Hi, I am new to this page. My name is Stephen I am 34 years old and have had Psoriasis for about 13 years. I started a new treatment last year called Infliximab and it started to work and I was clear, but since January the Psoriasis has come back worse and I don't know what the Doctor will do next.

This study set out to find the unmet needs of psoriasis & psoriatic arthritis patients, and concluded there are several identified unmet needs that warrant additional attention and action.

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Background:
Available psoriasis surveys offer valuable information about psoriasis and psoriatic arthritis (PsA), but are limited by methodology or enrollment requirements.

Objective:
To further the understanding of the unmet needs of psoriasis and PsA patients.

Methods:
This was a large, multinational, population-based survey of psoriasis and/or PsA patients in North America and Europe. Patients were selected by list-assisted random digit dialing and did not have to currently be under the care of a health care provider, a patient organization member, or receiving treatment; 139,948 households were screened and 3426 patients completed the survey.

Results:
The prevalence of psoriasis/PsA ranged from 1.4% to 3.3%; 79% had psoriasis alone and 21% had PsA. When rating disease severity at its worst, 27% (psoriasis) and 53% (PsA ± psoriasis) of patients rated it as severe. Psoriasis patients indicated that their most bothersome signs or symptoms were itching (43%), scales (23%), and flaking (20%). Of psoriasis patients, 45% had not seen a physician in a year; >80% of psoriasis patients with ≥4 palms body surface area and 59% of PsA patients were receiving no treatment or topical treatment only. Of patients who had received oral or biologic therapy, 57% and 45%, respectively, discontinued therapy, most often for safety/tolerability reasons and a lack/loss of efficacy.

Limitations:
The survey lacked a control group, did not account for ethnic and health care system differences across countries, and was limited by factors associated with any patient survey, including accurate recall and interpretation of questions.

Conclusions:
Several identified unmet needs warrant additional attention and action, including improved severity assessment, PsA screening, patient awareness, and treatment options.

There are a lot of studies about a link with Depression and Psoriasis, and although surveys are fine it could be interesting to have a survey right here on Psoriasis Club.

Guests and members can vote in the poll above, members can also post in this thread if they wish. 

Your vote is anonymous though I will be able to see the names of members that voted, so if you want to remain anonymous you should log-out to vote.

Obviously posts in this thread are in the public domain so you should only post what you are happy with.

So the question in the poll above is "As a psoriasis patient have you ever suffered with depression?" Vote in the poll above, and/or post in this thread.

Depression, Anxiety Common with Psoriatic Arthritis
Melissa Leavitt
People with psoriatic arthritis are at greater risk for depression and anxiety than people with psoriasis alone, according to findings from a recent study.
The study, led by researchers from the University of Toronto, asked patients at Toronto Western Hospital to complete a questionnaire assessing symptoms of depression and anxiety. Participants included 306 people with psoriatic arthritis, and 135 people with psoriasis alone.
Survey results revealed that 36.6 percent of participants with psoriatic arthritis had anxiety, while 22.2 percent had depression. Among participants with psoriasis, the rates were lower, yet still notable: 24.4 percent of people with psoriasis had anxiety, and 9.6 percent had depression.
The prevalence of depression and anxiety among people with psoriatic arthritis is not surprising, said Dr. Dafna Gladman, a co-author of the study. "But it was important to document it."
Although past research has assessed mental health comorbidities among people with psoriatic disease, this study is one of the first to zero in on mood disorders in psoriatic arthritis specifically.
The findings highlighted the need for increased awareness of these conditions among patients and caregivers.
"We've identified it as an issue, and now doctors should really be looking for it," Gladman said.
Gladman noted that even though patients identified themselves as being depressed, many had not received treatment for their depression. This may be due to the fact that mood disorders can easily go undetected in a clinic setting.
"When a patient comes to you with either skin psoriasis or joint disease, you concentrate on those physical findings," she said.
To ensure that patients get the comprehensive care they need, she recommends a multidisciplinary approach so that patients see physicians with different specialties.
"Somebody—the family doctor, a psychologist—should be assessing these people," she said.

This new study on the use of Simponi (Golimumab) looked into it's use over 5 years for treating psoriatic arthritis.

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Objectives:
Assess golimumab's long-term efficacy/safety in psoriatic arthritis (PsA).

Methods:
Adults with active PsA (≥3 swollen and tender joints, active psoriasis) were randomly assigned to subcutaneous placebo, golimumab 50 mg, or golimumab 100 mg every 4 weeks (q4wks) through wk20. All patients received golimumab 50 mg or 100 mg q4wks from wk24 forward. Methotrexate was allowed and taken by approximately half the patients. Findings through 5 years are reported herein. Efficacy assessments included ≥20% improvement in American College of Rheumatology (ACR20) response, C-reactive-protein-based, 28-joint-count Disease Activity Score (DAS28-CRP) response, ≥75% improvement in Psoriasis Area and Severity Index (PASI75) scores, and PsA-modified Sharp/van der Heijde scores (SHSs).

