Hi, new here, I developed Psoriasis at 10/11 years old, it went mad in my mid teens then disappeared, has now flared up again over the last two years & just wondering if hormones are a key factor as I have been going through menapause?

I hate my skin so much the only time im happy is when im driving my motorcycle

i'm in trials in barrie ontario and have had plecbo for the first 10 weeks im very bummed anyone else in the same boat as me ?

In case you didn't know August is psoriasis awareness week in USA.
Lots of details are on facebook (national psoriasis association) they are also running a photo competition!

I couldn't enter as in the UK but I posted my first ever psoriasis showing picture on Facebook to get into the spirit of things!

Perrigo Company  today announced that it has received final approval from the U.S. Food and Drug Administration for its abbreviated new drug application for clobetasol propionate shampoo, 0.05%, the generic equivalent of Clobex® Shampoo. Perrigo will commence shipment of the product immediately.

Clobetasol propionate shampoo, 0.05%, is indicated for the treatment of moderate to severe scalp psoriasis. Perrigo's Chairman, President and CEO Joseph C. Papa stated, "This is another example of our Rx team's commitment to launching difficult to manufacture extended topical products. We are excited to market this product and are dedicated to making quality healthcare more affordable."

Perrigo Company is a leading global healthcare supplier that develops, manufactures and distributes OTC and generic prescription (Rx) pharmaceuticals, infant formulas, nutritional products, and active pharmaceutical ingredients (API). The Company is the world's largest manufacturer of OTC pharmaceutical products and infant formulas, both for the store brand market. The Company's primary markets and locations of manufacturing and logistics operations are the United States, Israel, Mexico, the United Kingdom and Australia.

Background:
Despite widespread dissatisfaction and low treatment persistence in moderate to severe psoriasis, patients' reasons behind treatment discontinuation remain poorly understood.

Objectives:
We sought to characterize patient-reported reasons for discontinuing commonly used treatments for moderate to severe psoriasis in real-world clinical practice.

Methods:
A total of 1095 patients with moderate to severe plaque psoriasis from 10 dermatology practices who received systemic treatments completed a structured interview. Eleven reasons for treatment discontinuation were assessed for all past treatments.

Results:
A total of 2231 past treatments were reported. Median treatment duration varied by treatment, ranging from 6.0 to 20.5 months (P < .001). The frequency of each cited discontinuation reasons differed by treatment (all P < .01). Patients who received etanercept (odds ratio [OR] 5.19; 95% confidence interval [CI] 3.23-8.33) and adalimumab (OR 2.10; 95% CI 1.20-3.67) were more likely to cite a loss of efficacy than those who received methotrexate. Patients who received etanercept (OR 0.34; 95% CI 0.23-0.49), adalimumab (OR 0.48; 95% CI 0.30-0.75), and ultraviolet B phototherapy (OR 0.21; 95% CI 0.14-0.31) were less likely to cite side effects than those who received methotrexate, whereas those who received acitretin (OR 1.56; 95% CI 1.08-2.25) were more likely to do so. Patients who underwent ultraviolet B phototherapy were more likely to cite an inability to afford treatment (OR 7.03; 95% CI 3.14-15.72).

Conclusions:
Different patterns of treatment discontinuation reasons are important to consider when developing public policy and evidence-based treatment approaches to improve successful long-term psoriasis control.

Source: jaad.org

GlaxoSmithKline and Rosa to Present Psoriasis Collaboration Results at 17th International IRA Conference.

Rosa & Co. LLC, a drug development advisory firm with expertise in drug-disease modeling and simulation, today announced that results from its Psoriasis PhysioPD collaboration with Stiefel, a GSK Company, will be presented at the 17th International Inflammation Research Association Conference in Lake George, NY, September 9-13th, 2012. Dr. Betty Hussey, Director, Clinical Pharmacology of GSK will present a poster entitled "Physiological model to investigate and prioritize targets for psoriasis".

The presentation will describe the development and use of a custom-designed Psoriasis PhysioMap® which provided information and methodology to enable key decisions in early development target prioritization. The map was built using literature data and then critically reviewed by R&D scientists and disease experts. The presentation will show how the map was used to evaluate the roles of drug targets in disease pathways, their potential interactions, and their relative contributions to efficacy potential. This process has informed the selection and prioritization of drug development targets, and it set the stage for development of a quantitative PhysioPD model that will further elucidate and prioritize target potential.

"We are pleased to share the initial results from our ongoing collaboration with GSK", said Dr. Rebecca Baillie, Chief Scientist, PhysioPD at Rosa. "The results of this collaboration show the business value and scientific usefulness of developing a Psoriasis PhysioMap. The PhysioMap development process was critical for establishing a common understanding of the key data and material uncertainties relevant to psoriasis and providing a framework to facilitate cross-functional communication within GSK."

