You would never see this posted in the usa. Might be something for others around the world to look into.I know the esters work for some here.

Suzy



Effectively and without much effort: Ambulatory Phototherapy balneo

A brief assessment: Is Balneo phototherapy for the treatment of moderate to severe psoriasis

It is a century old experience: Certain climatic conditions
have a beneficial effect on chronic skin diseases. Stays at the Dead Sea, the North Sea or in the mountains are still very popular holiday destinations of human psoriasis. Hospitals in these areas use the therapeutic effect of the combination of swimming and natural ultraviolet radiation in sunlight. Other clinics, these conditions produced synthetically. More in PSO Magazine 6/11


----------------------------
Effectiveness and benefits of drugs

Systemic therapy with fumaric acid esters:
Historical development of a therapy for psoriasis

The therapy with fumaric acid esters in psoriasis has taken for medical science with a unique history. From a single observation was from an initially supported by only a few doctors wave of applications in psoriasis patients treated with preparations in pharmacies. The path to approval and the current state of Germany and a few other countries, licensed therapy describes Ulrich Mrowietz, Kiel, a member of the Scientific Advisory Board of the DPBS. More in PSO Magazine 6/11
----------------------
Full [/align]Webpage Translated from German to English below

==

The inclusion of balneotherapy phototherapy
in the service catalog of statutory
Health insurance is a major
Success for the dermatology dar. this very
particular form of treatment is a
exclusive power of Dermatologists in
Supply and the availability of psoriasis
to be welcomed.
During the period in which the Balneo phototherapy
was fought, the therapy
of moderate to severe psoriasis
however, experience a minor revolution.
The approval of biologics currently four
(Adalimumab, etanercept, and Infl iximab
Ustekinumab) as a "second-line" therapies *
has achieved considerable success of the therapy
conducted at the patients treated with
the conventional ways not
were adequately treated. The suitability
these new drugs for
continuous long-term therapy is
The new finding contrary to that psoriasis
Today, as a systemic disease
must be considered. Accordingly,
a long-term control of immunologically
mediated inflammation desirable
which not only the skin lesions **
effectively improved, but also some
Concomitant diseases (comorbidity) were positive
can they make will shape.
During this time, under
an intensive care research
also examined which factors in
Therapies related to stressful
are for patients. This could
are well represented, that for a
Therapy required time and effort
the number of doctor visits negative
Infl uence on the health-related quality of life
psoriatic patients have
can.
Thus, should the importance of balneotherapy
Phototherapy for the treatment medium
to severe psoriasis in the light of a
changed situation of the supply
ned redefined.
According to the Scientific Advisory Board
the German Federal psoriasis e.V.
suitable before the Balneo phototherapy
particularly for patients, the medical contraindications
for systemic therapy
and have the time and physically
are capable of the frequent gene treatments
perceive the doctor.
With a known, stable course of disease
Phototherapy may also balneotherapy
for the treatment of short bursts of
Psoriasis can be useful.
Fewer indicated (recommended) is the balneotherapy
Phototherapy for patients with a longer-term
Control of inflammation
Psoriasis, require as to the recommendations
the current S3 guideline
for the treatment of psoriasis long term
Treatment with UV light (maintenance therapy)
should not be performed.
In psoriasis patients, the successful under a
and acceptable treatment system
stand should be changed to
Balneotherapy, phototherapy does not occur.
Prof. Dr. Ulrich Mrowietz
For the Scientific Advisory Board of DPBS
* "Second line" therapy: A treatment may only
be used if other therapeutic
Options were used, not tolerated
are or are not used individually
can.
Skin lesions ** = diseased skin
A short positioning
Balneotherapy, phototherapy for the treatment of moderate to severe psoriasis
==

Background:  Severity assessment of patients with psoriasis is a critical issue. Classical clinical assessment has been recently combined with quality of life (QoL) scores, but a number of instruments are used. Moreover, studies have focus on patients with moderate to severe psoriasis.

Objectives:  To compare the characteristics of QoL instruments in patients with the full range of psoriasis severity attending dermatology clinics.

Methods:  Observational, prospective, multicentre study. Patients completed Skindex-29 (anchor) and a second instrument randomly selected from Dermatology Life Quality Index (DLQI), Psoriasis Disability Index (PDI), and Medical Outcome Study Short Form 36 (SF-36).

Results:  Demographic data, PASI and BSA were not different between the 3 groups. Skindex showed a weak but significant correlation with clinical severity; only PDI showed similar correlation. PDI, DLQI and SF-36 had substantial floor effect in patients with mild to severe psoriasis. Skindex showed strong correlations with the other 3 QoL instruments. SF-36 was more sensitive that the other instruments in detecting worse QoL in male patients.

Conclusion:  Skindex has better sensitivity to clinical severity with minimal floor effect, and cover the main domains explored by the other 3 QoL instruments in patients with mild to severe psoriasis.

