Sleep Apnea is a sleep disorder characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Each pause in breathing, called an apnea, can last from a few seconds to minutes, and may occur 5 to 30 times or more an hour.

Objective: In a cross-sectional study, we explored whether obstructive sleep apnea and hypopnea syndrome (OSAHS) is associated with psoriasis characteristics and metabolic parameters.

Methods: Thirty-five patients with chronic plaque psoriasis underwent a nocturnal polysomnography study and were analysed for Apnoea–Hypopnoea Index to assess OSAHS severity and Framigham score to predict the absolute risk of coronary artery disease at 10 years. The association of OSAHS with psoriasis was examined according to psoriasis characteristics (PASI and DLQI scores, disease duration and previous use of systemic treatments), metabolic parameters (Body Mass Index – BMI, waist to hip ratio – WHR, lipid profile) and other comorbidities (obesity, hypertension, arthritis and cardiovascular disease).

Results: There was no correlation between psoriasis characteristics and OSAHS. Psoriasis patients with OSAHS presented more frequent snoring and lower sleep quality compared with those without OSAHS. In univariate analyses, OSAHS was associated with increased BMI and hypertension in psoriasis patients. In multivariable logistic regression models, there was statistically significant evidence that only BMI and hypertension were associated with increased risk of OSAHS, adjusting for psoriasis characteristics, age and gender. Presence of metabolic syndrome, WHR, and smoking were not significant risk factors for OSAHS. In subgroup analyses, OSAHS correlated with duration of psoriasis (>8 years) in women (P = 0.021) and with Framigham score in men (P = 0.035).

Conclusion: OSAHS may be a comorbidity in obese psoriasis patients with hypertension. Treatment with continuous positive airway pressure and weight loss interventions should be initiated.

Source: onlinelibrary.wiley.com

Abbott scientists and independent researchers will highlight the latest investigational research findings on HUMIRA® (adalimumab) at the European League Against Rheumatism (EULAR) Congress in Berlin, Germany, from 6-9 June, 2012. The presentations include two of the longest open-label extension studies in rheumatoid arthritis (RA), featuring long-term data for disease activity and radiographic inhibition. Data will also be presented on investigational indications in axial and peripheral spondyloarthritis (SpA), moderate to severe polyarticular juvenile idiopathic arthritis (JIA), ankylosing spondylitis (AS) and health economics research.

"Data presented at this year's EULAR highlight Abbott's commitment to continue to expand our understanding of the efficacy and safety of HUMIRA and address the needs of patients and physicians across a broad spectrum of rheumatologic diseases," said John Medich, Ph.D., divisional vice president, Clinical Development, Immunology, Abbott. "Specifically, data highlighting the use of HUMIRA for long-term treatment of RA and new data in investigational indications like axial and peripheral SpA will be presented, reinforcing Abbott's ongoing investment in research in the rheumatology space."

Presentation Highlights:
Data being presented at EULAR include the comprehensive 10-year data for treatment of moderate to severe, long-standing RA in the DE019 trial and in the DE020 follow-up study. DE020 will be presented in a publication, while DE019 will be presented as a poster on 9 June.

Data will also be presented for ABILITY-I, the first, multi-national Phase 3 study evaluating the use of an anti-tumor necrosis factor (anti-TNF) medication in patients with active non-radiographic axial SpA – a debilitating condition closely related to AS that primarily presents with chronic back pain and stiffness, and can be accompanied by the presence of arthritis, and inflammation in the eye and/or gastrointestinal tract. There is currently no approved treatment for non-radiographic axial SpA. Results from 68 weeks of treatment with HUMIRA will be shown, highlighting not only the initial clinical responses in the 12-week, placebo-controlled trial, but also the responses over an additional year of treatment. These data will be presented as a poster on 7 June.

The initial results will be presented from ABILITY-2, the first Phase 3 study investigating the use of an anti-TNF medication in patients with active peripheral SpA that don't have a diagnosis of psoriatic arthritis (PsA)*. This patient population is characterized by peripheral arthritis (asymmetric, lower limb or both), enthesitis (painful inflammation where a tendon or ligament attaches to bone) or dactylitis (a painful and swollen digit), in addition to the presence of other features (family history of SpA, history of inflammation in the eye, diagnosis of other immune-mediated inflammatory diseases, sacroiliitis on MRI). There is currently no approved treatment for non-PsA peripheral SpA. Data following 12-weeks of treatment with HUMIRA will be shown as a poster on 7 June.

