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.

Hello there. At my visit to the dermatology clinic last week it was suggested by one of the nursing staff that I try Witch Doctor Gel on my PPP (PalmoPlantar Pustulosis). They said that it has worked really well for another patient with the same problem. Has anybody else used this? If so, how did you get on with it? I'm putting below a "description" of the gel.

Thanks for all your help and advice

Susie

Witch Doctor Skin Treatment Gel

A soothing, healing treatment for irritated skin

*Antiseptic
*Astringent

81.5% w/w Liquid Extract of Witch Hazel

Witch Doctor 81.5% w/w Gel combines natural witch hazel extract with skin treating conditioners in a clear gel. Acts immediately to relieve irritation and itching, reduce swelling and redness, and protect against infection.

For the treatment of itching, insect bites, stings, sunburn, minor burns, grazes, personal irritation, chafing, minor rashes and skin irritations.

Objective:  To describe the use of systemic therapy for psoriasis (biologic and nonbiologic classic drugs) in patients not adequately represented in randomized controlled trials (RCTs) and the risk of serious adverse events (SAEs) in these patients.

Design:  A registry inception cohort was used.

Setting:  Thirteen dermatology departments in Spain participated.

Patients:  A consecutive sample of patients treated with biologics and a systematic sample of patients treated with classic systemic therapy were evaluated. A total of 1042 patients (2179 person-years) were included.

Exposure: Inadequate representation in trials was defined as the presence of any of the following factors: elderly age (>70 years); type of psoriasis other than chronic plaque psoriasis; history of infection caused by hepatitis B, hepatitis C, or human immunodeficiency virus; history of cancer (excluding nonmelanoma skin cancer); and chronic renal or hepatic disease.

Main Outcome Measures:  Serious adverse events as defined by the International Conference on Harmonization were evaluated.

Results:  In all, 29.8% of patients receiving systemic therapy for psoriasis would not have been eligible for RCTs. These individuals had an increased risk of SAEs (incidence rate ratio, 2.7; 95% CI, 1.5-4.7). Patients exposed to biologics had an adjusted increased risk of SAEs (incidence rate ratio, 2.3; 95% CI, 1.1-4.8) that was similar in patients eligible and ineligible for RCTs.

Conclusions:  Patients ineligible for RCTs are an important proportion (30%) of those receiving systemic therapy for psoriasis. These patients have a higher risk of SAEs and should be closely monitored. Patients exposed to biologics (whether these patients are eligible for RCTs or ineligible) are susceptible to the same increase in risk of SAEs, but biologics add to a higher baseline risk in patients who are ineligible for RCTs. The risk-benefit ratio in ineligible patients receiving biologics might be different from the ratio in eligible patients.

Source: ama-assn.org

An expert in skin conditions has told a medical hearing he was “a bit shocked” to learn that another consultant dermatologist had prescribed a medication, normally given to adults only, to an 11-year-old boy with psoriasis.

The evidence was heard at the second day of a Medical Council inquiry into allegations of professional misconduct and poor professional performance against Dr Adam Jacobus Smith of the Whitfield Clinic in Waterford.

Dr Smith treated a boy with psoriasis and prescribed him Neotigason, described as “inappropriate” for children. Another patient, who was then 17, asked the consultant if using sunbeds would help his psoriasis. Dr Smith told him sunbeds could be “unsafe”, but that he could use them twice a week, for two weeks, and not return after that. Consultant dermatologist Dr Con Buckley told the inquiry he found it “extraordinary” that a dermatologist would “condone” the use of sunbeds, which were linked with skin cancer, to help any condition. The hearing continues today.

Source: irishtimes.com

well just to say my plaque psoriasis, is well on it,s way to turning into Erythrodermic, am very sore , and defo not feelin my best, but better note only 3 weeks till i go to the hospital, hopin he,s goin to take me off fumaderm, as i fink this as made it worse, don,t no what he will gave me this time , hope everyone else is feelin better than me have a lovely day

Thanks! I'm very excited to join the forum. Ive had psoriaisis since '97 and have been on every tx around, except Stellara. I currently have no insurance so my tx options are limited to steroid creams, prednisone and steroid injections every six weeks. Needless to say, I'm very uncontrolled and have total body coverage now. Look forward to meeting new friends!

