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

Thought this was interesting, the price of Dovobet is frightening !!

Hello you lot,
I'm back, I think. You see, I seem to remember joining before now, but lost my account I must have

Any how, for those that don't know me...
Geeky 37 year old bloke.
Likely Aspergers but not yet diagnosed.
Married with 2 children (aged 4 and 7, the kids that is, wifey is much closer to my age ).
Chronic Plaque Psoriasis since about 7 years old.
Psoriatic Arthritis first diagnosed at about 17 years old.
Been through about every treatment the NHS has to offer....
Currently having success with Stelara for about a year. Skin mostly clear although a little worse at the mo'. Joints not too bad either, although I don't think thats much to do with the Stelara. A change of lifestyle the last few months has meant I can look after myself better; Stretching/exercise/meditation etc. Currently no painkillers, funny story that, co-codamol was making my pain worse after I got addicted to it. So with some effort I got 'clean' and have been quite a lot better since.

RE: PM's - I can't reply yet, must need to post more and prove I'm no robot.

All the best,
Daniel

(soldersplash)

There has been a big media report about a Flesh Eating Disease in Pangasinan province of the Philippines, and the report is false according to the Philippine Information Agency and they appealed to media to check the validity of news reports on health-related cases before releasing to the public.

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LINGAYEN, Pangasinan, Feb. 26 (PIA) -- The supposed “mysterious flesh-eating illness” in Pangasinan is a hoax, the provincial health officer said in a press briefing on Tuesday.

Provincial Health Officer Dr. Anna Maria Teresa de Guzman belied a news report that two patients were suffering from a “mysterious” disease that is eating the flesh of its victims.

She said the patients from the towns of Santa Barbara and Villasis are actually afflicted with psoriasis and leprosy.

“Both ailments are controllable, not contagious and pose no threat to the public,” De Guzman said.

The Provincial Health Office came out with a finding after looking into a report from ABSCBN’s news program ‘Bandila” on Monday night that the patients were afflicted with rare necrotizing fasciitis or flesh-eating disease.

De Guzman said in 2011, the patient from Santa Barbara was diagnosed with leprosy, a disease that causes skin sores.

She added the patient was already treated but a drug reaction triggered the leprosy to resurface.

“Nagkaroon siya ng hypersensitivity doon sa gamot kaya nagkaroon ng reaction sa kanyang katawan (She developed hypersensitivity from a drug which caused skin reaction),” De Guzman said.

She has no menstrual period, a sign of malnutrition and anemia, which aggravated her condition, she said.

The patient, who was initially-treated in another private health facility, has now completed the treatment but may still need debridement for her skin lesions, she added.

The second patient from Villasis is ailed with severe case of psoriasis (a skin disease that causes peeling and red marks on the skin) with arthritis which prevents him from walking.

She said the victim already had psoriasis since birth (genetic) which was triggered due to various factors including weather changes and stress.

“The two reported patients are now admitted at the Pangasinan Provincial Hospital in San Carlos City to undergo further treatment and medical diagnosis,” she added.

De Guzman said the report only connected the two case studies to a prophecy by a self-titled prophet Sadhu Sundar Selvaraja of Jesus Ministries in April 2013 warning that a flesh-eating disease would spread from the Ilocos province to the world. He also prophesied the typhoons that caused destruction and heavy flooding in Luzon and Visayas last year.

She appealed to media to check the validity of news reports on health-related cases before releasing to the public.

Researchers at The Centre for Dermatology Research at Wake Forest Baptist assessed how often steroids were prescribed to treat psoriasis and trends in their use over time.

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When it comes to psoriasis management guidelines, use of systemic corticosteroids are discouraged, but a new study from Wake Forest Baptist Medical Center indicates they are widely prescribed by dermatologists.

Researchers at The Center for Dermatology Research at Wake Forest Baptist assessed how often these drugs - prednisone, dexamethasone and methylprednisolone - were prescribed and trends in their use over time.

