who showed a <74% reduction in the PASI score, were classified as insufficient-responders. A total of 74 patients (average 60.3 years old, male to female ratio 54:20) were examined retrospectively. Eighteen patients were identified as insufficient-responders.

Each of the factors, body weight (BW) over 80 kg, body mass index (BMI) over 25, or smoking habit over 20 cigarettes/day showed a higher proportion of insufficient-responders compared with responders, although the difference was not statistically significant. Patients with previous exposure to biologics showed a significantly lower response to the treatment. Furthermore, a statistical difference was identified between patients with none of these factors and patients with some of these factors.

Our data suggest that some factors, such as high BW, high BMI, a smoking habit over 20 cigarettes/day, or exposure previous treatment with biologics are likely to affect the quality of the response to ustekinumab. Therefore, these factors need to be taken into account when ustekinumab is administrated.

i've gpt moderate psoriasis on body, severe on scalp.i have been drinking way too much past several months and believe this is the trigger. started the clean gut cleanse, giving up all caffeine, sugar processed foods - following it strictly. a week into this find that I have a bad rash on my stomach and back. could this be due to the supplements dr. junger recommends? I'm taking all of them. or perhaps it is the hemp powder in the shakes? help. i don't know what to do. i don't want to go back on topical steroids.

will this rash go away? any suggestions on what to eliminate, if anything and still stay on clean gut?

hi my name is Andrea i have had psoriasis for 40 yrs.its really bad at the moment i am thinking of having stelare can anyone give me some help pls help

This article is an early view before publication in The The Journal of Dermatology.

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Abstract:
Psoriasis is a chronic inflammatory disease associated with several comorbidities. Osteoporosis is defined as a reduction in bone mineral density with impaired bone microarchitecture.

Several mechanisms may be implicated as a possible cause for the association between psoriasis and osteoporosis, such as systemic inflammation, anti-psoriatic drug intake and joint dysfunction for psoriatic arthritis (PsA).

The aim of the present study was to assess bone mineral density (BMD) in patients with psoriasis, correlating the prevalence of osteopenia/osteoporosis with Psoriasis Area and Severity Index (PASI) score, mean duration of psoriatic disease, PsA and previous treatments for psoriasis. Forty-three consecutive patients with psoriasis, 19 of whom were affected by the arthropathic form, were enrolled. We evaluated the severity of psoriasis as measured by PASI score, the CASPAR criteria and ultrasounds of the joints to verify the diagnosis of PsA and the age of psoriasis onset to estimate mean disease duration.

Patients underwent a bone density scan of the lumbar spine and femoral neck by dual-energy X-ray absorptiometry to measure BMD. Patients with osteopenia/osteoporosis showed a statistically significant longer average duration of psoriatic disease (17 years), compared to patients affected by psoriasis with normal T-score (8.8 years) (P = 0.04). The linear logistic regression confirms a significant relation between mean psoriatic disease duration and BMD alterations (P = 0.04).

Our results suggest the necessity of an early diagnostic evaluation of bone metabolism in patients with psoriasis, especially if characterized by longer disease duration.

This expert group consensus article published in The Journal of the European Academy of Dermatology and Venereology proposes a set of four items to screen psoriasis patients for psoriatic arthritis for routine clinical use by dermatologists.

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Background:
Up to 29% of patients with psoriasis seen by dermatologists have undiagnosed psoriatic arthritis (PsA). As early detection of PsA may be associated with improved joint and skin outcomes, it is essential for dermatologists to improve their ability to diagnose PsA. Skin and nail features of psoriasis associated with PsA are well known to dermatologists but they may feel less confortable assessing other symptoms and they rarely use PsA screening questionnaires.

Objective:
To develop a limited list of clinical signs and symptoms that a dermatologist should be looking for in a psoriasis patient in addition to specific skin features and nail involvement, to improve PsA detection.

Methods:
A systematic search was performed in pub med, Cochrane and Embase databases to identify clinical key symptoms associated with PsA. It yielded 27 studies in which we extracted a list of clinical signs and symptoms observed in PsA and submitted it to a panel of dermatology experts through a DELPHI selection process. The experts had to determine which minimal set of signs and symptoms dermatologists should look for in daily practice to improve detection of PsA in patients with psoriasis.