Bariatric surgery (weight-loss surgery) for obesity has beneficial effects on psoriatic symptoms, show study results.

Psoriasis is more common and severe in people who are obese than in normal-weight individuals, explain Magdalena Farias (Pontificia Universidad Católica de Chile, Santiago, Chile) and team.

However, recent findings have suggested that in addition to dramatic weight loss, bariatric surgery also has beneficial effects on comorbidities such as psoriasis and diabetes.

To investigate the effects on psoriasis further, Farias and co-authors assessed symptoms and severity of psoriasis in 10 obese (mean body mass index [BMI]=38.8 kg/m2) patients before and after bariatric surgery (eight laparoscopic Roux-en-Y gastric bypass and two sleeve gastrectomy).

In total, 50% of the patients were receiving topical treatment for psoriasis before their surgery and 40% systemic treatment.

Following surgery, 70% of the patients had a remission of their psoriasis symptoms that was sustained for at least 6 months. In addition, three of the four patients on systemic drug therapy were able to stop their medication.

The impact of psoriasis on quality of life, as assessed by the Dermatology Life Quality Index, improved significantly from a score of 14.9 before to 5.0 after surgery.

Bariatric surgery also had a beneficial effect on other comorbidities in these patients, resulting in a 75% resolution of diabetes in those who had the condition before surgery, as well as a 100% resolution of insulin resistance, and a 57% resolution of hypertension. Weight loss was also highly successful, with participants achieving a mean weight loss corresponding to 88% of their pre-surgery excess weight at 1 year.

"Bariatric surgery for positive metabolic, skin, and quality of life results should be considered as a useful adjuvant therapy for obese patients with psoriasis," write Farias and co-authors in Obesity Surgery.

However, they concede: "These first results have to be confirmed by long-term controlled studies."

An interesting and positive study on Multiple Sclerosis.
751955  and article 740695
don't know if you can see it, but otherwise you can registrate for free if you want to.

Why MS, while this is a psoriasis forum?
Well, that is because MS is an auto immune disease (what a coincidence!) and because of the treatment with BG-12, in other words dimethylfumarate, another coincidence, which also works very good against psoriasis.

It appears from the study that BG-12 seems to work very well against the progress of MS. The rumor is heard that shortly there will be a publication in The Lancet on the treatment.
Could it be, that one of the best cures for psoriasis, comes in sideways by means of the doorway of MS?
Only time will tell.

Comparative Effectiveness of Commonly Used Systemic Treatments or Phototherapy for Moderate to Severe Plaque Psoriasis in the Clinical Practice Setting

Objective: To compare the effectiveness of biologic systemic therapy, nonbiologic systemic therapy, and phototherapy for treatment of psoriasis.

Design:  A cross-sectional design was used.

Setting: Ten outpatient dermatology sites across the United States participating in the Dermatology Clinical Effectiveness Research Network contributed to the study.

Participants:  A total of 713 patients with plaque psoriasis receiving systemic monotherapy (ie, methotrexate sodium, adalimumab, etanercept, or ustekinumab) or narrowband UV-B phototherapy.

Main Outcome Measures:  The primary outcome of the study was clear or almost clear skin on the Physician Global Assessment scale. Secondary outcomes were score on the Psoriasis Area and Severity Index, affected body surface area, and score on the Dermatology Life Quality Index.

Results:  The proportion of patients with clear or almost clear ratings on the Physician Global Assessment scale differed among treatments: methotrexate (23.8%), adalimumab (47.7%), etanercept (34.2%), ustekinumab (36.1%), and narrowband UV-B (27.6%) (P < .001). In adjusted analyses, patients receiving adalimumab (relative response rate, 2.15; 95% CI, 1.60-2.90), etanercept (1.45; 1.06-1.97), and ustekinumab (1.57; 1.06-2.32) were more likely to have clear or almost clear skin vs patients receiving methotrexate. Patients receiving phototherapy showed no significant difference (1.35; 95% CI, 0.93-1.96) compared with those receiving methotrexate. No response difference was observed with respect to quality of life. Treatment doses were double the recommended doses in 36.1% of patients taking etanercept and 11.8% of those taking adalimumab;10.6% of patients undergoing phototherapy received the recommended treatment frequency.

