In its collaboration with Abbott, Biotest AG is pursuing an innovative therapeutic strategy to treat the autoimmune disorders Rheumatoid Arthritis and Chronic Plaque Psoriasis using the monoclonal antibody Tregalizumab (BT-061).

A phase IIa clinical trial with repeated doses has been completed in which Tregalizumab was tested for the treatment of chronic plaque psoriasis.

This trial was a placebo-controlled, double-blind, multicentre, multinational, multiple dose, dose-escalation study to evaluate the safety and efficacy of BT-061 in different doses and mode of administrations. Patients were treated subcutaneously or intravenously weekly for eight consecutive weeks in six different escalating dose groups. The primary endpoint of the study was PASI 75 (PASI : Psoriasis Area and Severity Index) response at Week 9, with PASI 50 and PASI 90 responses at Week 9 as secondary endpoints.

49 patients with Chronic Plaque Psoriasis were enrolled. Patients received Tregalizumab as monotherapy at doses between 25-100 mg as subcutaneous injections or 0.5 and 2 mg as intravenous infusions. Tregalizumab was administered once weekly for 8 weeks. In each treatment group, six patients received active treatment and two patients received placebo. After the treatment period, the patients were observed for further 12 weeks without Tregalizumab treatment (follow-up period).

Highest clinical response measured by the PASI score was achieved in the 100 mg dose-group. 71.4% of patients experienced at least a 50% improvement in psoriasis signs and symptoms as measured by PASI (PASI 50) at week 9, compared with 37.5% of those who received placebo. At the same time, in this dose-group, 42.9% of patients receiving active drug had an improvement of at least 75% (PASI 75) vs 12.5% for placebo.

In analogy to the results of the previous Phase I/II trial Study 967 (single dose administration), also in study 973 in the relevant active dose-groups, the PASI score generally further improved after the end of the 8 week treatment period. Further improvement of up to 90% (PASI 90) was observed in several patients during the treatment and follow-up period. The evaluation of response within the treatment and follow-up period (best response) showed a PASI 50 improvement in 71.4%, a PASI 75 in 57.1% and a PASI 90 in 14.3% of patients in the 100 mg SC dose-group. The respective numbers in the corresponding placebo group were 37.5%, 25.0%, and 0.0% (PASI 50, PASI 75, and PASI 90).

The good tolerability of Tregalizumab, which was expected based on the data from previous trials, has also been confirmed in the concluded phase IIa trial.

Further studies in Psoriasis in larger patient groups with a less frequent dosing schedule and a longer treatment period for Tregalizumab will only be started after finalisation of phase IIb trials in Rheumatoid Arthritis.

Source: pipelinereview.com

The LEO Pharma Research Foundation’s Gold and Silver awards 2011 go to Claus Johansen and Charlotte Menné Bonefeld – young researchers with exceptional achievements in dermatology.

The awards will be presented on 23 November at the Panum Institute in Copenhagen by Professor Povl Krogsgaard-Larsen, world-leading medicinal chemist and Chairman of the Board of the Carlsberg Foundation.

“This year’s award winners have made outstanding contributions to dermatology, despite their young age. Ultimately their research can lead to better care for patients with skin disorders. We hope that the awards can support their accomplishments in the future,” says Tore Duvold, chairman of LEO Pharma Research Foundation’s award selection committee.

Gold award:
The DKK 1,000,000 award goes to 38-year-old Danish dermatological researcher Claus Johansen. His research over the years has focused on the complex network of intra-cellular signals controlling inflammatory skin disorders, particularly in relation to psoriasis. The results have furthered understanding of the inflammatory process in psoriasis – key knowledge for the future development of new therapies.

Silver award:
The 36-year-old immunologist Charlotte Menné Bonefeld receives the DKK 500,000 award for her research achievements in dermatology. Her research includes new promising results, which show that the immune system weakens – in other words develops tolerance – when someone is repeatedly exposed to strong allergens such as those found in hair dyes. The results offer new insight into treatment possibilities and the reasons why people develop allergies.

Source: leo-pharma.com

Amgen announced today that a new U.S patent had been granted that could protect its big-selling drug Enbrel from generic competition for 17 more years.

Enbrel was one of several biotechnology drugs that were expected to face competition in the next few years from copycat versions, eventually saving the health care system billions of dollars a year.

The 2010 health care law established a way for such biologic drugs, which can cost tens of thousands of dollars a year, to face competition from near generic versions, which are often called biosimilars. A new law was needed because biologic drugs, which are made in living cells, were not covered by the 1984 law governing most pharmaceutical competition.

The main patent on Enbrel was to expire in October of next year. But the new patent could stave off such biosimilar competition until Nov. 22, 2028. By that time, Enbrel will have been on the market 30 years, far longer than the 20 years of protection expected in patent law.