Additionally, clinical and patient-reported outcomes will be presented from OPTIMA, the first global prospective trial using a treat-to-target philosophy in the treatment of moderate to severe RA. Treat-to-target is focused on achieving a clearly defined treatment goal within a set duration of time and adjusting the treatment if the target is not met. This approach is aligned to EULAR and American College of Rheumatology (ACR) rheumatoid arthritis treatment recommendations.

*Results from an Analysis Evaluating the Long-term Safety of Adalimumab in Patients with Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, Ankylosing Spondylitis, Psoriatic Arthritis, Psoriasis and Crohn's Disease; G. Burmester, et al
–    Abstract SAT0130; Poster; 9 June, 2012; 10:15 a.m.; Location: Poster Area.

Source: prnewswire.com

This is the start of a series of posts on Dimethylfumarates.
For long it is yet known that fumarates have a very positive effect on psoriasis and arthritic psoriasis. Still fumarates did not have their breakthrough in medicare. The causes for this will be part of this series.

In the Netherlands the use of fumarates is much more normal than in other countries, there is even a patients organization that promotes the use of a specific form and is busy starting up scientific research to prove that this form is much less toxic with a much better effect than most other medicines.

I do not write this "by my own", the texts are mainly a translation of publications of dr. L.Kunst and dr. Schweckendieck, and I will make references to existing literature on the subject.

Why do I do this?
Well, while speeding around on the different threads of this forum, I found out that there are lots of psoriasis sufferers. None of them are using fumarates, I seem to be the only one. And if I read well, I am also one of the posters that has minor problems with psoriasis, I even have arthritic psoriasis which is very "livable" and relatively under control, with very few extra problems from the medication.
I think it makes sense to share what I know. Maybe some of you will make a try with what I use, and maybe this will help them. The forum on the dutch site shows a lot of people that are very pleased with this medicine.

Below part one of a translation from the site psoriasistherapie dot nl on fumarates. As it is a translation, there may be stupid constructions in the sentences. My mastery of english is quite acceptable, but translating is quite a different job.

First some background information to build up the story.

Energy housekeeping and fumaric acid.

Fumaric aced is a body own substance. Chemically seen it is an unsaturated dicarbon acid. It is formed from cis-butanecarbonic acid (cis-barnstoneacid) under influence of succinatehydrogenasis. This biochemical conversion is a component of the so-called citric acid cycle, and takes place in the mitochondria. Mitochondria are not only the power of our cells, they play an important role in essential metabolic processes and the genetic transfer of a large number of degenerative diseases through specific mitochondrial DNA. A variety of genetic disorders can be attributed to mutations in the mitochondrial DNA, such as defects in the citric acid cycle. The citric acid cycle is a cycle in which oxidation of carbon compounds are oxidized to carbon dioxide. The carbon-containing compounds are derived from fats, sugars and amino acids. The vast majority of fuel is supplied in the form of acetyl-CoA. The citric acid cycle contains except fumaric acid, several intermediate metabolites, such as shown in the accompanying illustration.


The upper portion of pyruvic acid to acetyl-coenzyme A does not actually belong to the citric acid cycle, but it's there to follow up the glycolysis. The reactions involving NAD + conversion to NADH and GDP to GTP and FAD to FADH2 mean that energy is released and that this energy has gone into these compounds formed. This energy is required with all of the biochemical processes in the body.

More to follow in a next post.

Psoriasis patients who possess the HLA-Cw6 allele appear to be protected against the increased risk of cardiovascular and metabolic comorbidities associated with the disease.

In a study that included 199 psoriasis patients under the age of 40, those who carried the histocompatibility antigen HLA-Cw6 allele had a 66% reduction in the prevalence of comorbid hypertension and a 72% reduction in dyslipidemia, compared with HLA-Cw6-negative psoriasis patients, according to Dr. Trilokraj Tejasvi of the University of Michigan, Ann Arbor.

This is a particularly intriguing finding, he noted, because previous studies have demonstrated that HLA-Cw6-positive psoriasis patients tend to have more severe skin disease, an earlier age at disease onset, higher rates of the guttate and eruptive forms of psoriasis as well as Koebner phenomenon, and more extensive disease.

