Hello all

I have never had any sort of skin problem. However over the past few months I have had 'something' develop on my scalp. It started as clustered clumps of 'dandruff' on my scalp, but nothing to bad. I went to see GP who give me some coconut coal stuff, she said it was caused by stress. Then a few months later, I developed quite bad dry skin behind my ears, of which became infected and started weeping. Then my head became significantly worse, it become very very sore and cracked. It feels like it is burning and the skin is very tight. I can easily simply scratch my head and my nails will be full of 'clumps' of white / yellow stuff. Sometimes my scalp also weeps to the point that it soaks my hair at the back. I have looked at it when it has been oozing and it seems to be a greenish liquid seeping. Its becoming increasingly sore and I am still not sure what it is. My dr gave me some steriod cream for behind my ears, and antibiotics but nothing else for my hair. The coal stuff I got earlier this year does not work and actually hurts very much because I am putting it on sore cracked skin. Does this sound like psoriasis?

Thanks all

Hi im new to this site, I suffer from guttate psoriasis. Im currently covered in it, the only place thats not effected so far is my face. I itch all over, I cant sleep, its driving me crazy ! I dont need help I just need to moan about it ! Fed up

Please move if I've put this in the wrong section.

As you may or may not know, after my recent relapse, I've lost quite a few layers of skin from my feet. Luckily I now have my meds and will be away on holiday in a few weeks.

The problem now is........shoes!

My feet are still uber sensitive (as are my ankles from all that tippy toeing around) and still get a bit hot. It will take a while for the skin to toughen up again. I need to find some shoes that basically feel like slippers or perhaps try some memory foam insoles?

Just wondered if anyone had anyone suggestions or personal recommendations.

I've been on Humara. My plaque P is gone. I have some of the glut P which I didn't have before but only about 6 or 10. Finger nails are back to normal. PA seems to be much better. Under carriage is clear. Scalp is doing great which is good news because the cover over it is disappearing rapidly. I hope it doesn't quit working.

This article published in Journal of the American Academy of Dermatology suggests that psoriasis patients are at a significant risk of parkinsonism.

Quote:

---

Objective:
We sought to investigate the risk for parkinsonism during a 5-year follow-up period after a diagnosis of psoriasis using a population-based data set in Taiwan.

Methods:
We identified 4885 patients with psoriasis for the study cohort and randomly selected 24,425 patients as a control cohort. Each subject was individually followed up for a 5-year period to identify those who subsequently developed parkinsonism.

Results:
Stratified Cox proportional hazards regression showed that the adjusted hazard ratio for parkinsonism during the 5-year follow-up period for patients with psoriasis was 1.74 (95% confidence interval 1.35-2.20) that of control patients. Furthermore, the adjusted hazard ratios for parkinsonism within the 5-year follow-up period after the index date for subjects with psoriasis were similar between both sexes (1.78 and 1.66 for men and women, respectively).

Limitation:
Our data set did not provide detailed information on the severity of psoriasis, or individual factors such as cigarette smoking, alcohol consumption, body mass index, and dietary patterns.

Conclusion:
Patients with psoriasis were found to be at a significant risk of parkinsonism during a 5-year follow-up.

Source: NO LINKS ALLOWED

Hi i'm new to the psoriasis club. Started to develop a rash about a week and a half ago, which started on the palm of my hands and then gradually spread to most other areas of my body. i thought it was excema to begin with as I have suffered with excema on and off for years.

But after making an appointment to see the doctor today he told me that it was guttate psoriasis.

He has given me Dermol cream to apply, oilatum for the bath and antibiotics, I have to take the antibiotics 2 tablets at a time 4 times a day, 8 tablets in total. this seems a lot of tablets, just wanted to know if anyone else who was first diagnosed was given this many tablets to take a day. They are penicillin.

Thank you

xx

I'm new to this site, just wanted to say hello. I was diagnosed today with guttate psoriasis caused through having a throat infection. looking forward to posting on the site xx

Hi everyone
I stumbled onto this site whilst googling Apremilast. Spent some time browsing through and it looked like a friendly and informative place.

I am staying in the East and was trained in the West (UK) so I have the opportunity to treat my psoriasis with both Eastern and Western medicines.

During my 40 years of living with psoriasis, I have tried ayurvedic medicines, traditional Chinese therapies ( imbalance in the Ying and Yang) and even gone to Thailand to drink snake bile.

I have smeared myself with all sorts of creams ( steroids, Daivonex, moisturizers, herbal products). UV light therapy only helped for a short time.

I tried a course of cyclosporine... I suffered every known side effect and it did not help my skin a single bit.