Source: Amgen

LEO Pharma and Aarhus University have cloned the world’s first transgenic mini pig with a predisposition for psoriasis. The unique animal is expected to transform dermatological research and pave the way for safer and more effective skin treatments in the future.

Born in July, the pig was created using a new ‘handmade cloning’ technique pioneered in Denmark at Foulum Research Centre. The breakthrough offers new opportunities in the future for studying not only psoriasis, but also an array of skin diseases, from child eczema to skin cancer.

The successful result - part of a €6.4m project called Pigs and Health co-financed by the Danish National Advanced Technology Foundation ¬- will be presented in an all-day seminar at the Danish Agriculture and Food Council on 21 November in Copenhagen.

“This is an exciting breakthrough - not only for future psoriasis treatment, but also for the entire field of dermatological research,” says Thomas Kongstad Petersen, Director of Preclinical Development at LEO Pharma.

“Now we have the potential to test new drugs and therapies for a multitude of skin conditions, from eczema to skin cancer. We strongly believe that this animal will play a significant role in our future drug research and help us radically improve treatment for people with skin diseases.”

Cutting-edge cloning
The research also represents a globally significant advance in cloning, according to the research team at Aarhus University.

“The result is extremely promising. With this new discovery, we have established the genetic fundamentals for generating transgenic pig models of human skin disease”, says Jacob Giehm Mikkelsen, Associate Professor at the Department of Biomedicine, Aarhus University.

Thanks to the recent Danish progress in pig transgenesis – where this result is one of a series of breakthroughs - Denmark is now a global front runner in the production of cloned transgenic mini pigs by somatic cell nuclear transfer.

‘Handmade cloning’ involves removing an egg’s genetic material and replacing it with a genetically engineered somatic cell nucleus from a donor pig. The resulting egg is then transferred to a surrogate pig’s womb. To create the transgenic mini pigs with a predisposition for skin disease, the ‘handmade’ eggs were modified to carry two human genes. The next step is to standardise the animal model, which is expected to take up to two years.

Also involved in the Pigs and Health project are PixieGene, Danish Agriculture and Food Council, Pig Research Centre, University of Copenhagen, Technical University of Denmark and Ellegaard Göttingen Mini-pigs. The project aims to produce pigs that are sensitive to human disease for use in medical research.

Transgenetic means to have genetic material, or DNA, from another species.
A mini pig is raised under standardised conditions. For practical reasons, a mini pig therefore often used in scientific research and development of medicine.
‘Handmade cloning’ involves removing an egg’s genetic material and replacing it with a genetically engineered somatic cell nucleus from a donor pig. The resulting egg is then transferred to a surrogate pig’s womb.
Pigs are similar to humans in terms of physiology and anatomy, making them more suited for drug testing than mice or rats.
A somatic cell is a body cell i.e. from skin. 

Source: leo-pharma.com

BioTrends Survey of Over 1,300 Patients with Autoimmune Disorders Indicates High Disease Impact on Quality of Life Metrics and Challenges Patients Face with Their Disease.

In a comparison of patient reported ratings on autoimmune disease impact on quality of life metrics, BioTrends Research Group found that patients with ankylosing spondylitis (AS) and Lupus/SLE (SLE) reported significantly higher impact on “Activities of Daily Living” and “Emotional Health” compared to patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA).

Leading up to diagnosis, patients reported struggling with symptoms for many months before receiving a diagnosis. About one-third of AS and PsA patients had symptoms for more than one year before being diagnosed and close to half of these patients saw more than two physicians before receiving a diagnosis. On average, AS patients were symptomatic for nearly three years, often receiving another diagnosis prior to AS. By comparison, PsA and RA patients were typically diagnosed within the first year of presentation and gout patients were diagnosed almost immediately.

The degree to which loved ones are involved in the care of these patients also varies by disease as does the extent to which the patients are active versus passive seekers of information. While the treating physician plays the lead role in providing disease information for all of the conditions, other sources also influence the patients in their awareness about their disease and treatment options.

Reports are based on surveys and qualitative interviews with patients diagnosed with various diseases including rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout, chronic kidney disease, multiple sclerosis and hepatitis c. These reports seek to understand the patient journey from symptoms to diagnosis to current status. The reports also explore how often and in what ways patients seek information and probe into patient’s awareness about their disease, the treatments available and desired features in new treatment options.

Source: bio-trends.com

Objectives: 
To assess patients' preferences for psoriasis treatments and to identify the effect of sociodemographic and socioeconomic characteristics on these preferences.

