GPs should proactively assess the impact that psoriasis may be having on the daily lives of their patients, advises the National Institute for Health and Clinical Excellence (NICE) in new guidance out today (Wednesday 24 October).

Psoriasis is a skin condition characterised by red, flaky, crusty patches of skin covered with silvery scales. It is believed to affect up to 2.2% of the UK population (i.e. over 1.3 million people) with most cases seen in young people and adults under the age of 35. The disease can contribute to low self-esteem, anxiety, embarrassment and depression, much like other chronic conditions but this may be overlooked by healthcare professionals. For example, over a third of people who have psoriasis report clinically significant anxiety and depression. The condition can also affect a person's participation in social and physical activities, employment and education.

In its first clinical guideline on the assessment and management of the condition, NICE advises GPs and other healthcare professionals to assess the impact that psoriasis has on the physical, psychological and social wellbeing of their patients. They should do this when they first see their patients, before they refer them to specialists, and when they monitor how they are responding to treatments.

Dr Catherine Smith, a consultant dermatologist who chaired the development of the NICE guideline, said: "Psoriasis is much more than a skin irritation. The condition can have profound functional, psychological and social effects on a person's life. It is vital that GPs and other healthcare professionals recognise these possible consequences when they first see their patients, and that they routinely assess the impact that the disease is having on their daily lives. Early and proactive identification will allow patients to receive the support and effective treatment they need in a timely manner. Importantly, accurate assessment of people with psoriasis will ensure they can access the right treatment as early as possible whether in primary or specialist care."

Also in its new clinical guideline, NICE advises that everyone with psoriasis should be assessed for psoriatic arthritis on an annual basis, particularly during the first ten years as this is when the condition is most likely to develop.

Around one in seven people who have psoriasis will develop psoriatic arthritis, a progressive condition, which can cause pain, stiffness and swelling in and around the joints. Early diagnosis is crucial and so annual assessments will allow those with actual or suspected psoriatic arthritis to be referred to specialists sooner.

Dr Natasha Smeaton, a GP who helped develop the NICE guideline, said: "Psoriatic arthritis is rarely seen by GPs and so there may be confusion regarding how it should be diagnosed when compared to other joint problems, such as 'wear-and-tear' arthritis and gout. Early diagnosis is important because the condition is aggressive and associated with progressive joint damage. There are effective treatments available and so patients should receive these as soon as possible.

"The NICE guideline advises healthcare professionals to offer annual assessments for psoriatic arthritis to all of their patients who have psoriasis. They should use a validated tool in these assessments, such as the Psoriasis Epidemiological Screening Tool. This will facilitate more timely referrals to rheumatologists so that patients can receive the treatments they need."

Today's guideline is the first to be produced by NICE to help GPs and other healthcare professionals assess and treat their patients with this condition.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: "Whilst there is no cure for psoriasis, treatments are effective and can include topical therapies, phototherapy and systemic medication, depending on the severity and extent of the disease.

"Clinical practice for the treatment of psoriasis is variable across the NHS. This guideline provides clear advice for the NHS on the assessment and management of psoriasis in order to improve comfort and minimise the effects of living with the condition."

Source: nice.org.uk

Quote:

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Psoriasis is an inflammatory skin disease that typically follows a relapsing and remitting course. The prevalence of psoriasis is estimated to be around 1.3–2.2% in the UK. Psoriasis can occur at any age, although is uncommon in children (0.71%) and the majority of cases occur before 35 years. Psoriasis is associated with joint disease in a significant proportion of patients (reported in one study at 13.8%).

Plaque psoriasis is characterised by well-delineated red, scaly plaques that vary in extent from a few patches to generalised involvement. It is by far the most common form of the condition (about 90% of people with psoriasis). Other types of psoriasis include guttate psoriasis and pustular (localised or generalised) forms. Distinctive nail changes occur in around 50% of all those affected and are more common in people with psoriatic arthritis.

Healthcare professionals and patients using the term psoriasis are usually referring to plaque psoriasis, and unless stipulated otherwise, 'psoriasis' is used in this way in the guideline. The phrase 'difficult-to-treat sites' encompasses the face, flexures, genitalia, scalp, palms and soles and are so-called because psoriasis at these sites may have especially high impact, may result in functional impairment, requires particular care when prescribing topical therapy and can be resistant to treatment.