Results:
The four items that received a score higher than 90% in the DELPHI process were finally selected. Those items were as follows: peripheral inflammatory pain (100%), axial inflammatory pain (95.3%), dactylitis (93%), buttock and sciatic pain (90.7%). The remaining items: distal interphalangeal joints (DIPs) involvement (83.7%), Talalgia (79.1%), swollen Achille's tendon (41.9%), costo-chondral involvement (32.6%), uveitis (7%), mouth ulcerations (2.3%), were not retained.

Conclusion:
We propose a set of four items to screen psoriasis patients for psoriatic arthritis for routine clinical use by dermatologists.

This study looked into possible association between metabolic syndrome and psoriasis, (metabolic syndrome is a disorder of energy utilization and storage).

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Background:
Psoriasis (PS) has been suggested to be associated with the metabolic syndrome (MetS) in numerous studies with conflicting results. The vast majority of previous data were based on PS subjects from hospitals, and when based on data from the general population the PS subjects were often identified in insurance health databases. Furthermore, many studies used a single method approach, e.g. self-reported diagnosis.

Objective:
We have therefore investigated a possible association between PS and MetS on PS subjects from the hospital as well as the general population using combined methods, i.e. self-reported diagnosis, physical examinations and blood samples.

Methods:
A population- and hospital-based cross-sectional study of the possible association between PS and MetS.

Results:
Thirty-six hospital PS subjects, 860 population PS subjects and 14 016 non-PS subjects were identified. The odds ratios (ORs) for hospital PS subjects and population PS subjects vs. population non-PS subjects, respectively, were 5.14 (2.47–10.69) and 1.29 (1.09–1.53) for MetS, 4.55 (1.91–10.85) and 1.16 (0.85–1.59) for diabetes, 1.92 (0.87–4.22) and 1.00 (0.86–1.17) for hypertension, 4.34 (1.86–10.10) and 1.15 (1.00–1.34) for hypertriglyceridaemia, 3.88 (1.96–7.69) and 1.19 (1.01–1.42) for hypoHDL, 5.77 (2.89–11.52) and 1.19 (1.00–1.41) for general obesity and 2.92 (1.45–5.88) and 1.34 (1.16–1.55) for abdominal obesity. Obesity acted as a possible confounder. A uniform pattern of higher ORs for hospital PS subjects when compared to population PS subjects was observed. The severity and duration of PS did not seem to affect the results. As this is a cross-sectional study we cannot demonstrate causality.

Conclusion:
The data suggested an association between PS and MetS as well as its individual parameters on a hospital-based level, with the exception of hypertension. On a population-based level the associations were only significant for MetS, hypoHDL and abdominal obesity.

Hi everyone. So glad to find a friendly place that has a strong anti cyber-bullying policy. I've had plaque psoriasis for about 30 yrs but just recently began to deal with it. I live in Chicago. I'm here to learn and share.

Here on behalf of my 10yr old daughter Alisha. She has had psoriasis for 3 years, misdiagnosed for the first 6 months. Did 18mths of prescription medication with no improvement until her torso and scalp were thick with scales. Called a halt when they wanted to put her on Methotrexate and went homeopathic and using creams and shampoos from Holland & Barrett. Considerable improvement, scalp virtually clear and scattering of scales over torso. she had some problems at school with nasty comments but we tackled it head on and literally held a show and talk session where the kids could look and ask her questions! Worked amazingly and they all defend her if anyone says anything negative. She gets a little down now and again but we openly talk about it. Interested to share experiences and tips from other families of young sufferers.

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Psoriasis is not uncommon in the reproductive years and therefore in pregnant patients. There are limited data about the impact of psoriasis on the course and prognosis of pregnancy and about the impact of pregnancy on the course of psoriasis. Usually the disease improves during pregnancy and patients experience worsening between 4 and 6 weeks after delivery.

A safe option for patients with limited disease is topical therapy, including moisturizers and topical steroids as well as UVB phototherapy. In the case of active psoriasis or even psoriasis worsening during pregnancy, there might be a need for continuation or even introduction of systemic therapy.