So far I have avoided anti-TNF medication and the only thing that controls my skin is Methotrexate which I have been taking every 2 - 3 weeks for the past 30 years.

I am considering trying apremilast but it is still not available here. So I am still struggling to live with my itchy, scaly and often painful skin and hoping some day someone will find a cure.

Hi.

I'm plonky and I have P.

Sorry for the long, detailed post.

After reading the new study by Kantar Health below, I thought the subject would make a good poll for Psoriasis Club.

• This poll is available to guests
  
• Members are welcome to post on this thread.
  
• Physician = A person qualified to practice medicine.
  
• Please don't mention any physician's by name if posting on this thread. (I will remove them)
  
• You cant change your vote, but should your view change please let me know and I will edit it for you.
  
• Usernames are not shown in the results.
  

Quote:

---

Four in 10 psoriasis patients—including 25 percent of moderate to severe patients—currently are not under the care of a physician for their condition, according to new research conducted by Kantar Health, a leading global healthcare consulting firm.

Results from a survey conducted among psoriasis patients in the U.S. show that while most patients who do see a physician for their psoriasis are satisfied with the medical care they receive, about one-third have stopped seeing a physician because of their dissatisfaction with their psoriasis treatment or progress. As disease severity increases, these patients are more likely to have changed physicians multiple times.

Patients who are dissatisfied with the care they receive cited their physicians’ inability to provide effective treatment as the primary reason for their dissatisfaction. Only four out of 10 claim to have a satisfactory level of clearing of their psoriasis plaques, with those using prescription treatments being the most satisfied with clearing but still falling short of their expectations. Furthermore, some patients also mentioned their physician had a lack of attention, emotional support or empathy as contributing to their dissatisfaction.

“Physician advice is far and away the greatest influence on how psoriasis is treated,” said Rose Lorenzo, director of research at Kantar Health. “However, a relatively large number of moderate to severe patients are declining to see a doctor about their disease, and those who are being treated are much more likely to be dissatisfied with their physicians. It’s important for physicians to set more realistic expectations on the level of psoriasis clearance they are likely to experience to help close the gap between expectations and treatment satisfaction.”

Caroline I'm not sure if you have seen or posted about this on here, but I'm sure you will find it interesting.

Quote:

---

Background: 
Fumaric acid esters (FAE) are used as an effective and safe oral treatment for plaque psoriasis in adult patients, but little is known about their efficacy and safety in children with psoriasis.

Objectives: 
To assess the effectiveness and safety of FAE in the treatment of paediatric psoriasis.

Methods: 
This is a retrospective analysis of 14 paediatric patients with psoriasis (age < 18 years) treated with FAE between 2004 and 2012 at several Dutch university and regional clinics. Patients were identified through databases or registries.

Results: 
The median age at the start of FAE treatment was 15 years (range 8–17 years). The median duration of FAE treatment was 10 months (range 1–80 months), and the median maintenance dosage per day was 360 mg dimethylfumarate (range 240–600 mg). Five patients (36%) achieved a complete clearance of their psoriasis, one patient (7%) had a good improvement, three patients (21%) had a partial response and five patients (36%) were nonresponders. FAE treatment was well tolerated, but two patients (14%) discontinued FAE, one with severe diarrhoea and one with flushes. Five patients (36%) had transient, slightly abnormal laboratory values of liver-function tests or leucocytes that did not necessitate FAE dosage reduction or treatment discontinuation. No serious adverse events occurred.

Conclusions: 
In this retrospective case series FAE seemed to be an effective and safe treatment for children with psoriasis. FAE may be an attractive therapeutic alternative to the currently used systemic immunosuppressive agents for paediatric patients with psoriasis. Further studies are needed to evaluate the suitability of FAE in paediatric psoriasis.

Here's an interesting article that was published in the British Journal of Dermatology asking the question "Is the prevalence of psoriasis increasing?"

I found the results interesting as it shows that people are self reporting psoriasis to their GPs, and could be more aware about psoriasis than ever before. Lets hope Psoriasis Club is playing it's part in helping that result.

Quote:

---

Background:
There is indication of an increasing prevalence of psoriasis in some western populations. However, the results are not conclusive.

Objectives:
To analyse trends in the prevalence of psoriasis over the past 30 years, separating age, birth cohort and time period effects.

Methods:
Five population-based surveys in North Norway, the Tromsø Studies 2–6, collected between 1979 and 2008, were studied. Participants aged 20–79 years with self-reported psoriasis data in at least one of the surveys were included, yielding a total of 69 539 observations from 33 387 unique individuals born between 1915 and 1977. Trends in psoriasis prevalence were examined using cross-sectional, time lag and longitudinal designs of graphical plots. Observed trends were further evaluated in generalized linear-regression models.