Design:
A computer-based conjoint analysis experiment was conducted to analyze the preferences of individuals with moderate or severe psoriasis for outcome attributes (probability, magnitude, and duration of benefit, as well as probability, severity, and reversibility of adverse effects) and process attributes (treatment location, frequency, duration, delivery method, and individual cost) of psoriasis treatments. Relative importance scores (RISs) for each attribute were calculated. The effect of sociodemographic (age, sex, and marital status) and socioeconomic (income and employment) characteristics and Psoriasis Area and Severity Index and Dermatology Life Quality Index scores on preferences was assessed using analysis of variance, post hoc testing, and multivariate regression analysis.

Setting:
Outpatient dermatology clinic at a German university medical center.

Participants:
Patients with moderate or severe psoriasis (N = 163).

Main Outcome Measure: 
Relative importance scores for treatment attributes.

Results: 
The attribute considered to be most important in patients' preferences for psoriasis treatments was treatment location (RIS, 26.76), followed by probability of benefit (RIS, 23.77) and method of delivery (RIS, 23.49). The RISs for all process attributes were higher than for adverse effect–related attributes. Older individuals (≥65 years) were less concerned about the probability of benefit (β = –0.24; P = .005) compared with younger individuals.

Conclusions: 
When choosing among treatment options, individuals with psoriasis appear to be willing to accept treatment-related adverse effects to obtain process attributes compatible with their personal and professional life. Incorporating preferences in shared decision making may facilitate treatment adherence and optimize outcome.

Source: .ama-assn.org

It's a normal cause and effect reaction that when you get an itch, you scratch it. But for individuals with psoriasis, the "itchy" feeling can be taken to truly excruciating levels where scratching doesn't stop the itch and can may it even worse.

An array of prescription and over-the-counter (OTC) remedies specifically target the itch of psoriasis. This disorder is from an immune system glitch that causes skin cells to turn over much faster than normal, producing red, scaly skin lesions. To date, there is no cure for the disorder or the itching, only treatements.

The word psoriasis, in fact, is derived from the Greek word psora, meaning "itch," and alludes to one of the most troubling symptoms.

Although many people who have psoriasis (or "psoriatics") are disturbed by how the crusty lesions, or plaques, look -- particularly when they appear on the face and hands -- some are even more concerned with the itchiness.

For example, a 2004 study found that itching was the most frequent complaint among patients hospitalized for psoriasis, which can result in lesions on any area of the body, including the genitals, palms and soles of the feet.

Also, a survey of the National Psoriasis Foundation members indicated that only the scaling of lesions outranked the itch as the most vexing symptom of the condition.

Whenever a condition causes a chronic itch, it's likely to have an impact on quality of life. That's certainly the case with psoriasis, as evidenced by another scientific study. This study revealed that people with psoriasis reported various symptoms, including itchiness that disrupted their sleep, reduced their sex drive and interfered with their ability to concentrate.

However, many options are available to counter this uncomfortable symptom. Besides reducing discomfort, treatment can help avoid what's known as the "itch-scratch cycle," in which regular scratching can increase the inflammation, which leads to still more itching.

Moreover, scratching can actually trigger psoriasis flare-ups through the Koebner phenomenon, in which skin damage -- such as cuts, insect bites or sunburn -- elicits a disease response. This occurs in a wide range of psoriatics -- between 11% to 75%, depending on the study -- as well as in several other skin conditions.

In no particular order, here are some of the most common itch-fighters for psoriasis, including prescription, OTC and homemade preparations. Specific brand names may be mentioned because they're easy to find, but each of these remedies is sold under various labels. Consult a doctor about any unexpected reactions.

1) Antihistamines: These medications target the nerve pathways related to itching and can have a sedative effect, which may help psoriatics sleep through their itching. Look for "non-drowsy" antihistamines for daytime usage. Be sure to follow dosage guidelines.

2) Creams and lotions: The simple act of smoothing on a rich layer of emollients can help keep itch away, because dry skin tends to be itchy skin -- even in a person without psoriasis. Creams are more moisturizing than lotions. Certain anti-itch creams are particularly helpful for psoriasis, including Gold Bond Medicated Anti-Itch Cream and Aveeno Overnight Itch Relief (with oatmeal).

3) Topical corticosteroids: Whether in prescription or OTC strength, steroids -- such as Cortaid or Lanacort -- are widely used to treat various sorts of itching. However, you should exercise care in using these products. Over the long term, steroid creams can result in skin-thinning.

4) Capsaicin: An ingredient derived from hot peppers, capsaicin is proven to help itching, although for some it stings or burns at first. This product is available OTC, known as Capsin and Capzasin-P.

5) Topical anesthetics: An application of one of these nerve-deadening products can keep itch at bay for hours. Topical anesthetics include both prescription medications -- such as benzocaine and lidocaine -- and OTC products -- such as menthol and camphor -- found in Sarna lotion, Bengay and Vicks VapoRub.