Moreover, other studies have shown that patients with more severe psoriasis tend to have higher rates of comorbid cardiovascular and metabolic disorders. For example, a large recent study that included 4,065 psoriasis patients aged 45-65 years and nearly 41,000 age- and physician practice-matched controls showed that the risk of comorbid metabolic syndrome increased from 1.2-fold in patients with mild psoriasis to twofold in those with severe psoriasis, compared with controls.

A strikingly similar twofold increased risk of the metabolic syndrome in psoriasis patients was recently reported based upon data from the National Health and Nutrition Examination Survey for 2003-2006

Since neither the NHANES psoriasis patients nor those in the U.K. study underwent genotyping, there is no way of knowing what proportion of those who were HLA-Cw6-positive had the metabolic syndrome, Dr. Tejasvi noted.

In a recent, still-to-be-published genome-wide association study, he and his colleagues found that all known psoriasis-associated single nucleotide polymorphisms explained roughly 22% of the disease’s heritability – and nearly half of were because of genes located at HLA-C.

The study included 1,134 psoriasis patients and 1,174 unaffected controls who underwent genomic DNA analysis. He and his coinvestigators examined the rates of hypertension, dyslipidemia, acute MI, and diabetes mellitus in the two groups.

One analysis was restricted to the 199 psoriasis patients and 392 controls under age 40, since the comorbid conditions under scrutiny tend to less frequently in younger people. In this under-40 analysis, the prevalence of diabetes wasn’t significantly different between psoriasis patients and controls. Neither was a history of MI.

However, 15% of the younger psoriasis patients carried the diagnosis of hypertension, compared with 6.8% of controls, and 29% of the psoriasis patients were dyslipidemic, compared with 10.5% of controls. Thus, psoriasis patients under age 40 were 2.2-fold more likely than controls to be hypertensive and 2.75-fold more likely to be dyslipidemic. Both differences were highly significant.

The prevalence of hypertension among 80 HLA-Cw6-positive psoriasis patients under age 40 was 7.5%, compared with 22% in HLA-Cw6-negative psoriasis patients under age 40. And the prevalence of dyslipidemia in the HLA-Cw6-positive group was 12.5% vs. 44% in the HLA-Cw6-negative psoriasis patients.

The under-40 psoriatic HLA-Cw6 carriers and noncarriers were essentially the same in terms of body mass index – a mean of 28 kg/m2 in both groups – and in mean age at evaluation, which was 28 years in the HLa-Cw6-positive patients and 29 years in the HLA-Cw6-negative cohort, Dr. Tejasvi reported.

Several key findings stood out in the analysis of the overall study population comprised of 1,134 psoriasis patients and 1,174 controls. One was that among control patients without psoriasis, HLA-Cw6 status was unrelated to comorbid hypertension, dyslipidemia, diabetes, or a positive history for MI. And in the full group of psoriasis patients, hypertension and dyslipidemia remained significantly less common among those who were HLA-Cw6-negative, although the association was less robust than in the below-40 subgroup. Specifically, HLA-Cw6 carriers with psoriasis were 24% less likely to be hypertensive and 25% less likely to have dyslipidemia than psoriatic HLAL-Cw6 noncarriers.

Dr. Tejasvi commented that an HLA-Cw6 protective effect against hypertension and dyslipidemia isn’t the only possible explanation for the lower rates of these two components of the metabolic syndrome found in HLA-Cw6-positive psoriasis patients. The alternate possibility is that HLA-Cw6 noncarrier status in psoriasis patients is associated with other genetic loci that increase the risk of dyslipidemia and hypertension. Sorting this out will require a prospective study with a large sample size.

Source: skinandallergynews.com

Objective: To examine the association between total physical activity, walking, and vigorous exercise and the incidence of psoriasis in women.

Design: Cohort study.

Setting: The Nurses' Health Study II, a cohort of 116 430 women aged 27 to 44 years in 1991.

Participants: The study population included 86 655 US female nurses who reported whether they had ever been diagnosed as having psoriasis and who completed detailed physical activity questionnaires in 1991, 1997, and 2001. We excluded participants with a history of psoriasis prior to 1991.

Main Outcome Measures: Risk of psoriasis by quintile of physical activity as measured by a metabolic equivalent task score.