Psoriasis for many people results in profound functional, psychological, and social morbidity, with consequent reduced levels of employment and income. Factors that contribute to this include symptoms related to the skin (for example, chronic itch, bleeding, scaling and nail involvement), problems related to treatments, psoriatic arthritis, and the effect of living with a highly visible, stigmatising skin disease. Even people with minimal involvement state that psoriasis has a major effect on their life. Several studies have also reported that people with psoriasis, particularly those with severe disease, may be at increased risk of cardiovascular disease, lymphoma and non-melanoma skin cancer.

A wide variety of treatment options are available. Some are expensive and some are accessed only in specialist care; all require monitoring. The treatment pathway in this guideline begins with active topical therapies. The Guideline Development Group (GDG) acknowledged that the use of emollients in psoriasis was already widespread and hence the evidence review was limited to active topical therapies for psoriasis.

In this guideline, first-line therapy describes traditional topical therapies (such as corticosteroids, vitamin D and vitamin D analogues, dithranol and tar preparations). Second-line therapy includes the phototherapies (broad- or narrow-band ultraviolet B light and psoralen plus UVA light [PUVA]) and systemic non-biological agents such as ciclosporin, methotrexate and acitretin. Third-line therapy refers to systemic biological therapies such as the tumour necrosis factor antagonists adalimumab, etanercept and infliximab, and the monoclonal antibody ustekinumab that targets interleukin-12 (IL-12) and IL-23. NICE has published technology appraisals on the use of biological drugs, and this guideline incorporates recommendations from these appraisals where relevant (listed in alphabetical order). Biologic treatment is complicated by a poor response in a minority of people, and this guideline reviewed the literature for the use of a second biological drug.

For most people, psoriasis is managed in primary care, with specialist referral being needed at some point for up to 60% of people. Supra-specialist (level 4) tertiary care is required in the very small minority with especially complex, treatment resistant and/or rare manifestations of psoriasis.

A recent UK audit in the adult population demonstrated wide variations in practice, and in particular, access to specialist treatments (including biological therapy), appropriate drug monitoring, specialist nurse support and psychological services.

This guideline covers people of all ages and aims to provide clear recommendations on the management of all types of psoriasis. The term 'people' is used to encompass all ages. 'Children' refers to those up to 12 years, who become 'young people' thereafter, before merging with the adult population by 18 years of age. The GDG have focused on areas most likely to improve the management and delivery of care for a majority of people affected, where practice is very varied and/or where clear consensus or guidelines on treatments are lacking. It is hoped that this guideline will facilitate the delivery of high-quality healthcare and improved outcomes for people with psoriasis.

Hello! I just found you today on the internet and have joined up! I am a 59 year old female who has had psoriasis since age 6, showing up about 2 weeks after I had chicken pox. I was given many difference treatments as a child (including eating turkey every day for a month) most of which did not make a great difference. After reaching my mid-twenties, I just quit seeking treatment and have lived with it, feeling fortunate that I did not have it as bad as some people did.

However, late last week, I discovered a small balding spot on my head. I went to the Dermatologist who diagnosed it as Alopecia. That caused me to begin to research on the internet to see if there was any link with it and Psoriasis. So, I am wondering if anyone in the club has dealt with this and I am wondering if anyone out there has scarring from Psoriasis?

I'm Barbi C, I found out I have Pustular Psoriasis on my foot in the spring, when I went to the doctor, its been appearing for the past 5 years+.... & I thought it was veruca's or athletes foot.... ok should have gone earlier

dr asked me what had I got to be stressed about??? I could start a book!! mainly building a house with no budget, but don;t get me started. its seriously flared up at present, as we have my husbands ex staying with us.... and I am letting her get to me!

Today it has been so bad it woke me up, and by the end of today I need to have delivered around a 1000 poll cards for this police commisionar election which is what I was doing yesterday, walking on flaring psoriasis is a total pain.... sure I don;t need to say that here however!! So how did I get here?? I decided to google psoriasis to see what I could do to ease it, as I'm hobling big time. & I found you - what a wonderful find!! I don;t feel so alone, and I realise that some of my other complaints are either linked or are a likely stimuli. Mind if my foot is giving me a lot of grief at least it takes my mind off my digestion.....

right back to bed! I have an hour before I need to be up & at it, and to prove J (the ex) that I can get up & out before 9am.....

ps I'm really a happy person, just lately let things get on top, that makes my psoriasis flare that me me miserable.... and round we go! etc etc

Big hugs to everyone and thanks for being there, I've already found stuff that is useful & gives me hope that I will not end up cutting my foot off.....