Hello All

Reading the most recent posts regarding Fumaderm and those trying the product for the first time, I encourage you to continue. Stomach cramping seems to be the most traumatic side effect but well worth the tolerance to achieve the benefits of Fumaderm. What do you take to alleviate the cramping? I used antacids.

As reported previously, I was a +30 year sufferer of Psoriasis, ran the gamut of controls available in Canada and USA except for biologic treatments, and today am totally free of the disease. Some days, it is unbelievable to think back on the severity of the affliction and have no Psoriasis today. I have some scarring, mostly slight discoloration of previous Psoriasis sites, but that's it.

I went through the step-up program, then step-down to a maintenance program of 1 x 120 mg per day for the past 2-1/2 years.

A peculiarity of the disease is that not all treatments work for all people, but my experience prompts me to advise you to try it or stick with it if you are already one the medication.

Good Luck and Hang in there!

William Mateychuk

Hi everyone, like my username says, I'm just a farmboy from Canada My question to the forum is this: How genetically heritable is psoriasis? My mom has it on her elbows, neck, back and knees, and she is in a quite a bit of discomfort all the time.

Sandoz launches first-to-file calcipotriene cream, the first generic.

Sandoz, a Division of the Novartis group, is the second-largest generic pharmaceuticals company globally, offering a broad range of about 1000 high-quality, affordable products that are no longer protected by patents. announces the introduction of its first-to-file calcipotriene cream, the first generic version of LEO Pharma Inc.’s Dovonex® Cream, 0.005% in the US.

"Sandoz is proud to be both the first company to file for and the first to launch this important new generic dermatology medicine, which further strengthens Sandoz’s #1 position in generic dermatology medicines in the US and globally,” said Don DeGolyer, President of Sandoz US. “The launch of calcipotriene cream further demonstrates our commitment to improving patient access to high-quality, affordable medicines.”

According to IMS Health, US sales for the branded version of calcipotriene cream were approximately USD 118.8 million for the 12 months ending in May 2012. Sandoz is marketing calcipotriene in the 0.005% strength, the same strength that is marketed as Dovonex® Cream, 0.005%.

Currently Sandoz has a total of 172 ANDAs (Abbreviated New Drug Applications) pending approval with the US FDA, including 40 confirmed first-to-file opportunities.

Source: sandoz.com

Can-Fite BioPharma expects to publish positive data at the end of the third quarter regarding the safety and efficacy of its CF101 drug under development for the treatment of psoriasis, the Israeli company's acting CEO said on today.

CF101, a small molecule oral drug, is in advanced clinical development for the treatment of autoimmune inflammatory diseases such as psoriasis, and rheumatoid arthritis.

Can-Fite acting CEO and founder Pnina Fishman said the company was conducting a Phase II/III clinical study involving 300 patients in the United States, Europe and Israel.

"We are going to have the interim analysis clinical data towards the end of the third quarter," Fishman told Reuters. "The data is positive ... in terms of safety and efficacy."

Shares in Can-Fite were up 3.8 percent in midday Tel Aviv trade after the clinical trial's investigators presented their findings to investors.

The most effective treatments for psoriasis on the market are biological drugs focused on blocking the inflammatory factor in the body that causes the disease.

Though the drugs are effective, patients may suffer from adverse events that can cause inflammatory conditions as well as depression and sepsis, Fishman said. The cost of treatment per patient is about $20,000 a year and over time patients can stop responding to the drugs.

"There is a need for another type of drug that won't be so expensive and will not induce adverse events," Fishman said.

CF101 is administered as a tablet twice daily while the biological drugs must be administered intravenously.

"We will position it in the market so that the margin of profit will be high for the company but the cost will be much, much lower than for the biological drugs," Fishman said.

Can-Fite will need to conduct a Phase III study in addition to the Phase II/III study underway to obtain approval from the U.S. Food and Drug Administration. Fishman estimated it would take three to four years to register the drug.

About 2 percent of the world's population suffers from psoriasis and the market for treatment of the disease is valued at $3.6 billion a year worldwide. This is estimated to grow to $8.5 billion by 2017.

Can-Fite has licensed CF101 for the treatment of autoimmune diseases to Seikagaku Corp in Japan and for rheumatoid arthritis to Kwang Dong in South Korea. Can-Fite so far has received $8.5 million in upfront payments.

"There never will be a cure for psoriasis but we would like to turn it into a disease where the clinical manifestations will be minimal," Fishman said.