Conclusions: The effectiveness of psoriasis therapies in clinical practice may be lower than that reported in previous trials. Although relative differences in objective response rates among therapies may exist, absolute differences are small and may not be clinically significant. Dosing of common therapies varied from trial recommendations. These results provide novel benchmarks emphasizing the critical importance of studying effectiveness in real-world practice.

Source: ama-assn.org

Hi, I'm Dan and I have been a psoriasis sufferer for most of my life. I have been lucky in that my psoriasis is only mild and for the most part concealable. I've joined this forum to offer and share ideas, remedies and ideas with other sufferers of this condition.

Dan

Objectives:  To better define mechanisms by which etanercept (Enbrel) improves psoriasis and to gain insight into disease pathogenesis.

Methods:  We investigated the early biochemical and cellular effects of etanercept on skin lesions in responder patients prior to substantial clinical improvement (≤4 weeks).

Results:  By 1 week, etanercept acutely suppressed gene expression of the IL-20 subfamily of cytokines (IL-19, IL-20, IL-24), which were found to be predominantly epidermis-derived and which are implicated in stimulating epidermal hyperplasia. Additionally, by 1 week of therapy, suppression of other keratinocyte-derived products (chemokines, antimicrobial proteins) occurred, while suppression of epidermal regenerative hyperplasia occurred within 1-3 weeks. Th17 elements (IL-23p19, IL-12p40, IL-17A, IL-22) were suppressed by 3-4 weeks. In vitro, TNF-α and IL-17A coordinately stimulated the expression of the IL-20 subfamily in normal keratinocytes.

Conclusions:  Based on the rapid suppression of regenerative hyperplasia, chemokines, and other keratinocyte-derived products, including the IL-20 subfamily, we propose that epidermal activation is a very early target of etanercept. As many of these keratinocyte markers are stimulated by TNF-α, their rapid downregulation likely reflects etanercept’s antagonism of TNF-α. Additionally, decreased epidermal hyperplasia might result specifically from acute suppression of the IL-20 subfamily, which is also a likely consequence of etanercept’s antagonism of TNF-α. Thus, the IL-20 subfamily has potential importance in the pathogenesis of psoriasis and therapeutic response to etanercept.

Source: British Journal of Dermatology. onlinelibrary.wiley.com

Has anyone had any real success without any appreciable side effects
? Thanx, Marlin

psoriasisclub.org Hi, My name is Marlin, and I have Psoriasis Plaque BAD! I started getting it about 10 years ago,...and now my wife finally left me. Bout fed up feeling like a Leper, or a mangy dog. Seems as tho a Psoriasis person has 2 choices...Live with a Lousy Rash that irritates other people and try creams that dont work well...or take meds that threaten your very being by destroying organs etc. Anyhow,...I hope God has sent me to the right place for help. Here I am,...I'm reaching out...FINALLY

Hello My name is Emma and I have been diagnosed this week. On my various searches I found your forum.

I have had this for 2 years+ and have not gone to the doctors in that time as a) I thought it was something else and b) I have been too embarrassed. Over the last few months for so it has moved to my head and it's extremely itchy and have been feeling exhausted all the time which I have put down to my job. Previously it has been confined to my unmentionables and I put it down to being overweight (front and back, thought I had Hermaroids and thrush and trying to self treat). I went to the doctors on Wednesday and had a lecture about not going sooner and the embarrassment of being examined by a male doctor and a nurse whose intake a breath showed her disgust.

I don't have an intimate relationship with my partner which does not bod well as we are supposed to be getting married and want to have more children. I work nights in a highly stressful job, long shifts and plenty of stress however I do find this very enjoyable.

My boss has forced me to go to the doctors as she was worried that I was suffering from depression (was off for 4 months following my Dad's death last year). Feel embarrassed to talk to her about this new development. I just want to cry.

Any advice you can offer would be appreciated. I want to try and change my diet and an unsure how fast or what to cut out first. I want to get better and have a better standard of life.

Thanks in advance