Hello, I am new to all of this, my dermatologist suggested this to me so I have someone to talk to, as right now it feels like I am the only one, as psoriasis is sch a taboo subject. I am 19 years old, and have had psoriasis since i was 14, and I have it quite severly now. There isn't a part of my body that doesn't have patches on it. I'm wondering how other people cope with the pressures of every day life? being a young woman, i feel like i have been stripped of my femininity, and my ability to even feel like a woman. I never wear dresses, or anything that reveals any part of my skin. I feel depressed all of the time, and whenever i see pretty women, who are able to wear what they want and are confident it makes me want to break down. I have a wonderful boyfriend who supports me, but I can't feel confident, even though he tells me he thinks i am beautiful, i don't believe him. i trust him more than anything but there is always a voice in my head telling me he wishes i looked 'normal'. I am so fed up feeling like this and need someone to talk to who knows what it feels like to constantly be uncomfortable in their own skin.

Hi everyone,
new to the forum and hoping to hear some positive stories about how you manage to look after your skin.
im trying a special diet at the moment and hoping it will help me heal...
i have also started an e-petition as psoriasis can be a debilitating condition and believe we need more support. Feel free to read it and sign it if you wish
*Old link removed as it's not secure
kind regards
pina

More evidence has been posted about the link of Diabetes with Psoriasis. I first reported about it here: Psoriasis and Diabetes

Objective: 
To compare the prevalence and incidence of type 2 diabetes mellitus between patients with psoriasis and those without psoriasis.

Data Sources: 
MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews between January 1, 1980, and January 1, 2012.

Study Selection: 
Observational (cohort, case-control, and cross-sectional) studies published in English that compared the prevalence or incidence of diabetes among patients with psoriasis with individuals serving as controls.

Data Extraction: 
Two independent investigators extracted the data. The quality of evidence was assessed using a 6-point scale.

Data Synthesis: 
Among 142 identified publications, 27 observational studies were included in the meta-analysis. Five of these studies assessed the incidence of diabetes in patients with psoriasis and were analyzed separately. Among studies assessing the prevalence, psoriasis was associated with an odds ratio (OR) of 1.59 (95% CI, 1.38-1.83) for diabetes. The pooled OR was 1.53 (95% CI, 1.16-2.04) for mild psoriasis and 1.97 (1.48-2.62) for severe psoriasis. Meta-regression of prespecified potential sources of heterogeneity revealed a nonsignificant difference (P = .10) of increased reported strength of association among studies that used medical record review (OR, 1.52 [95% CI, 1.31-1.77]) or patients' report of diabetes (2.79 [1.42-5.48]) compared with studies that used billing data (1.46 [1.01-2.09]). Among studies that assessed incidence, psoriasis was associated with a relative risk of 1.27 (95% CI, 1.16-1.40) for developing diabetes.

Conclusions: 
Psoriasis is associated with an increased prevalence and incidence of diabetes. The association of psoriasis with diabetes may be strongest among patients with severe psoriasis.

Source: jamanetwork.com

If you don’t have psoriatic arthritis, I hope you never get it. Today has been a terrible day. It started in the early hours of the morning; I woke up in a tight ball and felt like I had been stuffed in a jam jar!

I had to get up early too, as the nurse was coming for a blood test. It took me a while to roll out of bed and shuffle off to the bathroom, shower and drying was difficult as my bones just wouldn’t wake up. Usually I can get them working after an hour or so, but today it’s been like someone has come along and tightened all my joints up with a monkey wrench.

Hobbled around all-day in a grumpy mood and it’s not even a Full Moon. Time for another glass of red I think to help with the numbness, no not to get rid of the numbness but to bring it on.

Night Night

Greetings, mates!

I have had psoriasis since age 6-used a variety of treatments-cortisone, Hobson's DermaZema-a mix of pine tar and zinc oxide-worked but STUNK and stained things badly! It's no longer manufactured....last April my brother took me to a homeopathic chiropractor who practices Traditional Chinese Medicine and is also a Reiki master. He tested me and said my liver was dystunctional due to many years of using petrochemicals from creams, lotions and all the drugs I'd taken over the years. As a result of being clogged up, the job of excretion had shifted from my liver to my skin and the psoriasis was the result He put me on a diet with no red meat, no shellfish, little rice and soy abd supplements.