6) Oatmeal baths: Especially for those with widespread plaques, oatmeal baths soothe all affected areas in one step. Just pour in the recommended amount of ground colloidal oatmeal (such as Aveeno Soothing Bath Treatment) as you fill up the tub and soak in its milky smoothness for awhile. Immediately after drying off, follow with a liberal layer of moisturizing cream for longer-lasting itch relief.

7) Ice packs: Among the quickest and easiest solutions, a frozen gel pack applied to psoriatic skin not only eases itch by numbing nerve endings, but cools the rawness of inflamed patches.

8) Plastic wrap over lotion: Covering psoriasis-covered areas with lotion and then plastic wrap, socks or gloves -- known as occlusion -- keeps medicated or nonmedicated preparations airtight for hours, increasing their itch-fighting effect and helping to discourage scratching. Check with a doctor to determine which preparations may work best for your case.

Data Presented at the American College of Rheumatology Annual Scientific Meeting Are Welcome and Exciting News for Patients with Ankylosing Spondylitis and Psoriatic Arthritis

There is currently no cure for ankylosing spondylitis.  Current medical treatments for spondyloarthropathy are all aimed at reducing overall inflammation, and include non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs) including both traditional medications and newer biologics.

Psoriatic arthritis is also a spondyloarthropathy and is associated with the skin condition psoriasis, which is caused by immune system problems that result in increased cell growth. In the United States, approximately three percent of the population, or more than five million adults, have psoriasis.  For people with psoriatic arthritis, quality of life is impacted by both the physical symptoms of the disease and the emotional burden of disfiguring skin symptoms.

Continued research has pointed the way to new methods of fine-tuning the immune response and controlling inflammation that may someday offer better relief with fewer side effects. One study seen at ACR was of an investigational treatment that may be the first small molecule to show an effect in both psoriatic arthritis as well as the axial and peripheral components of ankylosing spondylitis.

"Exciting advancements in research are going on in spondyloarthropathies.  Apremilast – is a novel oral therapy that could potentially offer a new disease-modifying treatment option for people who are affected by this debilitating condition," said Dr. Peter Taylor, Professor of Musculoskeletal Sciences, Honorary Consultant Rheumatologist and Head of Clinical Trials, Kennedy Institute of Rheumatology, University of Oxford, UK. "I am delighted to be working with the Spondylitis Association of America in order to educate people about this disease and show them the hope that potential new treatments may provide."

Spondyloarthropathies (sometimes called spondyloarthritis) are a group of interrelated chronic diseases that cause inflammation in the spine (spondylo) and other joints, as well as at the points where ligaments and tendons attach to the bone.  Ankylosing spondylitis (AS) is a crippling form of arthritis falling under this category that generally strikes young people in their teens and twenties, sometimes even earlier. Left untreated, it causes pain, disability and can eventually cause the spinal vertebrae to fuse together forming one brittle bone, often in a stooped over position.  The most common symptoms of ankylosing spondylitis are pain and stiffness. 

Source: prnewswire.com

Skin is the largest organ of the human body and the average adult skin has a surface area of between 1.5-2.0 square metres, its thickness varies from 0.5mm on your eyelids to 4mm or more on the palms of your hands. The average 6.5 cm² of skin holds 650 sweat glands, 20 blood vessels, 60,000 melanocytes, and more than 1,000 nerve endings.

Skin acts as a waterproof, insulating shield, guarding the body against extremes of temperature, damaging sunlight, and harmful chemicals. It also exudes antibacterial substances that prevent infection and manufactures vitamin D for converting calcium into healthy bones. Skin additionally is a huge sensor packed with nerves for keeping the brain in touch with the outside world. At the same time, skin allows us free movement and without it, we'd literally evaporate.

Skin is composed of three primary layers:
#1 the epidermis, which provides waterproofing and serves as a barrier to infection.
#2 the dermis, which gives the organ its strength and elasticity.
#3 the hypodermis (subcutis) contains blood vessels and nerves It also works as insulation and cushions us from knocks and falls.

Skin offers Protection, Sensation, Heat and Evaporation Regulation, Storage and Synthesis, Excretion and Absorption, it’s also Water Resistant and can even Heal Itself.

So remember even though you have psoriasis and your epidermis cells reproduce in 2-10 days instead of 20-30, the skin is still a wonderful organ.

Psoriatic arthritis patients on biologic therapy reported a decrease in pain, but MR imaging of their joints showed that there was still active disease, researchers reported here.

Among 29 patients who responded to treatment with adalimumab (Humira), the patient perception of pain dropped markedly as measured on a visual analog scale from 62 at baseline to 12 at week 48 (P<0.0001), said Rene Poggenborg, MD, research fellow in rheumatology at Glostrup University Hospital, Copenhagen.