"Expert guidelines discourage their use for psoriasis due to concerns about causing flares of generalized pustular psoriasis, but there are no randomized controlled trials of systemic corticosteroids in psoriasis to look at these issues," said Scott A. Davis, M.S., a co-author of the study and assistant director of the Center for Dermatology Research at Wake Forest Baptist Medical Center.

Davis and colleagues used National Ambulatory Medical Care Survey data to determine the systemic medications prescribed for psoriasis from 1989 to 2010. They found that systemic corticosteroids were prescribed at 650,000 of 21 million psoriasis visits. Of these prescriptions, 93 percent were from dermatologists. Corticosteroids were the second most commonly prescribed systemic medication for psoriasis, according to the study which appears online this month ahead of print in the journal of Cutaneous Medicine and Surgery.

Despite the warnings and concerns, the drugs are widely used, the study showed. "Psoriasis has an enormous impact on patients' lives, and there have been major recent advances in treatment," Davis said. "While the new treatments are highly effective and appear very safe, they are costly; their effects are well studied. In contrast, while corticosteroids have been available for decades, their use in psoriasis has not been extensively studied."

I am wondering if anyone has any advice or tips on dealing with nail Psoriasis.
Mine are pretty bad at the moment, pitted and very sore if i knock them. Two of them look like they are coming away from the nail bed (which makes me feel queasy everytime i think about it.)

I guess its hard to treat but just wondered if there was anything out there.

Anacor Pharmaceuticals announced today that a peer-reviewed article describing the recent progress of boron-based compounds in medicine and the properties of these compounds that support their development for the treatment of various skin disorders will be published in the February 17, 2014 edition of the Journal of Clinical and Aesthetic Dermatology. “From the Test Tube to the Treatment Room: Fundamentals of Boron-Containing Compounds and Their Relevance to Dermatology” is co-authored by James Q. Del Rosso, D.O., F.A.O.C.D., dermatologist in private practice at Las Vegas Skin and Cancer Clinics in Henderson, Nevada and Clinical Professor of Dermatology at Touro University College of Osteopathic Medicine in Henderson, Nevada and Jacob. J. Plattner, Ph.D., Senior Vice President of Research, Anacor Pharmaceuticals.

The authors note that the therapeutic benefit of incorporating boron into a chemical compound is derived from boron’s unique physical, chemical and structural properties. Boron has an empty p-orbital which gives it the capacity to form covalent bonds at a target site on a protein, rendering the protein inactive or less active. Several examples of proteins that boron-containing compounds have been found to inhibit include phosphodiesterase-4 (PDE4) thereby reducing the cytokine production in psoriasis and atopic dermatitis; leucyl tRNA synthetase thereby blocking protein synthesis in dermatophytes; and β-lactamases, thereby reducing resistance to antibiotic therapy.

The authors also note that, until recently, the use of boron in drug development has been widely overlooked. Initially, boron was incorporated into drug candidates as boronic acid which made the compounds overly reactive resulting in off-target binding and decreasing their potential effectiveness as therapeutic agents. However, since then, researchers found that if they incorporated boron into compounds as part of a cyclic structure rather than as an acid, they were able to produce small boron-based molecules that are highly stable, demonstrate effective target binding and selectivity and exhibit optimal physical properties that allow access to the necessary site of the disease target.

“The use of boron in drug discovery and development is very exciting to dermatology and other fields of medicine. Boron’s unique properties allow it to bind to target proteins involved in key pathophysiologic pathways which has opened the door to new potential therapies in dermatology including fungal infections such as onychomycosis, atopic dermatitis, psoriasis, acne, bacterial infections and other skin diseases,” said Dr. Del Rosso.

Boron-based compounds currently in development for dermatologic indications include tavaborole, which is being reviewed by the FDA for the treatment of toenail onychomycosis and AN2728, a PDE4 inhibitor which has completed Phase 2 studies in psoriasis and atopic dermatitis. A third compound, AN3365, is being evaluated as a gram-negative antibiotic. All three compounds were discovered and are being developed by Anacor Pharmaceuticals.