It's better; not gone but better. At times my ankle swells, the rash iteches and burns and then it's better. I believe it's genetic; Dad had it so bad he was fired from a job because it covered the top of his hands and he had a large bandaid on them.

Prior to starting my treatment with Dr. Rob, I'd been using coal tar without any visible results. My insurance didn't cover it and THE DARN STUFF COST ME $14.95 USD! Not happy with that.

Any thoughts on other holistic treatments?

Objective: 
To compare the efficacy of Stelara (ustekinumab) with that of other biological agents using the Psoriasis Area and Severity Index (PASI) among adult patients with moderate to severe plaque psoriasis.

Data Sources: 
We conducted a systematic search of the period January 31, 1992, to February 1, 2012, using MEDLINE (pub med), Embase, the Cochrane Library, and clinicaltrials.gov.

Study Selection: 
We included randomized controlled trials of biological agents compared with placebo or other biological agents using the PASI in patients who had moderate to severe plaque psoriasis.

Data Extraction: 
Study data were extracted independently by 2 of us, with disagreement resolved by consensus. Data extracted included the size of the trial, follow-up period, age range of patients, disease duration, body surface area involvement, baseline PASI, PASI response, and previous treatment with biological agents.

Data Synthesis: 
A Bayesian network meta-analysis was performed by fitting 3 regression models: a fixed-effects model, a random-effects model, and a random-effects model with meta-regression coefficients. The random-effects model achieved the best fit for these data. In pairwise comparisons, ustekinumab use was associated with statistically significantly higher odds for achieving a 75% reduction in the PASI compared with adalimumab use (odds ratio [OR], 1.84; 95% credible interval [CrI], 1.01-3.54), alefacept use (OR, 10.38; CrI, 3.44-27.62), and etanercept use (OR, 2.07; 95% CrI, 1.42-3.06) but was associated with lower odds compared with infliximab use (OR, 0.36; 95% CrI, 0.14-0.82) . In the therapeutic class comparison, the interleukin-12/23 inhibitor had the highest odds for achieving a 75% reduction in the PASI compared with placebo (OR, 69.48; 95% CrI, 36.89-136.46), followed by tumor necrosis factor inhibitors (OR, 42.22; 95% CrI, 27.94-69.34) and the T-cell inhibitor (OR, 5.63; 95% CrI, 1.35-24.24).

Conclusion: 
For the treatment of moderate to severe plaque psoriasis, Stelara (ustekinumab) may be more efficacious than Humira (adalimumab), and Enbrel (etanercept), but not Remicade (infliximab).

Source: jamanetwork.com

XBiotech, a privately held biotechnology company, announced positive preliminary results today from their Phase II study using a True Human™ monoclonal antibody (MABp1) in patients with moderate to severe psoriasis. Data from the trial indicate a relatively rapid response in skin lesion severity following an initial subcutaneous injection, and continued improvement over 70 days with a maximum of three injections. Preliminary results demonstrated a 30 percent improvement in Psoriasis Area and Severity Index (PASI) scores within three weeks of receiving the initial subcutaneous dose. Full data from the study will be submitted to a peer-reviewed journal for future publication.

“What I was most impressed by was the immediate decrease in redness in skin lesions,” said Kyle M. Coleman, M.D., American Academy of Dermatology (ADA), and American Society for Dermatologic Surgery (ASDS) member and a lead clinical investigator in the Phase II study from Westlake Dermatology, Austin, Texas. “Inflammation is a driving force in psoriasis, but other therapies aren’t directed at addressing the underlying cause first. Most address skin thickness initially, with resolution in inflammation and redness occurring as a last result. This is a whole new approach that appears to provide a well tolerated therapy with significant patient benefit.”

"IL-1α is a master regulator of chronic inflammation that plays a pivotal role in triggering and sustaining the inflammatory process in a variety of disease indications,” said John Simard, president and CEO, XBiotech. “Based on data being generated in our clinical trials, we believe that targeting IL-1α holds significant promise as a unique therapeutic option for psoriasis and a variety of other diseases. We are pleased to continue to advance a new medial paradigm for treatments that block chronic inflammation, and to develop therapies that represent a breakthrough in safety and efficacy for patients.”