Source: reuters.com

Hi I,m new here, so hello everyone. I have psoriatic arthritis with psoriasis. 7 weeks ago my legs were burning so bad and I assumed I was just having a flare up, but that night when I got home and removed my compression stockings, my legs were swollen, sore and bright pink from the feet to my knees on both legs. I went straight to the ER where I received an IV with antibiotics. Diagnosis, Cellulitis with the psoriasis. It has been 7 weeks and I am still on the antibiotics. A nurse comes to my home and administers antibiotic IV drip each morning. Having psoriasis of the legs I don't know what is now the psoriasis and what is the cellulitis. I wondered if anyone on the forum has ever had cellutitis and if so could the please give me a little info on how long they were on the antibiotics and so on. My legs are still pink and burning, the feeling reminds me of when I have a flare up with my psoriasis, I'm feeling so depressed and don't see much difference in 7 weeks.

Sorry my post is so long, would appreciate if anyone has any info. All these years I thought that having psoriasis is bad, but this is the worst.

Liz.

Horizon Pharma, Inc announced today that the U.S. Food and Drug Administration (FDA) has approved RAYOS® known as LODOTRA® in Europe (prednisone) delayed-release tablets (1 mg, 2 mg and 5 mg) to treat a broad range of diseases including rheumatoid arthritis (RA), polymyalgia rheumatica (PMR), psoriatic arthritis (PsA), ankylosing spondylitis (AS), asthma and chronic obstructive pulmonary disease (COPD)

"We are extremely pleased the FDA has approved RAYOS for a broad range of indications, including RA and polymyalgia rheumatica,” said Timothy P. Walbert, chairman, president and chief executive officer, Horizon Pharma. “Our initial focus will be on the launch of RAYOS in rheumatologic diseases such as RA and polymyalgia rheumatica in the fourth quarter of this year. Based on the extent of the approved indications, we will be developing a broader commercial strategy to expand the opportunity for RAYOS in key IL-6 mediated diseases, including asthma and COPD."

"Prednisone is a common therapy for patients with various inflammatory diseases, including RA, and the delayed-release enhancement offered with RAYOS is an important treatment advance,” said Michael Schiff, M.D., Clinical Professor of Medicine at the University of Colorado School of Medicine, Rheumatology Division. “RAYOS is engineered to benefit the underlying patterns of inflammatory diseases. RAYOS, as studied in its clinical trials with ten p.m. dosing, reduces the overnight rise of inflammatory mediators, which results in less pain and stiffness for patients as they begin their day."

Important information about RAYOS
Do not use RAYOS if you are allergic to prednisone.

Long-term use of RAYOS can affect how your body responds to stress. Symptoms can include weight gain, severe fatigue, weak muscles, and high blood sugar.

RAYOS can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have or have recently had.

RAYOS can cause high blood pressure, salt and water retention and low blood potassium.

There is an increased risk of developing holes in the stomach or intestines if you have certain stomach and intestinal disorders.

Behavior and mood changes can occur, including intense excitement or happiness, sleeplessness, mood swings, personality changes or severe depression.

Long-term use of RAYOS can cause decreases in bone density.

RAYOS can cause cataracts, eye infections and glaucoma.

Do not receive a "live" vaccine while taking RAYOS. The vaccine may not work as well during this time, and may not fully protect you from disease.

Taking RAYOS during the first trimester of pregnancy can harm an unborn baby.

Long-term use of RAYOS can slow growth and development in children.

The most common side effects with RAYOS are water retention, high blood sugar, high blood pressure, unusual behaviour and mood changes, increased appetite and weight gain.

Source: horizonpharma.com/

A new study suggests that Methotrexate may not be helping *Synovitis in Psoriatic Arthritis.

Objective:
MTX (Methotrexate) is widely used to treat synovitis in PsA (Psoriatic Arthritis) without supporting trial evidence. The aim of our study was to test the value of MTX in the first large randomized placebo-controlled trial (RCT) in PsA.

Methods:
A 6-month double-blind RCT compared MTX (15 mg/week) with placebo in active PsA. The primary outcome was PsA response criteria (PsARC). Other outcomes included ACR20, DAS-28 and their individual components. Missing data were imputed using multiple imputation methods. Treatments were compared using logistic regression analysis (adjusted for age, sex, disease duration and, where appropriate, individual baseline scores).