Results: We documented 1026 incident psoriasis cases during 1 195 703 person-years of follow-up (14 years, 1991-2005). After adjusting for age, smoking, and alcohol use, increasing physical activity was inversely associated with the risk of psoriasis. The most physically active quintile of women had a lower multivariate relative risk (RR) of psoriasis (0.72 [95% CI, 0.59-0.89; P < .001 for trend]) compared with the least active quintile. Vigorous physical activity (≥6 metabolic equivalents) was associated with a reduced risk of psoriasis (multivariate RR for the highest quintile, 0.66 [95% CI, 0.54-0.81; P < .001 for trend]); this association remained significant after adjusting for body mass index (RR, 0.73 [95% CI, 0.60-0.90; P = .009 for trend]). Walking was not associated with psoriasis risk. In a subset of 550 confirmed psoriasis cases, we observed a similarly reduced risk of psoriasis associated with vigorous physical activity (multivariate RR for the highest quintile, 0.64 [95% CI, 0.48-0.86; P = .03 for trend]).

Conclusion: In this study of US women, vigorous physical activity is independently associated with a reduced risk of incident psoriasis.

Psoriasis is an immunologic disorder characterized by systemic inflammation and cutaneous plaques.1 Prospective studies have demonstrated that higher body mass index (BMI),2 weight gain, alcohol intake,3 and smoking4 are associated with an increased risk of psoriasis. However, the role of physical activity in psoriasis prevention remains undetermined. Results from cross-sectional studies have been inconsistent; an association between psoriasis and physical inactivity was observed in some studies5 - 6 but not in others.7 The Iowa Women's Health Study found that women who engaged in regular physical activity were less likely to have psoriasis than women who denied exercising regularly (age-adjusted odds ratio, 0.8 [95% CI, 0.7-0.9]).5 Another study found no difference in mean physical activity between women with and without psoriasis.7 These cross-sectional analyses did not adjust for other lifestyle factors, such as BMI, that may vary across groups of differing physical activity levels and do not permit a determination of cause and effect. No prospective studies have evaluated the association between physical activity and incident psoriasis.

Physical activity has been associated with a decreased risk of disorders characterized by systemic inflammation, including type 2 diabetes mellitus,8 colon cancer,9 coronary artery disease,10 and breast cancer.11 Walking and vigorous exercise appear to have an equal role in reducing the risk of developing coronary artery disease, type 2 diabetes, and breast cancer. A dose-response relationship has also been demonstrated, with higher amounts of physical activity associated with a lower risk of disease. The relative effects of walking and vigorous activity on psoriasis risk and the dose-response relationship between physical activity and psoriasis remain unknown. It is biologically plausible that physical activity may affect psoriasis risk through effects on systemic inflammatory mediators.

In this study, we prospectively evaluated the association between physical activity and incident psoriasis in a large cohort of women in the United States. We also assessed the association between type of physical activity (eg, walking vs vigorous exercise) and the risk of psoriasis, using detailed, repeated assessments of physical activity, and validated our findings in a subset of confirmed psoriasis cases.

Source: NO LINKS ALLOWED

BACKGROUND: With a prevalence of 0.71%, psoriasis represents one of the most frequent dermatoses in childhood.

PATIENTS AND METHODS:
Eight children with severe psoriasis who failed to respond to other therapy received a weight- adapted treatment with Enbrel (etanercept) (0.8 mg/kg body) administered subcutaneously once weekly after latent tuberculosis had been excluded. Follow-up visits were at week 4 and 12, subsequently every 12 weeks.

RESULTS: Mean age at the start of treatment was 11.8 (range 7-16), six patients were boys. Within three months, six patients reached Psoriasis Area and Severity Index (PASI) reduction of 75%. Two patients stopped use at week 12 because of ineffectiveness. Apart from local side reactions and minor infections, no adverse events were observed.

CONCLUSION: In our case series, Enbrel (etanercept) proved to be an efficient drug in juvenile psoriasis without serious adverse events. However, patient registries and further randomized, double-blinded control studies are crucial to evaluate long-term efficacy and safety of etanercept.

Source: NO LINKS ALLOWED

Objectives:  To examine the association between psoriasis and viral infections including hepatitis B, hepatitis C and human immunodeficiency viral infections in the general U.S. population.