True Human™ antibodies represent the next generation of therapeutic antibodies. These antibodies are identified using the Company’s proprietary platform technology to ensure faithful reproduction of the original human antibody gene. True Human™ antibodies are “invisible” to the body’s immune system and thus have the potential for better safety, efficacy and patient tolerability compared to earlier generation antibody therapeutics.

XBiotech is pioneering breakthrough therapies that improve the safety and efficacy of antibody therapeutics. The Company’s lead product candidate inhibits chronic sterile inflammation by targeting IL-1α, a master regulator of inflammation. The clinical development program addresses tremendous unmet medical need in multiple disease indications including, acne, psoriasis, cachexia, cancer, type 2 diabetes and cardiovascular disease. XBiotech is also revolutionizing scalable, flexible manufacturing systems for the production of biological therapies. Using minimal infrastructure and disposable bioreactor technology – to dramatically reduce capital requirements, operating complexity, and lead times - the Company has established a compelling commercialization path for its True Human™ antibody platform.

Source: xbiotech.com

I am 48 years of age and have been suffering from Ps since I was about 27 just came on when very stressful time in my life. It has gone completely when pregnant . when bad in early 90's and early 2000 did have uvb treatment which worked really well and managed to keep under control. It has just flared up over the last two weeks but seem to be settling down with use of pine tar soap and salcura spray .

I've added a new thingy to the forum that will show a few words from a threads first post. It also shows a few words from the latest reply. See Red Arrows in photo!



Just hover your mouse to make it work, any problems let me know.

Objective:
To determine the “real-world” clinical effectiveness and safety of leflunomide (Arava) in patients with psoriatic arthritis (PsA).

Methods:
This prospective, multinational 24-week observational study involved adult patients with active PsA who initiated treatment with leflunomide.Patients were evaluated at baseline, 12 weeks, and 24 weeks.The primary outcome was response as assessed by Psoriatic Arthritis Response Criteria (PsARC) in patients with pre- and post-treatment data.A modified PsARC response analysis included patients with joint counts, but no severity scores.Other effectivenessevaluations included global assessments, fatigue, pain, skin disease, dactylitis, and nail lesions.All patients were evaluated for safety.

Results:
A total of 514 patients were enrolled in this study (mean age, 50.7 years; mean disease duration,6.1 years). In the primary effectivenessanalysis, 380 of 440patients (86.4%; 95% confidence interval 82.8% – 89.4%) achieved a PsARC response at 24 weeks. Significant improvements were observed in tender and swollen joint scores and counts, patient and physician global assessments, fatigue, pain, skin disease, dactylitis, and nail lesions.The discontinuation rate was 12.3%.Ninety-eight adverse drug reactions occurred in 62 (12.1%) patients; 3 were serious (2 increased liver enzymes, 1 hypertensive crisis).

Conclusion:
Leflunomide is an effective and well tolerated option for PsA in daily clinical practice, with beneficial effects on peripheral arthritis and on other PsA manifestations, including pain, fatigue, dactylitis, and skin disease. © 2012 by the American College of Rheumatology

Source: onlinelibrary.wiley.com

Hey all

great idea with a new forum, very clean design I must say.

I wanted to finally join a PSO forum to share my thoughts and worries and experiences with you other sufferers.

First off a little about me.
Living in North of Europe in a country called Denmark near the city of Copenhagen.
I am married to my wife and we have 2 beautiful boys of 3 years and 4 months.
I am 34 years old and have had PSO since i was around 21 years old.


In Denmark we have gov. paid healthcare which can be a great benefit but also requires that you go trough a lot of loops to be eligible to the biologics.
It is required that you try all other treatments before you can get the biologics.

Thus I started seriously 6 years ago to get on the new biologics, since my PSO was getting worse. Today I have plagues on the lower legs, lower arms, a few spots here and there. Nails also hit. Lately feet and hands are getting attack sometimes but still not that bad.

here is short brief of my trials, I will write more later on

generally I will say, I have positively given up on wonder treatments. I read the book called Sunbathing Naked and Other Miracle Cures by Guy Kennaway, which I will recommended all PSO to read, it is a fun and upbeat description on how to live with PSO.


I stated out with UVB treatments which had some effect but PSO came back fast after that. Right now I am on UVB again since I found out that you since have to be fairly clear before you can get any effect form the UVB treatments.