Results:
The self-reported lifetime prevalence of psoriasis increased from 4·8% in 1979–1980 to 11·4% in 2007–2008. Graphical plots showed an increasing prevalence of psoriasis with each consecutive survey in all examined age groups and birth cohorts, leaving time period effects as the explanation for the increase. The odds for psoriasis in the cohort were 2·5 times higher in 2007–2008 than in 1979–1980 (adjusted odds ratio 2·49, 95% confidence interval 2·08–2·99). The prevalence of persons reporting a doctor’s diagnosis of psoriasis was 9·9% in the last survey. In subgroups of the study population, psoriasis was associated with higher body mass index, lower physical activity during work and leisure time, lower educational level and smoking.

Conclusions:
Our findings indicate an increasing prevalence of self-reported psoriasis. This could represent a true increase in prevalence, possibly due to changes in lifestyle and environmental factors, or an increased awareness of the disease.

Background: 
In the pathogenesis of psoriasis, proinflammatory T cells are strongly involved in the inflammatory process, where regulatory T-cell (Treg) function is impaired.

Objectives: 
As effective Treg function is associated with a numerical balance between Treg and effector T cells, we wondered whether Treg/T-helper cell ratios may be associated with certain stages of the inflammatory process. We opted for the margin zone model as a dynamic approach.

Methods: 
From nine patients with chronic plaque psoriasis, 3-mm punch biopsies were obtained from the centre and margin of the lesion, perilesional skin and distant uninvolved skin. Skin biopsies of 10 healthy volunteers were included as a control. Samples were analysed using immunohistochemistry and immunofluorescence.

Results: 
In the transition from symptomless to lesional skin, a significant increase of CD3+, CD4+ and Foxp3+ cells was found. In seven of nine patients the ratio of Treg (Foxp3+) vs. CD4+ T cells was higher in the distant uninvolved skin than in the perilesional and lesional skin. Interestingly, the Foxp3/CD4 ratio in the distant uninvolved skin was even higher than in the skin of healthy controls. Notably, we found that most of the interleukin (IL)-17 expression was not related to CD4+ cells, but to mast cells.

Conclusions: 
The relatively high Foxp3/CD4 ratio in symptomless skin of patients with psoriasis suggests an active immune controlling mechanism distant from the psoriatic plaque. In the margin and centre of the plaque the ratio appears skewed towards effector cells associated with inflammation. IL-17, an important driver of the psoriatic process, is mostly related to mast cells, and only sporadically to T cells.

Source: NO LINKS ALLOWED

Summary Background: 
In 2007 the International Psoriasis Council proposed that palmoplantar pustulosis (PPP) should be considered a separate condition from psoriasis, despite the presence of certain phenotypes common in both diseases.

Objectives: 
To describe and compare demographic and clinical characteristics among patients with PPP and palmoplantar plaque psoriasis.

Methods: 
This was a retrospective case series study from 2005 to 2010. The following data were obtained: age, sex, family history, smoking habits, nail involvement, joint involvement, disease duration, lesion morphology (plaque or pustular), histological diagnosis, comorbidities, and Physician’s Global Assessment (PGA) score for extrapalmoplantar lesions. The sample size calculation indicated that 80 patients, 40 patients for each group (palmoplantar plaque psoriasis and PPP) were needed to see clinically relevant differences between groups.

Results: 
Ninety patients were selected, 51 with palmoplantar plaque psoriasis and 39 with PPP. No statistically significant differences were registered between patients affected by PPP and palmoplantar plaque psoriasis as regards age at onset of the disease (48 vs. 44 years; P = 0·4), disease duration (6 vs. 10 years; P = 0·1), family history of psoriasis (28% vs. 33%; P = 0·7), concomitant arthritis (26% vs. 25%; P = 1·0), or smoking habits (54% vs. 41%; P = 0·2). We observed a female predominance (P = 0·01) and a lesser frequency of nail involvement (P = 0·03) in patients affected by PPP.

Conclusions: 
Our data suggest a close relationship between PPP and psoriasis. The existing data concerning epidemiology, clinical presentation, genetics, histopathology and pathogenesis do not permit a clear distinction between these two entities, which seem to coincide in many aspects. PPP appears to have a marked predilection among female smokers.

Source: NO LINKS ALLOWED

Hi all,

As suggested by Fred I have started my very first thread on a forum! Eeeek!