Source: anacor.com

*Anacor is a biopharmaceutical company focused on discovering, developing and commercializing novel small-molecule therapeutics derived from its boron chemistry platform.

A new study published in Science Translational Medicine shows there could be a new target for the treatment of psoriasis, and it is the first time that this gene has been identified as having a specific link to the condition.

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Cytokines are critical checkpoints of inflammation. The treatment of human autoimmune disease has been revolutionized by targeting inflammatory cytokines as key drivers of disease pathogenesis. Despite this, there exist numerous pitfalls when translating preclinical data into the clinic.

We developed an integrative biology approach combining human disease transcriptome data sets with clinically relevant in vivo models in an attempt to bridge this translational gap. We chose interleukin-22 (IL-22) as a model cytokine because of its potentially important proinflammatory role in epithelial tissues.

Injection of IL-22 into normal human skin grafts produced marked inflammatory skin changes resembling human psoriasis. Injection of anti–IL-22 monoclonal antibody in a human xenotransplant model of psoriasis, developed specifically to test potential therapeutic candidates, efficiently blocked skin inflammation.

Bioinformatic analysis integrating both the IL-22 and anti–IL-22 cytokine transcriptomes and mapping them onto a psoriasis disease gene coexpression network identified key cytokine-dependent hub genes. Using knockout mice and small-molecule blockade, we show that one of these hub genes, the so far unexplored serine/threonine kinase PIM1, is a critical checkpoint for human skin inflammation and potential future therapeutic target in psoriasis.

Using in silico integration of human data sets and biological models, we were able to identify a new target in the treatment of psoriasis.

New research published by Research And Markets shows Market value of Systemic psoriasis treatments are set to rise from $5 billion in 2013 to $10.4 billion by 2020.

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The systemic psoriasis treatment market value in the eight major countries (8MM) — the US, Canada, France, Germany, Italy, Spain, the UK and Japan — is expected to more than double in the near future, jumping from $5 billion in 2013 to $10.4 billion by 2020, at a significant Compound Annual Growth Rate (CAGR) of 11.1%

The company’s new report states that across the 8MM, 4.1 million people were diagnosed with some form of moderate-to-severe psoriasis in 2013. This number is expected to climb slightly to 4.4 million by 2020, with 1.5 million of the population being treated with systemic agents.

Fiona Chisholm, report analyst, says: “This growth in the treatment population will be driven by a marginal rise in the global prevalence of psoriasis, as well as an increase in the diagnosis rate resulting from higher disease awareness and improved diagnostic methods.

“Additionally, psoriasis is increasingly being recognized as a serious systemic disease with associated quality of life impairment and disability, rather than as a simply cutaneous disease. As perceptions of psoriasis continue to change, healthcare professionals will consider treatment as non-optional.”

Although some revenue losses are anticipated to occur throughout the forecast period, due to patent expiries, the introduction of new, novel biologics with positive efficacy profiles will drive further market growth.

According to the authors, secukinumab, brodalumab and ixekizumab are three particularly promising, late-stage pipeline monoclonal antibodies directly targeting IL–17, a pro-inflammatory cytokine. In addition to these upcoming biologics, some orally administered, small molecule compounds are also expected to enter the market over the coming years, such as Xeljanz, a janus kinase inhibitor, and apremilast, a PDE4 inhibitor.

This report was built using data and information sourced from proprietary databases, primary and secondary research, and in-house analysis conducted by a team of industry experts.

Hello there,

Before I start, I'd like to express my sheer relief at the stories I've been reading on here of fellow psoriasis sufferers and their experiences; not that I feel good about other people suffering, just that it is *so* good not to feel so isolated with this very lonely condition.

I've had psoriasis from a very young age, but nothing more dramatic than a scaly scalp and a bit of itching behind the ears.