Methods:  Population data representative of the U.S. cohort were analysed from the National Health and Nutrition Examination Survey (NHANES), 2003–2006. Hepatitis B, hepatitis C, and human immunodeficiency antibodies status were ascertained from laboratory evaluations. Univariate and multivariate analyses were performed to assess the associations between psoriasis and these viral infections.

Results:  Among 6532 participants aged 20–59 years who provided responses to their psoriasis status, 162 patients reported having psoriasis. Based on multivariate regression analyses, psoriasis was not significantly associated with positive serology for hepatitis B core [odds ratio (OR), 0.83; 95% confidence interval (CI), 0.32–2.17; P = 0.7060], hepatitis B surface [OR, 7.89; CI, 0.52–119; P = 0.1355], hepatitis C [OR, 0.24; CI, 0.03–2.01; P = 0.1915], or human immunodeficiency virus [OR, 0.73; CI, 0.09–5.93; P = 0.7646] antibodies, after adjusting for age, gender, race and smoking status.

Conclusions:  From the limited sample of the NHANES database on psoriasis and viral infections, psoriasis does not appear to be associated with an increased risk of hepatitis B, hepatitis C, or HIV infection in the U.S. population. Epidemiology of these viral infections in psoriasis needs to be continually studied and updated given their importance in management considerations.

Source: onlinelibrary.wiley.com

*Celiac (Coeliac) Disease is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy onward. Symptoms include chronic diarrhoea, failure to thrive (in children), and fatigue.

Because a number of past studies examining the connection between celiac disease and psoriasis have had contradictory findings, researchers wanted to get a better idea of the actual risk of psoriasis in patients with biopsy-verified celiac disease.

The researchers were J.F. Ludvigsson, B. Lindelöf, F. Zingone, and C. Ciacci, with the Department of Pediatrics at Sweden's Örebro University Hospital.

For their study, they used data from 28 pathology departments in Sweden to identified individuals with celiac disease diagnosed between 1969 and 2008. They found 28,958 patients with Marsh 3 villous atrophy.

They then used Cox regression to compare those celiac disease patients with 143,910 sex- and age-matched control subjects, and to assess the risk of psoriasis.

They found that celiac disease was a risk factor for future psoriasis (hazard ratio (HR) = 1.72; 95% confidence interval (CI) = 1.54-1.92. They found that, during follow-up, 401 individuals with celiac disease and 1,139 controls were diagnosed with psoriasis.

They found that the absolute risk of future psoriasis in patients with celiac disease was 135 per 100,000 person-years, with an excess risk of 57 cases per 100,000 person years.

Overall, 42% of the cases of psoriasis in patients with celiac disease could be attributed to celiac disease. Moreover, in children the team saw a strong association between celiac disease and psoriasis (HR = 2.05; 95% CI = 1.62-2.60).

Their results show that the connection between celiac disease and psoriasis seems to be far more than coincidental, as we also found a positive association between celiac disease and psoriasis before celiac diagnosis, with an odds ratio of 1.91; 95% CI = 1.58-2.31).

They conclude that individuals with celiac disease do, in fact, face an increased risk of psoriasis both before and after celiac diagnosis.

Source: celiac.com

Hey, I'm new to this website and forum but I'm not new to Psoriasis. I've been dealing with it for 24 years now. Sometimes I felt like doing that. Recently, I've had a major flare. I'm now covered more than I've ever been covered with spots and it's so painful. I'm changing my diet to see if it helps and I'm glad to see there is a forum because sometimes I feel very alone.

*Behçet's disease, sometimes called Behçet's syndrome, Morbus Behçet, or Silk Road disease, is a rare immune-mediated systemic vasculitis that often presents with mucous membrane ulceration and ocular involvements. Behçet's disease (BD) was named in 1937 after the Turkish dermatologist Hulusi Behçet, who first described the triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis. As a systemic disease, it can also involve visceral organs such as the gastrointestinal tract.

Background: 
Behçet’s disease (BD) and psoriasis are chronic inflammatory diseases characterized by multisystemic vasculitis and epidermal hyperplasia respectively. Although it has been found that the pathogenesis of BD and psoriasis share common perspectives, reports of patients who have both diseases in concurrence are rare.

Objectives: 
To analyse and evaluate the clinical manifestations of BD patients who have psoriasis together.