"A surprising finding was that the synovitis -- the inflammation of the joint -- did not decrease very much," Poggenborg told MedPage Today at his poster presentation during the annual meeting of the American College of Rheumatology.

At baseline the PsAMRIS (Psoriatic Arthritis Magnetic Resonance Imaging Scale) score was a 9, and after a year it was a 6 (on a scale of 0 to 36).

"While this was of borderline significance (P<0.05), it did not correlate with clinical response, which was very good," he said. "So we had a very good clinical outcome, but not much of an improvement radiologically. We were able to document, using a contrast agent, that inflammation in the joints of patients disappeared after 48 weeks of treatment."

Poggenborg noted that the use of MRI to assess outcomes in these patients is useful, but is also time-consuming. "It takes a while to do the scoring on these scans; I estimate it takes about an hour per patient," he said.

"We had 29 responders among the 41 patients in the study. There were dropouts and in others, for some reason, adalimumab didn't appear to work. This is one way to monitor how well patients are doing on certain treatments," Poggenborg added.

"There is a disconnect between clinical remission and MRI remission in patients with rheumatoid arthritis," commented Amanda Brown, MD, assistant professor of pediatrics at Children's Hospital New Orleans at the Louisiana State University Health Science Center. "Some of the adult data has shown about a six-month difference."

In Poggenborg's study, more than half the patients were women and the average age of the study cohort was 49. They had experienced skin disease for about 20 years and had experienced joint disease for about nine years.

In the visual analog scale of global discomfort, the baseline score was 65. At 48 weeks, the responders had a score of 11 (P<0.0001). The visual analog scale using the doctors' perception of pain was 50 at baseline and 3 among responders after 48 weeks of therapy (P<0.0001), Poggenborg reported.

In addition to the decrease in synovitis, flexor tenosynovitis decreased from 2 to 1 on a scale of 0 to 36 (P<0.005). Bone erosion scores increased from 2 at baseline to 3 after a week of treatment on a scale of 0 to 240 (P=NS); and the overall MRI inflammation score decreased from 16 to 9 on a scale of 0 to 168 (P<0.005).

Poggenborg said the patient population had relatively early disease so there wasn't much bone damage, but even after a year of therapy, the MRI still indicated some disease activity persisted.

"Once the joints are clinically silent there is still activity on MRI," Brown told MedPage Today. "We have the opportunity to put these patients in remission with biologics, but are we really putting them into remission?"

Brown, who presented a similar study of imaging among pediatric patients with forms of rheumatoid arthritis, but who was not a researcher on the Danish study, noted, "One of the goals in rheumatoid arthritis is to treat to target, but is this really enough? Is this mild synovitis we see on MRI clinically important or are we just finding it because we are looking for it?

"I think there definitely is a lag time between clinical improvement and imaging improvement, but we don't know how long that is," she said. Brown added that although treatment with biologics can put patients in clinical, and eventual radiological remission from rheumatoid diseases, few patients ever return to baseline.

Source: medpagetoday.com

If your having trouble getting around the clubs website here are tips that can help.
Suzy
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Get to know your users cp.You can find its link at the top of all pages and can quickly view new posts and replies,update your profile,check your pm's,etc. I have it set as a homepage and it makes it so easy to see what's new.
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I have found out I can subscribe to threads or to the whole topics and I get an email when someone posts or replies to the topics or forums I have subscribed to. It makes the group so easy tofollow and I love the feature!
The subscribe link is at the upper left when you are viewing a thread ,post or topic.You also will see what you subscribe to on your cp so you don't have to get the emails if you don't want to.You can also unsub anytime.
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As reported in doc guide dermatology news.
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Sitagliptin, a Dipeptidyl Peptidase-IV Inhibitor, Improves Psoriasis; Nishioka T, Shinohara M, Tanimoto N, Kumagai C, Hashimoto K; Dermatology (Nov 2011)

A patient with a 17-year history of plaque psoriasis accompanied by type 2 diabetes mellitus discontinued cyclosporine and steroid ointment given for treatment of psoriasis because she was dissatisfied with the effects of the drugs. After sitagliptin, a dipeptidyl peptidase-IV (DPP-IV) inhibitor, was administered for control of blood glucose, psoriatic skin lesions were gradually diminished, although HbA1c did not improve. Three months after the administration of sitagliptin, infiltration, scales and erythema on all psoriatic plaques disappeared, leaving pigmentation on flat skin. DPP-IV in serum degrades the incretin hormones which stimulate β-cell insulin secretion. DPP-IV inhibitors, as incretin enhancers, cause an increase in glucose-dependent insulin secretion, and are applied for the treatment of diabetes mellitus. DPP-IV is also expressed on T cells as CD26, a surface antigen which plays an important role in activating T cells. As helper T cells are involved in the pathogenesis of psoriasis, it is possible that DPP-IV inhibitors improve psoriatic skin lesions by inhibiting T cell activation, independently of glycemic control. DPP-IV inhibitors could be an alternative for the treatment of psoriasis.