Results: Four hundred and sixty-two patients were screened and 221 recruited. One hundred and nine patients received MTX and 112 received placebo. Forty-four patients were lost to follow-up (21 MTX, 23 placebo). Twenty-six patients discontinued treatment (14 MTX, 12 placebo). Comparing MTX with placebo in all randomized patients at 6 months showed no significant effect on PsARC [odds ratio (OR) 1.77, 95% CI 0.97, 3.23], ACR20 (OR 2.00, 95% CI 0.65, 6.22) or DAS-28 (OR 1.70, 95% CI 0.90, 3.17). There were also no significant treatment effects on tender and swollen joint counts, ESR, CRP, HAQ and pain. The only benefits of MTX were reductions in patient and assessor global scores and skin scores at 6 months (P = 0.03, P < 0.001 and P = 0.02, respectively). There were no unexpected adverse events.

Conclusions:
This trial of active PsA found no evidence for MTX improving synovitis and consequently raises questions about its classification as a disease-modifying drug in PsA.

Source: nih.gov

*Synovitis is the medical term for inflammation of the synovial membrane. This membrane lines joints which possess cavities, known as synovial joints. The condition is usually painful, particularly when the joint is moved. The joint usually swells due to synovial fluid collection.

Sunbeds are often used by people with psoriasis so I thought this study could be of interest.

Cutaneous *Melanoma attributable to sunbed use:

Objective:
To estimate the burden of melanoma resulting from sunbed use in western Europe.

Design:
Systematic review and meta-analysis.

Data sources:
pub med, ISI Web of Science (Science Citation Index Expanded), Embase, Pascal, Cochrane Library, LILACS, and MedCarib, along with published surveys reporting prevalence of sunbed use at national level in Europe.

Study selection:
Observational studies reporting a measure of risk for skin cancer (cutaneous melanoma, squamous cell carcinoma, basal cell carcinoma) associated with ever use of sunbeds.

Results:
Based on 27 studies ever use of sunbeds was associated with a summary relative risk of 1.20 (95% confidence interval 1.08 to 1.34). Publication bias was not evident. Restricting the analysis to cohorts and population based studies, the summary relative risk was 1.25 (1.09 to 1.43). Calculations for dose-response showed a 1.8% (95% confidence interval 0% to 3.8%) increase in risk of melanoma for each additional session of sunbed use per year. Based on 13 informative studies, first use of sunbeds before age 35 years was associated with a summary relative risk of 1.87 (1.41 to 2.48), with no indication of heterogeneity between studies. By using prevalence data from surveys and data from GLOBOCAN 2008, in 2008 in the 15 original member countries of the European Community plus three countries that were members of the European Free Trade Association, an estimated 3438 cases of melanoma could be attributable to sunbed use, most (n=2341) occurring among women.

Conclusions:
Sunbed use is associated with a significant increase in risk of melanoma. This risk increases with number of sunbed sessions and with initial usage at a young age (<35 years). The cancerous damage associated with sunbed use is substantial and could be avoided by strict regulations.

Source: bmj.com

*Melanoma is less common than other skin cancers. However, it is much more dangerous if it is not found early. It causes the majority (75%) of deaths related to skin cancer. According to a WHO report, about 48,000 melanoma related deaths occur worldwide per year. The treatment includes surgical removal of the tumor. If melanoma is found early, while it is still small and thin, and if it is completely removed, then the chance of cure is high.

*Subclinical Enthesitis Is More Common in Psoriatic Arthritis

Subclinical enthesitis occurs more commonly in patients with psoriatic arthritis than in those with psoriasis, possibly as a result of age and obesity rather than disease severity, to judge from the findings of a cross-sectional study conducted by investigators at Toronto Western Hospital.

The investigators used ultrasound as well as clinical examination to assess the extent, if any, of enthesitis in study participants, who were 59 patients with psoriatic arthritis and 79 patients with psoriasis. Study participants were recruited from longitudinal cohorts. The control group was made up of 60 healthy volunteers who did not have any personal or family history of spondyloarthropathy. They were evaluated for enthesitis at sites in the calcaneus, knee, and olecranon.

Findings on ultrasound – any enthesophytes, bony erosions, tendon thickness, and bursitis, within tendons – were scored using GUESS (Glasgow Ultrasound Enthesitis Scoring System), which reflects the overall burden bilaterally of enthesitis from abnormalities in five lower limb sites, and the MASEI (Madrid Sonography Enthesitis Index), which additionally includes calcifications and Doppler signals as elemental lesions as well as abnormalities of the olecranon tuberosity enthesis.

The average ages were 52, 53, and 42 years in the psoriasis, psoriatic arthritis, and healthy volunteer groups, respectively, and men accounted for 64%, 57%, and 32% of participants. Corresponding mean body mass indices were 27, 30, and 26 kg/m2, respectively.