Methods: 
Retrospective evaluation of the medical records of nine BD patients who were also diagnosed with psoriasis at the BD Specialty Clinic of Severance Hospital was carried out. We analysed the characteristics of patients and the clinical activity of both diseases, and also the effect of the treatment of one disease against the other.

Results: 
Of the nine BD patients who also had psoriasis, male to female ratio was 1 : 2. Two (22.2%) patients had a complete type of BD and seven (77.8%) patients had an incomplete type of BD. For the psoriatic lesions, all nine (100%) patients were diagnosed as psoriasis vulgaris. Five (55.6%) patients had BD as the preceding disease and four (44.4%) patients had psoriasis as the preceding. All five patients who formerly developed BD followed by psoriasis had an active state of BD, but the activity of psoriasis of all nine patients was minimal to average.

Conclusion: 
In this study, we evaluated the clinical manifestations of nine patients who had BD and psoriasis together. Although the exact pathogenesis remains unclear, there might be some influence by each disease to the other between BD and psoriasis.

Source: onlinelibrary.wiley.com

*Chlamydophila psittaci is a lethal intracellular bacterial species that may cause endemic avian chlamydiosis, epizootic outbreaks in mammals, and respiratory psittacosis in humans. Chlamydophila psittaci is transmitted by inhalation, contact or ingestion among birds and to mammals. Psittacosis in birds and in humans often starts with flu-like symptoms and becomes a life-threatening pneumonia.

Objective: 
Recent evidence indicates that subclinical infection by Chlamydophila psittaci occurs in a significant percentage of patients with chronic inflammatory polyarthritis, including psoriatic arthritis.

Methods: 
The presence of a subclinical C. psittaci infection was investigated in 64 patients with psoriasis, including 12 patients with psoriatic arthritis. Two hundred twenty-five healthy controls were also investigated. The presence of infection was assessed in peripheral blood mononuclear cells using several PCR protocols, targeting different regions of the bacterial genome. The DNA of other Chlamydia spp (C. pneumoniae and C. trachomatis) was also investigated.

Results: 
C. psittaci infection was observed in a significantly higher percentage of patients with psoriasis (11/64; 17.2%) compared to healthy controls (1/225, 0.4% in healthy donors; OR:46.49, 95%CI:5.87 to 368.03, p<0.0001).

No differences in age, sex, disease duration were noticed between positive and negative patients, but the majority of the positive patients were on immunomodulatory treatments.

Conclusion:
C. psittaci may be an infectious trigger possibly involved in the pathogenesis of psoriasis.

Source: onlinelibrary.wiley.com

A new purpose-built dermatology unit has opened at the Royal United Hospital to enable more patients with skin conditions to be treated.

The new unit houses clinics run both by consultants and nurses, as well as a day treatment service.

Staff treat 30 to 40 patients a day for conditions including psoriasis, skin cancer and leg ulcers.

The new facilities have replaced the Kinghorn Dermatology Unit, which was set up in an existing part of the hospital with a bequest from Sheila Kinghorn, in 1994.

Jess Ball, from Whiteway, has been treated at the hospital for six years for rheumatoid arthritis and an auto immune skin condition.

She said: "When I first came to the unit, my leg was badly ulcerated and if the staff had not intervened when they did, I would have lost my leg.

"The knowledge that they have is incredible and I feel very supported.

"There have been times when I don't know how I would have managed without their skill and care, and their wonderful sense of humour.

"The staff deserve this lovely new unit. It feels very light and spacious and welcoming, and patients and staff are sure to benefit from it."

Senior sister Jacky Strange said: "This is the first time dermatology has been in a purpose-built unit in the RUH. We had outgrown the Kinghorn unit.

"We'll continue to provide a high standard of care to our patients, but now we can do that in a light and spacious environment, that offers greater confidentiality.

"And having the extra space will allow us to expand and treat a greater number of patients."

Good evening everyone. I have always felt completely on my own since I was diagnosed with psoriasis five years ago when I was 18. Today I felt like the future was entirely hopeless and to continue on was a difficult idea to comprehend. A google search brought me to this forum and after reading posts of people with such widespread and painful psoriosis that putting on clothes is difficult, I began to feel like my story did not even compare and wondered if I even belonged. But somehow, in reading the posts I felt some kind of hope. If nothing else I felt empowered just knowing that someone else may go through their day with some of the same thoughts and experiences that I have. My outbreaks are mainly concentrated on my scalp and genital regions. While by using protopic ointment and clobex spray I am somewhat able to control the day to day discomfort of the outbreaks, I find myself unable to stop the continual feeling of helplessness. At it's worst, there are times when I feel worthless and left out from being a human. But being able to say this does give me comfort. And I must apologize for my complaining, because I know that there are many people who can't even walk out their door without their psoriosis causing great pain or being witnessed by everyone they come in contact with.