Results:
126/405 (31%) randomised patients discontinued treatment through wk252. Golimumab was effective in maintaining clinical improvement through year-5 (ACR20: 62.8–69.9%, DAS28-CRP: 75.2-84.9% for randomised patients; PASI75: 60.8–72.2% among randomised patients with ≥3% body surface area involvement) and inhibiting radiographic progression (mean changes in PsA-modified SHS: 0.1–0.3) among patients with radiographic data. While concomitant methotrexate did not affect ACR20/PASI75, it appeared to reduce radiographic progression. No new safety signals were identified. Antibodies-to-golimumab occurred in 1.8%/10.0% of patients with/without methotrexate).

Conclusions:
Long-term golimumab safety/efficacy in PsA was demonstrated through 5 years.

New drugs and cosmetics are currently tested on animals, but a team led by King's College London has grown a layer of human skin from stem cells which could pave the way for testing without animals.

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Stem cells have been turned into skin before, but the researchers say this is more like real skin as it has a permeable barrier.

It offers a cost-effective alternative to testing drugs and cosmetics on animals, they say.

The outermost layer of human skin, known as the epidermis, provides a protective barrier that stops moisture escaping and microbes entering.

Scientists have been able to grow epidermis from human skin cells removed by biopsy for several years, but the latest research goes a step further.

The research used reprogrammed skin cells - which offer a way to produce an unlimited supply of the main type of skin cell found in the epidermis.

They also grew the skin cells in a low humidity environment, which gave them a barrier similar to that of true skin.

Lead researcher Dr Dusko Ilic, of King's College London, told BBC News: "This is a new and suitable model that can be used for testing new drugs and cosmetics and can replace animal models. "It is cheap, it is easy to scale up and it is reproducible." He said the same method could be used to test new treatments for skin diseases.

Researcher Dr Theodora Mauro said it would help the study of skin conditions such as ichthyosis - dry, flaky skin, psoriasis or eczema. "We can use this model to study how the skin barrier develops normally, how the barrier is impaired in different diseases and how we can stimulate its repair and recovery," she said.

Research and toxicology director Troy Seidle said: "This new human skin model is superior scientifically to killing rabbits, pigs, rats or other animals for their skin and hoping that research findings will be applicable to people - which they often aren't, due to species differences in skin permeability, immunology, and other factors."

Hi I am new to this forum. I have had my Psoriasis for around 8yrs it started after I had my hip operation. I have it severe on the soles of my feet, making some days impossible to walk. I have now been taking Fumaderm for 5 weeks dosage now 390mg a day, but not seeing any sign of improvement. Can someone give me some light at the end of the tunnel and advise me the more I increase my dosage by week, it will start to see an improvement.

A 30k photo-therapy machine paid for by voluntary fund-raising to treat people with psoriasis is laying dormant in Ireland.

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A €30k phototherapy machine, paid for by voluntary fundraising efforts, was installed in 2010 in Bantry hospital, but has not been used to treat psoriasis since last August. Now people in West Cork, for whom photo-therapy is recommended to treat psoriasis, must travel over 160km a couple of times a week to avail of a few minutes of therapy at Cork University Hospital.

The €30,000 phototherapy machine was paid for by the voluntary fundraising efforts of the Friends of Bantry General Hospital Ltd. It was installed in 2010, but has not been used since August.

Friends’ spokesman Robert Fennell said they were “disgusted” the equipment was lying idle.

“We raised money to buy the equipment for people who are already paying their taxes,” he said. “The State should be providing the service, but it is not. We fundraised so that phototherapy could be delivered locally and now that isn’t happening.”

The HSE blamed the unavailability of the Bantry service on staff shortages. It said the standards for the delivery of phototherapy changed in 2012, and the revised standards advised “that to ensure a safe dose was delivered, an additional staff member was required”.

“In August 2013, due to the limited number of staff available, the service had to be suspended.”

A similar situation exists at Beaumont in Dublin, where a phototherapy service was “temporarily suspended” in November 2012 due to staff losses, but has yet to be reinstated.

This survey looked at the use of Methotrexate for the treatment of psoriasis from 62 countries, and suggests there are significant differences concerning the doses, routes of administration and safety monitoring among clinical practices.

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Background:
Methotrexate is one the most commonly used systemic therapies for psoriasis. Despite its widespread use in psoriasis therapy, dermatologists' practice regarding the use of methotrexate has not been investigated on global scale.

Objective:
To evaluate the real life use of methotrexate for psoriasis treatment in the dermatological community worldwide.

Methods:
A questionnaire consisting of 41 questions was designed by the Psoriasis International Network (PIN). Questions focused on safety, dosing, administration, folic acid supplementation and combination therapy aspects of methotrexate use. The anonymous web-based survey was distributed to dermatologists by the national coordinators of PIN.