Dating and intimacy with psoriasis


By Dr. Robert H. Reiner
Executive Director of Behavioral Associates in New York City, and a faculty member of the New York University Medical Center

Please be advised that the content displayed addresses mature issues.

When you're looking for a partner, psoriasis can feel like a barrier to closeness. Dr. Robert H. Reiner, a clinical psychologist, explains how to help keep your skin from getting in the way.

In my practice, I see both married and single patients with psoriasis. For both of these groups, psoriasis can often become a barrier to the establishment of intimacy. But it is even more challenging for someone who is single and dating.


Severity and security

Within any group of people with psoriasis, disease severity is a major issue. But another important factor is the basic security or self-esteem of the patient. For example, there are people who catastrophize, which means that they make things seem worse than they really are by focusing on the worst possible outcome. When these people suddenly start having flaky facial patches, they simply refuse to go out. They think that if they do, people will stare or turn away in disgust.

The desire to hide is understandable. The problem is, once a person begins behaving that way, which is called behaving protectively, their symptoms tend to get worse—not the psoriasis itself, but the psychological symptoms that can go along with the disease. Their perception of what they look like and other people's reactions to their appearance become exaggerated in their mind. These exaggerations become their distorted realities. If you expect the worst possible reaction, you're bound to "see" it. On the other hand, I have a patient whom I consider very secure. He's had psoriasis his whole life—a pretty bad case. I've seen it when it's all over his chest. He tells me he sometimes gets it on his genitals. But it never seems to stop him. He is very confident with women and he's had girlfriends all his life.

Be as direct as possible, as early as possible

When it comes to meeting someone for the first time, looks are, unfortunately, very important. The dating ritual really is a kind of checklist of getting past certain things. A blind date is the first level—"Are your looks and general personality acceptable enough that I would want to get to know you?" Because of this, I can't stress enough how important it is for people to be as direct as possible about their psoriasis, as early as possible. What I usually advise is this: If it's visible, bring it up right away. By bringing psoriasis out in the open and talking about it, you will defuse the other person's fear or anxiety. Things that are not talked about are left to the imagination—which usually makes them seem worse than they really are. Even consider telling someone over the phone before you meet. Say, "I want to let you know, I have a skin condition called psoriasis. It's not contagious, and for me, it sometimes looks worse than it is. I am going through a tough stage right now; if you would rather wait a couple of weeks to meet me, I'll understand."


The power of proactive behavior

By being open about psoriasis, you are communicating some very positive things about yourself: that you are somebody who can be counted on to be honest and direct and that you are an initiator—"I'm kind of going out on a limb here by disclosing this to you. I don't want you to get spooked when you see me. I also want to reassure you that you can't catch it." You are also demonstrating consideration, honesty, and the courage to expose yourself. Most importantly, you are being proactive by not waiting for things to come to you. This helps you gain a sense of control. The more you take control of the things that you can control, the less likely you are to feel thrown by the things you cannot control.


How to describe psoriasis

One good way to describe psoriasis is "my body produces skin cells faster than the average person." It helps explain the condition and is easier to deal with. People will then realize: "The body is just producing too many skin cells. No big deal." This reduces the odds that someone will be "shocked" by your appearance or needlessly worried that your condition might be contagious.



Humor can help

Humor can be a terrific help in making people feel more at ease with psoriasis. I can't stress enough how important it is. For example, you might say, "This is psoriasis...proof that you can have too much of a good thing." But remember, if you don't know how to tell a joke, or your timing is off, this strategy won't work so well. You don't want it to seem contrived or forced. If you do want to use humor, I recommend careful role-playing, rehearsing, and practicing. Imagine you are on a date, and think, "How am I going to say it?" Then, role-play it over and over again—at home, in the office, alone, or with a friend.



Helping others say what they feel

When people are afraid or nervous about dating someone with psoriasis, you want to open as many doors to them as possible. By doing this, you are communicating your own confidence, diminishing their anxiety, and reassuring them that you aren't being deceitful. Consider this approach:
•Say something like, "Sometimes people are squeamish about this and I understand. Sometimes I gross myself out with it." This is what someone is probably thinking anyway, so it's a good icebreaker.
•When you're in the middle of a bad flare, say, "Obviously, I'm having a tough time with my skin right now. It isn't always this bad."
•It's also important to tell somebody, "I want you to understand what this condition is about. If you have any questions, feel free to ask."