Hi Guys,

I know I've been rather quiet on the forum recently but I've been struggling to cope with my PsA and have been dealing with potential redundancy from work too.. kind of a sucky situation and the stress has not helped the PsA. Also been trying to medicate my pain with the tramadol I've been prescribed in such a way as so as not to end up like a complete zombie.

Anyways, I just wanted to let you all know that I have started a new blog where I will be talking about my experience of living with psoriasis for over 30 years and during many stages of my life. I am hoping that it may give others a sense that they are not alone in how they feel, especially those just diagnosed and that I'll be able to write about the immunology/physiology of psoriasis and PsA in laymans terms.... I know a lot of people struggle to understand and read all the research out there.

I hope that some of you will have a read, there are only a couple of posts there at the moment but any feedback/comments will be appreciated.

Have rheumatology appointment date through at long last, despite my GP writing to speed up the process as I have now been signed off work for 2 months I still have to wait until the 29th May before I can be seen y the same "specialist" who told me there was nothing wrong with me 3 years ago.

Take care

Krissie

As I am 20 weeks pregnant now I was wondering how being pregnant will affect my psoriasis!

I have an older half sister who has psoriasis, and the only time she has been fully clear of psoriasis was whilst she was pregnant.

In my early stages of pregnancy I was still have UVB therapy (I was told it is one of the very few treatments I could have if wanting to try for a baby, and safe to have while pregnant)

My psoriasis is coming back, worse on my lower arms than before and a lot of my usual areas are also returning including the areas on my face, I must admit I am really struggling with this as I'm meant to have "glow".....it really doesn't feel like it.

I had always hoped that my psoriasis would act the same as my older sisters, even my derm nurse said she often finds people who suffer with server cases often clear.
I have heard one theory on this being that your immune systems naturally lowers. 

I'm trying to keep positive and remind myself I still have 20 weeks to go and the summer to look forward to.

Please feel free to add to this thread with your own experiences or things you may know or have read.

I will keep updates on how things progress with my own psoriasis!

Hanna  

Hi There,brigantia here,have been having a bit of bother trying to get back on the PSORIASIS FORUM.But i am back and feeling a lot better.I have started Light Treatment at a local hospital,it is my second week and i must admit i think i can notice it getting slightly better not so itchy either.In going to the hospital i have also started to tell myself stop being a flipping WIMP.When i see the state of some of them i feel rather ashamed that i feel so sorry for myself.So i have decided to hope there is light at the end of the tunnel

Hi all. Have psoriasis 30 yrs , currently on stelara, so far so good, but cant seem to get hold of any Dovenex gel. Had great results from it previously ( using alongside stelara ). Anuone know if this has been taken out of production ?? Ta.

So I haven't been on this forum for a few months, but about 2 months ago my psoriasis was really getting bad (still is a pain of course) and I decided to buy a one month tanning package to see if it could do anything for me. about 2 weeks in of going every other day, I started to notice my psoriasis was much milder and didn't start flaking quite as fast. I dunno, maybe it was all in my mind, but the owner noticed the psoriasis on my forehead and asked if that was why I was tanning and I said yes. The lady looked like, right at me and said, "I legally cannot tell you that tanning helps or cures anything, but I can tell you, that we have many people with psoriasis who come here regularly and in the time I have owned this salon I have seen the worse psoriasis you can imagine, some people that have it so bad they need help in and out of the beds, and the beds require extra cleaning after. It's not a pretty thing to talk about, but since you know what it's like, I feel okay telling you about this. I have seen much improvement in people who are diligent."

I live in a very cold cloudy environment, and would prefer natural sunlight, but it just isn't possible here. In that month I did notice a difference in my skin, and improvement, but unfortunately being unemployed and full time student that can hardly afford gas to get to school, I can't afford a tanning package any more. But when it is sunny here, rare as it is, I bask... boy do I bask.