In all, 12 anatomical sites were assessed. The mean number showing ultrasonographic enthesitis differed significantly across groups, reported study coauthor Jai P. Jayakar at the annual meeting of the Canadian Rheumatology Association. The number of anatomical sites that showed enthesitis was highest in the psoriatic arthritis group (7.1), intermediate in the psoriasis group (5), and lowest in healthy volunteers (4).

There was also a significant, graded difference across groups in GUESS scores (8.9, 5.6, and 4.4 out of a possible 36, respectively, for psoriatic arthritis, psoriasis, and healthy controls) and in MASEI scores (18.5, 9.9, and 7.7 respectively for psoriatic arthritis, psoriasis, and healthy controls out of a possible 136). However, in multivariate analyses, disease status was not associated with these scores; only increasing age and BMI showed significant associations.

"Our study is one of the first comparative assessments of subclinical enthesitis in psoriasis vs. psoriatic arthritis," noted Mr. Jayakar. "Our results reveal that the prevalence of ultrasonographic entheseal abnormalities and indices of entheseal burden ... are greater in psoriatic arthritis than in psoriasis; however, this relationship may be modulated in a multifactorial manner by factors other than disease status, such as age and body mass index.

"Now, it is possible that enthesitis could be of predictive value in specific patient subgroups – for example, age- or obesity-stratified subgroups," he added. "However, larger studies are needed to confirm the utility of subclinical enthesitis as a predictive factor for the development of psoriatic arthritis in patients with psoriasis."

How could the investigators be certain, a session attendee asked, that they were detecting disease-related enthesitis and not simply mechanical tendonitis?

That is a valid concern, given the lack of consensus among rheumatologists as to which ultrasonographic abnormalities result from degeneration, inflammation, mechanical stress, or other etiologies, acknowledged Mr. Jayakar, a medical student at the University of Western Ontario, London. Large cohorts with well-defined disease status would be required to investigate this further, he said.

"One direction in which we could move forward is if we can find specific elemental lesions – or aggregates of elemental lesions – that are of predictive value, then perhaps those could be used pragmatically to help us in our clinical management," he noted. "But as of now, the pathophysiological underpinnings of these abnormalities are not very well described."

Source: skinandallergynews.com

*Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone. Symptoms include multiple points of tenderness at the heel, tibial tuberosity, iliac crest, and other tendon insertion sites.

Following on from my old thread about Stelara which you can find here Stelara 16 Months On. I thought I would start a new one in case it helps someone and also so I can monitor my results.

I have used Stelara before for 2 years see the old thread, and was about to go on to a new trial. however I was not suitable in the end to start the trial, so it's back on to Stelara for the moment as my skin is going crazy. the psoriatic arthritis is not to bad, but I desperately want that feeling of clear skin again.

So here goes, I have just taken my first shot and will be having another in 8 weeks followed by another visit with my dermatologist. My psoriasis score is 33 today, and here is a photo of my left leg showing between my ankle and knee. I had got the scaling down using Cold Cream, and I will carry on using that for the moment.



I will give updates on this thread as I go on through the treatment, and if you have any questions or comments please post here so I can keep it all together or PM me.

Anyone else had a swollen ankle with psoriasis? I have never had this before, I do have a very bad flare up from my ankles to my knees at the moment and the left one is worse than the right.

The left one is slightly swollen, it's not painful and I'm thinking it's fluid retention due to the inflammation of the psoriasis.

Any thoughts?

Hi im new to this and a little shy i have had P for many years and at my wits end im thinking of going on methotrexate (my dermo recommends ) any advice?

The Effects of Chronic Periodontitis and Its Treatment on the Subsequent Risk of Psoriasis

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

Objective: 
This study aimed to investigate the subsequent risk for psoriasis following a diagnosis with 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 five-year period to identify those who had subsequently received a diagnosis of psoriasis. A Cox proportional hazards regression was performed to compute the five-year risk of subsequent psoriasis following a diagnosis of CP.

Results: 
We found that the incidence rate of psoriasis during the five-year follow-up period was 1.88 (95% CI=1.77-1.99) per 1,000 person-years in patients with CP and 1.22 (95% CI=1.14-1.32) per 1,000 person-years in comparison patients. After censoring those who died during the follow-up period, and adjusting for monthly income and geographic region, compared with comparison patients, the 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 only had a slightly higher adjusted risk of psoriasis than comparison patients (HR=1.26).

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

Source: onlinelibrary.wiley.com

*Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues.
Symptoms may include: Redness or bleeding of gums while brushing teeth, Gum swelling that recurs, Halitosis, Gingival recession, Deep pockets between the teeth and the gums, Loose teeth.