Getting more intimate

The closer you get to becoming physically intimate, the more important it is to be honest and direct. The last thing you want is to wake up with someone in the morning and then agonize while this person sees your psoriasis for the first time. If that happens, you may feel awkward, and the person may think you were hiding the truth. Some people might need time to get used to your psoriasis. Don't try to hide it—inform them. Start by reminding people that psoriasis is not contagious. Tell them that you understand if they're a little squeamish about it. And reassure them that you are doing everything you can to deal with it. Also mention that psoriasis has its ups and downs—it's not a constant thing. In the short run, talking about psoriasis may seem difficult, but in the long run, it can help you become closer with another person. If someone is interested in becoming a larger part of your life, they are going to want to know about these things—just as you would want to know about them. And by being open and honest, you are communicating to them that you would like them around in your future.

I noticed today my Cadum Shower Gel had the words "Sans Paraben" I knew the word Sans in French meant without but I have never noticed the word Paraben.

So I have just been doing a bit of research about Paraben. I was surprised when I put it in Google, I was expecting it to be a French word but it's not. Parabens are a class of chemicals widely used as preservatives in the cosmetic and pharmaceutical industries. They are also used in cosmetics, skin care products, medications, foods, and industrially in oils, fats, shoe polishes, textiles and glues.

Other names for Parabens are: Methylparaben (E218), Ethylparaben (E214), Propylparaben (E216), Butylparaben, Benzyl-parahydroxybenzoate (p-hydroxybenzoate), Methyl-parahydroxybenzoate (p-hydroxybenzate), Ethyl-parahydroxybenzoate (p-hydroxybenzoate), Propyl-parahydroxybenzoate (p-hydroxybenzoate), Butyl-parahydroxybenzoate (p-hydroxybenzoate), Parahydroxybenzoate (p-hydroxybenzoate).

Where you can find them: Cosmetics: Foundations, powders, concealers, Eye makeup (liners, shadows, mascara), Facial makeup (blushes), Bronzes, Makeup removers, Lipstick, Quick-dry nail products. Pharmaceutical/self-hygiene products: Topical dermatological medications, Eye, ear and nose drops, Rectal and vaginal medications, Bandages, Local anaesthetics, Moisturizing lotions and creams, Dentifrices, Sunscreens, Cleansers and other skin care products, Antiperspirants and deodorants, Soaps and toothpastes. Food products: Marinated fish products, Salad dressings, Mayonnaise, Mustard, Spiced sauces, Processed vegetables, Blueberries, Frozen dairy products, Jams and jellies, Soft drinks and fruit juices, Baked goods and candies.

OK so what? well I went a bit deeper in my research and this is what I found:

#1 Parabens have been shown to cause allergic reactions and are one of the leading causes of contact dermatitis and rosacea.

#2 In addition they have been found in extremely low concentrations in breast cancer tumors (an average of 20 nanograms/g of tissue).

#3 Studies indicate that methylparaben applied on the skin may react with UVB leading to increased skin aging and DNA damage.

#4 They mimic estrogen in the body which disrupts the delicate hormonal balance that our bodies, and there is some concern that parabens affect the development of the fetus.

All this led me back to why they put Sans Without Paraben on my Shower Gel. well in France methylparaben are banned or restricted for use. So I have now checked out some other products and out goes the Golgate, Witch Hazel Gel, and even the Dexeryl that my Dermatologist gives me.

Call me paranoid if you like but if I can find alternative products without, then I will.

Inflammation predicts risk for cardiovascular disease (CVD) events, but the relation of drugs that directly target inflammation with CVD risk is not established.

Methotrexate is a disease-modifying antirheumatic drug broadly used for the treatment of chronic inflammatory disorders. A systematic review and meta-analysis of evidence of relations of methotrexate with CVD occurrence were performed. Cohorts, case-control studies, and randomized trials were included if they reported associations between methotrexate and CVD risk.

Inclusions and exclusions were independently adjudicated, and all data were extracted in duplicate. Pooled effects were calculated using inverse variance–weighted meta-analysis. Of 694 identified publications, 10 observational studies in which methotrexate was administered in patients with rheumatoid arthritis, psoriasis, or polyarthritis met the inclusion criteria. Methotrexate was associated with a 21% lower risk for total CVD (n = 10 studies, 95% confidence interval [CI] 0.73 to 0.87, p <0.001) and an 18% lower risk for myocardial infarction (n = 5, 95% CI 0.71 to 0.96, p = 0.01), without evidence for statistical between-study heterogeneity (p = 0.30 and p = 0.33, respectively).

Among prespecified sources of heterogeneity explored, stronger associations were observed in studies that adjusted for underlying disease severity (relative risk 0.64, 95% CI 0.43 to 0.96, p <0.01) and for other concomitant medication (relative risk 0.73, 95% CI 0.63 to 0.84, p <0.001). Publication bias was potentially evident (funnel plot, Begg's test, p = 0.06); excluding studies with extreme risk estimates did not, however, alter results (relative risk 0.81, 95% CI 0.74 to 0.89).