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I found this very interesting as I remember as a child having problems with my belly button and the doctor telling my mother to use Talcum Powder. Could that have been the first sign of psoriasis!
It would be interesting to know if anyone else remembers having a problem with their belly button when a child.

Quote:A diagnosis of pediatric psoriasis is a major event for a child and their family – especially given the long-term medical and psychosocial implications – so proceed cautiously, said Dr. Ronald C. Hansen.

"I am never in a big hurry to make the diagnosis of psoriasis if I am not sure. When you make the diagnosis, you are pretty much saying: ‘You are going to have some degree of psoriasis the rest of your life," Dr. Hansen said at the South Beach Symposium.

And, "I never ever underestimate the impact of psoriasis on the child’s life," he said. "I’ve had 5-year-olds already psychologically stricken."

Affected children – particularly those with more severe disease – will be self-conscious and avoid undressing before gym class or joining others to swim at a pool, said Dr. Hansen, chief of pediatric dermatology at Phoenix Children’s Hospital. "These kids end up loathing their bodies." Psoriasis often has long-term impacts on relationships and intimacy as well.

"The psychosocial impacts ... are immense," agreed session moderator Dr. Lawrence A. Schachner. Because of this, consider whether your patient needs psychosocial counseling when you diagnose psoriasis, added Dr. Schachner, who is director of pediatric dermatology at the University of Miami.

Pediatric psoriasis impacts the whole family. Counsel parents that psoriasis will require a long-term commitment to provide care for their child.

The onset of childhood psoriasis can occur at any age, even at birth. "It is genetically loaded," Dr. Hansen said.

For example, a child born to unaffected parents has about a 4% chance of developing psoriasis, he said. In contrast, a child born to one parent with psoriasis has a 28% likelihood of also developing psoriasis, and if both parents are affected, it jumps to 65%. The chances are even greater if the child has a sibling with psoriasis.

A clinical tip is to ask parents about a history of diaper dermatitis. In his experience, when Dr. Hansen suspects childhood psoriasis, he asks families about whether the child has had difficult diaper rashes. "The parents roll their eyes and say, ‘Yes, diaper rashes from hell.’ This is one of the things I hear routinely when I make the diagnosis in a 4-year-old."

Umbilical and scalp involvement often suggest psoriasis. Severe seborrheic dermatitis, for example, is another diagnostic clue. "We all know about the flaky, persistent scalp dermatitis, sometimes misdiagnosed as seborrheic dermatitis, but again it’s the seborrheic dermatitis from hell. It doesn’t respond to usual treatments," he said.

Even with a rash that looks like psoriasis, most children will have something else: seborrheic dermatitis, atopic dermatitis, or a candidal infection. "If it’s the first time I see this rash, I don’t make the diagnosis of psoriasis. ... Maybe about 20% of them will end up with psoriasis," Dr. Hansen said.

In contrast to adults with psoriasis, pediatric patients can present with prominent, full facial involvement. Flexural involvement is common in all ages, and the lesions can be thick and white or erythematous.

Be particularly thorough with your differential diagnosis of annular psoriasis. "The annular form can fool us. There are a lot of things that cause rings," Dr. Hansen said. A misdiagnosis of extensive tinea can occur, for example.

Some children with psoriasis can have extensive nail involvement. But "nail pits typify psoriasis. ... You can only use nail pits as a diagnostic [criterion] for psoriasis if the cuticle and proximal nail fold are intact," he said.

Pustular psoriasis is rare but important to diagnose in children, Dr. Hansen said. "These patients can be physically quite ill, and treatment has to be instituted right away."

Acute generalized pustular psoriasis is a severe form. Patients can present with fevers, polyarthritis, alopecia, cholestatic jaundice, acute respiratory distress syndrome, eye complications, conjunctivitis, and other adverse signs and comorbidities. "These kids tend to be medical emergencies," Dr. Hansen said. "Consider hospitalization if they have fever."

Many potential factors can elicit this condition. Acute generalized pustular psoriasis can be triggered by an upper respiratory infection or urinary tract infection. "Infections can open the door to anyone already predisposed to get psoriasis," Dr. Hansen said. Withdrawal from systemic or topical steroids and sunburn are other triggers. "Interestingly enough, the [tumor necrosis factor] antagonists which we use to treat psoriasis can also precipitate generalized pustular psoriasis. This confuses most people," he said.