Five years ago it flared up and I had it all over my scalp and on my arms and body ... again, it wasn't particularly dramatic - just redness and itching - and coal tar shampoo plus some gooey medicated oinkment (the name of which escapes me) sorted it out.

This time, it has kindly enveloped my whole body (bar my face, thankfully) in painful redness and plaques, and has decided for extra measure to infect my right shin. It has been dramatic and life-changing, and has greatly reduced my quality of life. I can get no relief from the pain and everything I do causes pain, ie standing up, sitting down, walking, going to the Ladies, getting dressed, getting undressed and so on. I am here because I have reached a level of desperation ... not being one to generally feel sorry for myself, I have twice in a week burst into tears from the unremitting pain and the futility of the several medications I've tried, none of which have worked.

I have an appointment with a dermatologist next Friday, which I am hoping (praying!) will help ... so far I have seen 6 doctors and am on my fourth dose of antibiotics since 3 December 2013. The steroid creams are too painful to use, and I had an allergic reaction to one of the bath lotions I was prescribed. I have also tried two different (prescribed) antihistamines, neither of which have worked.

I'm sorry to whinge, but was hoping there might be someone out there who could maybe identify with what I am going through, who might be able to suggest something ... I have wonderful supportive friends, but don't know anyone who has this condition to the degree that I am experiencing it. Any advice would be greatly appreciated ...................... thanks x

I was contact today by a member asking if it was possible to get Emails from the forum in their own language.

I didn't think it was, but I was wrong you can get Emails in your chosen language. Obviously the content of the Email will still be in English.
But instead of getting  

Has anyone had any success with forming a new relationship whilst living with Psoriasis?
I mean how and when do you bring it up?
How do you get past the embarrassment of the flaking for instance.

Hello,

I'm 37 years old and was diagnosed just over a year ago. It came as a big surprise because I have friends with psoriasis and have always thought that it is the kind of condition you develop in your teens and it is genetic. I thought I was definitely not getting it because no one in my family has it and I was already in my 30s. How wrong I was!

I must say I was quite depressed when I was first diagnosed because I had seen how bad it could be. The doctor first prescribed 2 doses of anti-fungal pills (he said it slowed down the growth rate of the skin cells which is one of the causes) and Dermovate mixed with some kind of ointment. It took me 2-3 weeks to get rid of a patch on my elbow (about 2 cm in diameter).

After that my super sensitive skin went a bit mad. I would feel burning sensation on my elbows and arms, but no patches. After a while, it went away.

About 4-5 months later, I got another flare up around the same area, just a few bumps similar to insect bites. I couldn't find time to go to see the doctor, so I searched the Internet for some homemade cure to help until I could find the time. I came across the baking soda method. I made a paste and applied it on my elbow once a day. After 3 days, it got so much better that I didn't even go to see my doctor.

I also drank fresh mangosteen juice. And that helped me a lot. According to a recent research I read, people with psoriasis has a high level of TH2 which is the stuff your white blood cells produce. The mangosteen juice helps increase the T-regulator which helps control the level of TH2. I don't know if this is scientifically sound, but a friend of mine has tried a dose of new medicine which helps control the immune system as a way to help control psoriasis. So she said my mangosteen juice was not that far off from modern medicine.

The down side of it is magosteen juice is quite pricey. A 300g bag is about 160 THB (maybe it doesn't sound much for those of you in the US or UK, but it is certainly not cheap if you think of the cost of living here in Bangkok) because it uses up to 5 kg of mangosteen to make one bag. And it's a hassle when you travel because it's heavy and takes up a lot of space. (Having said that, I did take 6 bags with me when I was on a 9-day Japan trip last year)

I'm having another visit from psoriasis now. Just a few bumps. I'm back to one bag mangosteen juice a day, baking soda paste and generous application of coconut oil twice daily. Let's see how it goes. I'm tempted to try the Eucalyptus oil too.

When I look at my psoriasis, I wonder if it is red in color or?? Currant? Wine as in Cabernet or Zinfandel? What do you consider red in the coloring of skin?