Daivobet/Dovobet/Xamiol
Great drug, but afraid of long term use if I end getting crushing syndrome, have gained weight when on Daivobet. Xamiol is a gel of daivobet great for the scalp. still us every other day.

MTX
was on for 6 months. Sick with fever for 3 weeks, generally looked bad and was often sick from nothing. Effect was pretty good on PSO.

Remicade
3 days after 1 injection lameness came to the hands, then the whole body could not move, was taken to hospital by ambulance, MRI scan showed nothing, but we needed up stopping treatment after that.

enbrel/humirca
Doctor and !I rules these out becasue of the recently discovered adverse effects of getting MS from these drugs. also same type as Remicade.

Cream/baby oil
lots of cream and oil every day, twice a day. keep the doctor away.

Next step?

Stelara?
Doctors can order it to me now, but i am afrid of the adverse effects and if as Fred says only works 2 years.

for now i just wanted to say hey to all

Janssen announced today that STELARA® (ustekinumab) has been awarded the prestigious 2012 International Prix Galien Award at a ceremony in Lyon, France.  The Prix Galien Award recognizes extraordinary efforts in biopharmaceutical and medical technology research and development by honoring biomedical advances impacting both individuals and public health in the past decade. The honor is acknowledgment of the technical, scientific and clinical research skills necessary to develop innovative medicines and devices.

"It is a tremendous honor for Janssen to be recognized with the International Prix Galien Award for STELARA," said Jay P. Siegel, M.D., Chief Biotechnology Officer and Head, Global Regulatory Affairs, Janssen Research & Development, LLC.  "We remain focused on bringing innovative medicines, like STELARA, to patients and health care professionals around the world."

STELARA is a human monoclonal antibody currently approved in more than 60 countries, including Canada, Europe, the United States, Brazil, Mexico, Australia and Japan, for the treatment of moderate to severe plaque psoriasis.

"STELARA exemplifies the convergence of science, technology and medicine," added Susan Dillon, Ph.D., Global Therapeutic Area Head, Immunology, Janssen Research & Development, LLC.  "We are proud of the difference that STELARA has and continues to make in the lives of patients battling moderate to severe plaque psoriasis, and are humbled to receive the International Prix Galien Award."

Considered the industry's highest accolade, the international Prix Galien Award is given every other year and selected from previous national contest Prix Galien winners.  STELARA received the Prix Galien USA Best Biotechnology Product Award in 2011 and the Prix Galien Canada Innovative Product Award in 2010.  Prix Galien was first established in 1970 by French pharmacist Roland Mehl, and the international award was inaugurated in 1990. 

Source: prnewswire.com

Stelara (ustekinumab)

Following on from the study I posted in June Psoriasis and oral health here is another study that suggests an increased risk of psoriasis among patients with CP* (Chronic periodontitis)

Background: 
Although psoriasis and chronic periodontitis (CP) may share an underlying immune dysregulation as part of their pathologies, to date only one small-scale cross-sectional pilot study has investigated the potential association between CP and psoriasis.

Objectives: 
This study aimed to investigate the subsequent risk for psoriasis following a diagnosis of CP by utilizing a cohort study design and population-based dataset in Taiwan.

Methods: 
In total, 115 365 patients with CP were included in the study cohort and 115 365 patients without CP were included in the comparison cohort. We individually tracked each patient for a 5-year period to identify those who had subsequently received a diagnosis of psoriasis. A Cox proportional hazards regression was performed to compute the 5-year risk of subsequent psoriasis following a diagnosis of CP.

Results: 
We found that the incidence rate of psoriasis during the 5-year follow-up period was 1·88 [95% confidence interval (CI) 1·77–1·99] per 1000 person-years in patients with CP and 1·22 (95% CI 1·14–1·32) per 1000 person-years in comparison patients. After censoring those who died during the follow-up period, and adjusting for monthly income and geographical region, compared with comparison patients, the hazard ratio (HR) of psoriasis for patients with CP was 1·52 (95% CI 1·38–1·70). Furthermore, the study subjects who had undergone a gingivectomy or periodontal flap operation had only a slightly higher adjusted risk of psoriasis than comparison patients (HR 1·26).