After 2 doses of MTX and a horrible reaction I got my first dose of Stelara last Thursday - the injection was a doddle and my nurse was lovely!

Its too early to now anythign really but so far no nasty side effects and I think theres a change, my right arm was a favourite picking spot and would be an area that the psoriasis came back daily, but i noticed yesterday that the skin I picked hasnt come back thick enough to pick since before the weekend.

Sorry - that description sounds terrible but not sure how else to explain what I mean. I did take some pictures on the day of the injections so hope that helps me monitor how it goes. I think my comfort eating has decreased but thats maybe cos my wine intake has increased due to work being utter pants!

Fingers crossed peeps!

I have a thread in Off Topic [Group Specific] about loosing my sense of smell after having a bad case of the flu.

I didn't think at the time that it may be of interest to others with psoriasis, but in the end I thought I would mention it here too as I'm using Stelara.

I'm not for one minute saying it's a problem with Stelara as I have researched and can't find any evidence of loss of smell whilst using it. But to cut a long story short you can read more in off topic I lost my smell after a bad case of the Flu around Dec/Jan and it has not come back. I have now seen a specialist and he confirmed the virus probably killed my smell senses.

Again I'm not saying it's related, but Stelara and other Bio treatments do lower your immune system, and the specialist told me as I was taking it I should have gone to him sooner.

So if you loose your smell, go to your GP immediately if you are on a Bio as I have been told there is no guarantee of it coming back.

If anyone does know more about a link with the loss of smell and psoriasis please post here.

hi my name is moflow i am a sufferer to its is getting me down now

Long story short - I've been on Ciclosporin for two years now. I can honestly say it has made a huge difference to my severe Palmoplantar Pustular Psoriasis.

However, my math deficient Dermatology Clinic can't seem to give me an appointment that occurs before my meds run out.My next appointment is June 11th but my meds run out on Monday. Consequently, after just 3 days dry, I revert back to looking like the surface of Mars.

So I'm keeping a Journal and hopefully pictures (don't worry, I will warn you in advance) of my journey Back Into Hell.

The rationale behind this Journal is

a) because I'm probably going to need somewhere to rant
b) so I can raise awareness via social networking (and hopefully steer more sufferers to the site)

Might as well try to get something positive out of it.

I'll be absent over the weekend as I have to get ready for the onslaught (stocking up on books/DVDs, food, organising school runs and setting up my bed downstairs etc) as I wont be able to walk further than the loo by next week.

At the moment my Psoriasis score is a lovely, snuggly 8. Lets see what it looks like by June 11th. I'll begin the updates on Monday.

TTFN!

P.S Dear Mods. I hope posting this in the Please Help Me section is correct. If not please move to wherever you feel it's appropriate.

After a frankly horrific round of steroid creams, light treatment and numerous infections (hard not to get infected when your skin is constantly tearing) plus major bouts of Black Dog (my pet name for depression) I finally got onto Ciclosporin. Took over a year and I gradually became housebound/bedridden.

Anyhow, the Ciclosporin kicked in pretty fast. Took a bit longer to get my mobility back to normal and slightly longer to get the Black Dog back in it's cage.

I was prescribed 320mg per day but I have managed slowly drop it to 200mg and still stay comfortable. I did experience some nausea when I first began the treatment but that seems to have died down. The tips of my toes and fingers do tend to sting somewhat when I bathe or wash up but it's manageable. The bl***y excessive hair growth is a pain. I must be keeping Veet in business.

What annoys me though is, on two occasions, my prescription has run out before my next appointment. I can't get them on repeat prescription, it has to be at the hospital after a blood test and a consultation. Fair play, they have to keep a check on my kidneys and all that but it annoys me that, every so often, I have to go back to square one because I've only got say 3 months worth between 4 monthly appointments.

I'm facing yet another relapse. My meds run out on Monday but my appointment is not until June 11th. Within three days of coming out of my system I'm going to be in Agony Central again. Absolutely no cancellations available (believe me, I've begged).

Sorry for the long post but I just wondered if anyone else had had a similar experience with their Dermatology Clinic (or is mine just very bad a math)?

Well I used to use this Forum a couple of years ago (or maybe 3, I'm a scatterbrain).
It's changed a little in appearance from what I remember but good to see it going strong.
I stopped posting because, frankly, I went into a deep pit of depression for ages and by the time I climbed back out of it I was too 'embarrassed' to post again.
Yes, I know that's silly but you know how it is. It's like neglecting to speak to a friend for ages and the longer you leave it, the harder it gets.
Anyway, I've rejoined and I've got my head sorted out (well, most of the time anyway).
So hello and sorry for the rambling.