Results:
Between 2 April and 7 August 2012, 481 dermatologists from 63 countries completed the questionnaire. Most respondents were from European and South American countries, whereas the response rate from Central America and the Near East was lowest. The majority of responders were experienced dermatologists (86% had more than 5 years of experience in psoriasis treatment). Starting and maintenance doses of 10 mg of methotrexate or lower were reported by 67% and 42% of respondents respectively. Thirty-eight per cent of respondents stop treatment at a cumulative dose of 2 g, whereas 36% did not consider cumulative dose important in this respect. The primary mode of administration was oral, and the majority of respondents administer folic acid supplementation. Almost all respondents monitored full blood count, liver and renal function tests, whereas procollagen 3 amino terminal peptide measurement and transient elastography is used by only a minority of dermatologists. There were significant differences concerning the doses, routes of administration and safety monitoring among the clinical practices in different geographical locations.

Conclusion:
Current clinical practice of methotrexate use in psoriasis is not uniform, depends on geographical location, and is not in full agreement with clinical guidelines.

Hi I thought it was time to introduce myself properly, my Name is Looby and i've had Psoriasis for as long as i can remember and can't really remember not having it somewhere on my person, for the last 16 years I've been on Methotrexate, sometimes tablets and sometimes the injections but my Dermatologist has just started me on Fumaderm and stopped my Methotrexate (eeeeeeekkkkkk) I am at the moment beginning to wonder if I have made the right decision? It's not so much the side effects it's that my P is raging out of control!! Can any of you fabulous forumers help? L x

Following on from Galapagos announces phase 2 study Galapagos have released the following information.

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“Study JAK116679 was a phase 2a multi-centre, randomised, double-blind, placebo-controlled, dose ranging study (100mg bid, 200mg bid, 400mg bid) that evaluated the safety and efficacy of GSK2586184 compared with placebo in 66 patients with chronic plaque psoriasis. Preliminary results showed that a significantly higher proportion of patients treated with GSK2586184 at the 400mg bid dose met the primary endpoint compared to placebo. The primary endpoint was defined as achieving ≥75% improvement from baseline in Psoriasis Area Severity Index (PASI75) score at Week 12. PASI75 for patients randomised to placebo was in the range expected.

During the treatment period the most common adverse events occurring with a frequency of more than 20% on either placebo or pooled GSK2586184 were headache (36% placebo, 27% GSK2586184) and nasopharyngitis (21% placebo, 29% GSK2586184). A final analysis of the data from study JAK116679 will be submitted for presentation at an upcoming scientific congress and/or a peer-reviewed publication. GSK remains responsible for the study and intends to review the complete data from all GSK2586184 studies before determining next steps.”

“We at Galapagos are pleased to hear that GSK2586184 met the primary endpoint in GSK’s psoriasis study. This is the second selective JAK1 inhibitor and candidate drug based on Galapagos’ novel target approach to show efficacy in patients. The next patient readout from our pipeline is expected in June 2014: our Phase 2 Proof of Concept study with GLPG0974, a fully proprietary and novel mode of action in ulcerative colitis,” said Dr Piet Wigerinck, Chief Scientific Officer of Galapagos.

GSK2586184 is a selective JAK1 inhibitor which was discovered and developed within Galapagos’ inflammation alliance with GSK. GSK in-licensed the molecule in February 2012, gaining worldwide rights to further development and commercialization. Galapagos is eligible, without further financial investment from Galapagos, to receive from GSK up to €34M in additional milestones, plus up to double-digit royalties on global commercial sales of all therapeutic indications of GSK2586184.

This study published in The Journal of Rheumatology suggest that the chance of depression and anxiety are higher for people with psoriatic arthritis than those with only psoriasis.

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Objective:
(1) To determine the prevalence of depression and anxiety in patients with psoriatic arthritis (PsA) and to identify associated demographic and disease-related factors.
(2) To determine whether there is a difference in the prevalence of depression and anxiety between patients with PsA and those with psoriasis without PsA (PsC).

Methods:
Consecutive patients attending PsA and dermatology clinics were assessed for depression and anxiety using the Hospital Anxiety and Depression Scale. Patients underwent a clinical assessment according to a standard protocol and completed questionnaires assessing their health and quality of life. T tests, ANOVA, and univariate and multivariate models were used to compare depression and anxiety prevalence between patient cohorts and to determine factors associated with depression and anxiety.

Results:
We assessed 306 patients with PsA and 135 with PsC. There were significantly more men in the PsA group (61.4% vs 48% with PsC) and they were more likely to be unemployed. The prevalence of both anxiety and depression was higher in patients with PsA (36.6% and 22.2%, respectively) compared to those with PsC (24.4% and 9.6%; p = 0.012, 0.002). Depression and/or anxiety were associated with unemployment, female sex, and higher actively inflamed joint count as well as disability, pain, and fatigue. In the multivariate reduced model, employment was protective for depression (OR 0.36) and a 1-unit increase on the fatigue severity scale was associated with an increased risk of depression (OR 1.5).

Conclusion:
The rate of depression and anxiety is significantly higher in patients with PsA than in those with PsC. Depression and anxiety are associated with disease-related factors.

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?