Conclusions: 
This study detected an increased risk for psoriasis among patients with CP. Treatment for CP attenuated, but did not nullify, the risk for subsequent psoriasis.

Source: onlinelibrary.wiley.com

*CP (Chronic periodontitis) is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by accumulation of profuse amounts of dental plaque.

Signs and symptoms:

• Redness or bleeding of gums while brushing teeth.
  
• Gum swelling that recurs.
  
• Halitosis, or bad breath, and a persistent metallic taste in the mouth.
  
• Gingival recession, resulting in apparent lengthening of teeth.
  
• Deep pockets between the teeth and the gums.
  

Maybe some of you may be interested...

Prescription for pustular psoriasis by the Medical board of the National Psoriasis Foundation.

So Britney Spears has psoriasis

Good on her getting the flakes on show

Shame on the media for making such a deal of it

This is a very sad piece of news, but I felt it should be posted on here to help raise awareness that Psoriasis is not just a skin problem.

Quote:

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BANGALORE: Depressed over a skin ailment that curtailed her liking to dress up, a II BCom student allegedly hanged herself from the ceiling of her home late on Sunday night.

She was found hanging by her mother and brother in their residence at Subramanyanagar near Rajajinagar, off Rajkumar Road.

Sadhana Arulananda (20), daughter of businessman and Ramamohanapalya resident Arulananda, was diagnosed with psoriasis over 10 years ago. The disease exacerbated a couple of years back, resulting in inflammation and scaling.

Sadhana's elder brother, Arun, and mother had gone to her grandmother's house at Rama Mandir in Rajajinagar in the evening. "They later tried calling Sadhana over the phone but received no response. They returned home around 10pm and found the front door locked from inside," Subramanyanagar police said.

Sensing something amiss, Arun stood on the compound and peeped from the kitchen ventilator. "He saw his younger sister hanging from the ceiling in the room. With neighbours' help, he broke open the door and untied the noose," police said.

Arun, a private company employee, told cops that Sadhana showed signs of life when he brought her down. "They shifted her to a hospital on Dr Rajkumar Road but doctors declared her brought dead," police said.

Sadhana was a student of Maharani College, Sheshadri Road.

In his statement to cops, Arun said his sister was distraught over her deteriorating skin ailment. Sadhana had stopped attending functions, given the ailment's visible symptoms. The ailment also resulted in her developing allergies to particular dresses.

"This disease is not allowing me to dress neatly or wear different clothes. My life is ruined," Arun quoted Sadhana as saying.

Janssen Biotech, Inc. (“Janssen”) announced today that it has entered into a license agreement with Astellas Pharma Inc. (“Astellas”) for the worldwide development and commercialization, except in Japan, of ASP015K, an oral, small molecule Janus Kinase (JAK) inhibitor. ASP015K is currently in Phase 2b development as a once-daily oral treatment for moderate-to-severe rheumatoid arthritis (RA), following a successful Phase 2a study demonstrating its potential in the treatment of moderate-to-severe plaque psoriasis.

“Janssen has a heritage of innovation and delivering transformative medicines to address unmet needs in immunologic diseases,” said Susan Dillon, Ph.D., Global Therapeutic Area Head, Immunology, Janssen Research & Development, LLC. “We are committed to expanding the portfolio of new treatments for patients with serious immune-mediated diseases and are excited to add Astellas’ ASP015K to our pipeline.”

Under the terms of the agreement, Janssen gains exclusive worldwide rights to develop and commercialize ASP015K, except in Japan, as an oral treatment for immune-mediated inflammatory diseases. In addition to an upfront payment, Janssen and Astellas have agreed to future milestone and royalty payments if certain development and commercialization milestones are achieved. Astellas will be responsible for completing the ongoing Phase 2b studies. Janssen will be responsible for all other development, clinical and regulatory filing activities in its territories. Astellas will continue development and commercialization of ASP015K in Japan.

About ASP015K
ASP105K is an oral, small molecule Janus Kinase (JAK) inhibitor, which blocks critical components of signaling mechanisms used by a number of inflammatory cytokines, including those that are believed to be important to mediating disease in people with immune-mediated inflammatory diseases. ASP015K is currently in Phase 2b studies evaluating the efficacy and safety of once-daily oral dosing in the treatment of moderate-to-severe RA. A Phase 2a study in the treatment of moderate-to-severe plaque psoriasis has been completed.

Source: janssenbiotech.com