Methotrexate and acitretin are known teratogens and mutagens, and they must be avoided. Ciclosporin may be regarded as a possible rescue therapy for pregnant psoriasis patients in the case of severe disease.

Post-marketing experience regarding the safety of biologics is accumulating, with largely reassuring results. All four biologics approved for the treatment of moderate to severe psoriasis Enbrel (etanercept), Remicade (infliximab), Enbrel (etanercept), and Stelara (ustekinumab) are not currently recommended in pregnant psoriasis patients.

The existing evidence implies that the risk of biologics in pregnancy is relatively low and that the risk of fetal drug exposure may be outweighed by the benefits for the mother.

I've just been reading a case report about a woman being treated with Thalidomide for multiple myeloma who developed psoriasis and thought it could be worth sharing.

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Summary:

A 54-year-old woman developed psoriasis on the plantar surface of her feet after 2 weeks of thalidomide 100 mg daily for the treatment of multiple IgG myeloma. She did not have any previous history of psoriasis.

Thalidomide was immediately stopped and topical treatment with calcipotriol ointment and β-methasone valerate was started. Psoriasis disappeared completely after 2 weeks of topical therapy.

This is the first case of de novo psoriasis in a patient with multiple myeloma under treatment with thalidomide. Our observation provides further evidence of the potential paradoxical effect of thalidomide on tumour necrosis factor-α production.

Following on from this report in 2012 XenoPort gets patent for Fumarate Analog XenoPort announced it has started a phase 2 trial of XP23829 in patients with psoriasis, XP23829 is a fumaric acid ester compound that is a prodrug of monomethyl fumarate (MMF).

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XenoPort, Inc. announced today that it has initiated a Phase 2 clinical trial of XP23829, its proprietary investigational next-generation fumaric acid product candidate. The trial is a multi-center, randomized, double-blind, placebo-controlled study designed to assess the efficacy and safety of XP23829 as a potential treatment of patients with moderate-to-severe chronic plaque-type psoriasis.

Richard Kim, M.D., XenoPort's chief medical officer, stated, "We are excited to take this next step in the advancement of the development of XP23829. From this Phase 2 trial, we hope to further our understanding of the efficacy, safety and tolerability of XP23829. In addition, the study is designed to generate information on the effect of dose and treatment duration on potential reduction in psoriatic lesions and modulation of sub-populations of blood immune cells. Based on historical enrollment rates of psoriasis studies conducted in the U.S., we expect top-line results of the trial in the third quarter of 2015."

XenoPort expects to enroll approximately 200 subjects in this trial, which is being conducted in the United States. The study will include a screening and washout phase of up to four weeks, a 12-week treatment phase and a four-week post-treatment phase. Eligible study subjects will be randomized to placebo or one of three treatment arms of XP23829: 400 mg or 800 mg once daily or 400 mg twice daily. The primary endpoint of the study will examine the percent change in Psoriasis Area and Severity Index (PASI) score from baseline at the end of week 12. Secondary endpoints will include the proportion of subjects who achieve a reduction of 75% or greater from baseline in PASI (PASI-75) score and subjects who achieve a Static Physicians Global Assessment (sPGA) score of "clear" or "almost clear."

Ronald W. Barrett, Ph.D., XenoPort's chief executive officer, further commented, "Fumaric acid ester drugs have been previously shown to be effective in psoriasis, although there are no products in the class that are approved by the U.S. Food and Drug Administration (FDA) for this indication. We believe that this trial will begin to define the distinguishing attributes of XP23829 as a potential best-in-class drug. These attributes could potentially include convenient once-a-day dosing, reduced flushing and gastrointestinal side effects and possibly more rapid onset and increased magnitude of efficacy. We believe that the results from this trial, if positive, could allow advancement of XP23829 directly into Phase 3 studies as a potential treatment for psoriasis. In addition, based on the strong correlation of results in psoriasis and relapsing forms of multiple sclerosis (MS) observed for other fumaric acid based drugs, we believe that this study could also form a basis for moving XP23829 into Phase 3 studies as a potential treatment for relapsing forms of MS."