In conclusion, methotrexate use is associated with a lower risk for CVD in patients with chronic inflammation. These findings suggest that a direct treatment of inflammation may reduce CVD risk.

Source: ajconline.org

Collaborative research from Perelman School of Medicine at the University of Pennsylvania has shown that psoriasis patients have an increased risk of heart attack, stroke and cardiovascular death, especially if the psoriasis is moderate to severe. Now, Penn researchers have discovered the potential underlying mechanism by which the inflammatory skin disease impacts cardiovascular health. In two new studies presented at the 2011 American Heart Association Scientific Sessions, Penn researchers show that the systemic inflammatory impact of psoriasis may alter both the makeup of cholesterol particles and numbers, as well as impair the function of high density lipoprotein (HDL), the "good" cholesterol.

"Anecdotally, many researchers have observed that HDL levels may be lower in states of inflammation, such as rheumatoid arthritis, psoriasis and even obesity," said lead study author Nehal Mehta, MD, MSCE, director of Inflammatory Risk in Preventive Cardiology at Penn.  "However, these new findings suggest that in addition to lower levels, chronic inflammation associated with conditions like psoriasis may change the composition and decrease the function of HDL as well."

In the current studies, researchers enrolled 78 patients with psoriasis and 84 control subjects. In the first study, the authors measured fasting lipid levels and examined the number and size of cholesterol particles using nuclear magnetic resonance (NMR) spectroscopy.  This analysis revealed that patients with psoriasis had a higher number of smaller LDL particles, or "bad" cholesterol, which was independent of traditional risk factors and obesity.  "It was striking that the NMR profiles from patients with psoriasis resembled those seen in patients with diabetes, and that these patients with psoriasis had otherwise normal traditional lipid panels" Dr. Mehta added.

In the second study, the researchers measured HDL efflux, which is the ability of a patient's HDL to remove cholesterol from cells involved in atherosclerosis.  This process, known as 'reverse cholesterol transport', is why HDL may have protective properties. In a previous study, researchers at Penn have demonstrated that measuring HDL efflux capacity may be a more effective barometer of protection from heart disease than measuring HDL levels alone.

In this same group of patients who had normal cholesterol levels compared to controls, patients with psoriasis demonstrated dramatically reduced HDL efflux capacity compared to control patients. This negative association observed between psoriasis and HDL efflux persisted after adjusting for traditional lipid levels and other traditional risk factors, including body mass index (BMI).

"Patients with psoriasis had an approximate 25 percent reduction in the HDL efflux capacity than the controls, despite their relatively normal overall lipid profiles which leads to the question of whether function is more important than concentration in chronic inflammatory states" Dr. Mehta noted.

The new findings may provide a critical clue to the link between psoriasis and heart disease, but the researchers say larger studies are needed to validate their findings.  Joel M. Gefland, MD, MSCE, assistant professor of Dermatology and Epidemiology, and a senior author on the studies, said "We've been able to show that psoriasis is an important risk factor for vascular disease, and now we may finally be able to identify and ultimately treat the pathways by which psoriasis increases these risks."

The work was a multidisciplinary collaboration between the Penn Medicine Cardiovascular Institute, the Division of Cardiovascular Medicine, Department of Dermatology, and the Division of Translational Medicine and Human Genetics.

Relating to someone with psoriasis

The more you know, the better you can both feel

When someone you know has psoriasis—especially if it's a close friend, coworker, spouse, or partner—the way you act can have an impact on how he or she feels. On the other hand, if you have psoriasis, understanding and acknowledging your feelings can help you relate to others. Sometimes, people believe that the easiest way to cope with something difficult is to ignore it, or act like it's not a big deal. But often, that may not be the best way to cope. There are other options.



Be a supportive partner

When you're with someone you care about, consider the following suggestions:
•Stay active yourself and help your partner or friend do the same.
•Try not to guess what your friend or loved one is thinking—always ask.
•Join or develop a support group to hear other people's stories about being close to someone with psoriasis.
•Listen to the person you care about, but don't push him or her to talk about it.
•Don't pass judgment about what lifestyle and medications are best for another person.
•Let the person you care about work out his or her feelings and decide how to live with psoriasis.


Tips for people with psoriasis

As you learn to live with your disease, you may find yourself feeling angry, embarrassed, or frustrated. Understanding and acknowledging these feelings can help you cope with your psoriasis and relate to others.

Here are a few tips to help you stay close to the people who are close to you.
•Try not to guess what your friend or loved one is thinking—always ask.
•Don't go it alone. Build a tight support system of people you can count on.
•Try to acknowledge the help you receive from others, and let them know you are grateful.
•Take advantage of psoriasis message boards
•Find a support group online and in your area.