Source: onlinelibrary.wiley.com

There are a lot of Psoriasis advice websites on the internet today. Some good, some bad, and some just want to rip you off for your money. But what do you think about the help and information websites that are run by the drug manufacturers? 

I’m not talking about their own sites which tell you about the company and the drugs they make, they are an important part of internet information and are needed.
I’m talking about websites that offer information and advice that give the impression of being independent, but when you look closely at them and dig a little deeper you find they are owned by drug manufacturers.

I’m not saying the information is wrong; In fact a lot of it is good. But would the manufacturer of say Humira recommend you use Dovonex on that information website?
Take for example the biological treatments. This is a huge market and Abbot, Amgen-Pfizer, Janssen , Johnson & Johnson, and Merck & Co are all in competition to promote their product as the best. 

I use Stelara which is manufactured by Janssen, and today I found out that psoriasis360 and livingwellwithpsoriasis are owned and run by Janssen!
I dug a little deeper and found the following

Quote:A Janssen Canada educational campaign around psoriasis goes a step further, offering a list of available treatments, and a dermatology locator that returns only those dermatologists who “agree that they will use biologics” – Janssen markets Stelara, an immunomodulating biologic – and who have voluntarily signed up to be listed on Janssen’s Living Well With Psoriasis website, according to Spilios Asimakopoulos, director of marketing technology, Janssen Pharmaceuticals Canada.

Anacor Pharmaceuticals (NASDAQ:ANAC) announced today positive preliminary results from two safety studies of AN2728 - a maximal use systemic exposure (MUSE) study in psoriatic patients and a local tolerability study. The results of these two studies demonstrate that AN2728 Ointment, 2% appears to be safe and well-tolerated when applied to very large body surface areas and that it is well-tolerated when applied to areas of sensitive skin. AN2728 has previously demonstrated safety and efficacy in multiple Phase 1 and 2 trials for mild-to-moderate psoriasis and most recently in a Phase 2a study in atopic dermatitis.

"These data confirm the safety of AN2728 and the potential for it to be used on areas of the body that are susceptible to side effects from steroids and tend to be sensitive to irritation from vitamin D analogs," said David Perry, CEO of Anacor Pharmaceuticals. "All of the clinical studies we have done to date on AN2728 in psoriasis and atopic dermatitis support that it could be a potentially safe and effective topical treatment for patients who suffer from mild-to-moderate psoriasis or atopic dermatitis."

AN2728 MUSE Study

The MUSE study was designed to obtain a full pharmacokinetic profile in psoriatic patients under Phase 3 maximal use conditions. The multi-center, open label study enrolled 33 patients with extensive psoriasis with a mean involvement of 38% of total body surface area. Patients applied AN2728 Ointment, 2% twice daily for eight days. No serious adverse events were reported and no subjects discontinued early from the study. Application of AN2728 Ointment, 2% on larger body surface areas resulted in higher plasma exposure levels but did not correlate with greater adverse events.

AN2728 Local Tolerability Study

The local tolerability study was designed to examine the potential irritancy of AN2728 Ointment, 2% when applied to sensitive skin areas such as the face, skin folds (groin, armpits), genitals, etc. This single-center, double-blind, vehicle-controlled study randomized 32 adult healthy volunteers (3:1) to receive AN2728 Ointment, 2% or Ointment vehicle. Subjects applied study drug as instructed twice daily for 21 days to sensitive skin areas. At each of seven visits, each tolerability parameter was graded on a scale of 0 (none) to 3 (severe) in intervals of 0.5. Overall, almost 99% of the nearly 8,700 tolerability measurements were scored as 0 (none). None of the treated anatomic areas appeared to be particularly sensitive to irritation by the study drug or vehicle. No serious adverse events were observed in the trial. Adverse events occurred at a low rate and were generally mild.

Updated Results from Phase 2a Study of AN2728 and AN2898 in Atopic Dermatitis

On December 12, 2011, Anacor announced preliminary results of a Phase 2a study of AN2728 and AN2898 in atopic dermatitis, a chronic rash characterized by inflammation and itching. The final audited data demonstrate a slight improvement in the AN2728 treatment group, while the results for AN2898 did not change. The primary endpoint for both compounds was successfully achieved after 28 days of twice-daily treatment. In the final analysis, 68% of AN2728-treated lesions showed greater improvement in Atopic Dermatitis Severity Index (ADSI) score versus 20% for vehicle (P = 0.02) and 71% of AN2898-treated lesions showed greater improvement in ADSI score versus 14% for vehicle (P = 0.01). There were no severe adverse events reported that were considered related to either study drug.

In addition, lesions treated with AN2728 showed a 66% mean improvement in ADSI score at day 28 compared to 39% mean improvement in ADSI score for lesions treated with vehicle (P < 0.01). Lesions treated with AN2898 showed a 68% mean improvement in ADSI score at day 28 compared to 45% mean improvement in ADSI score for lesions treated with vehicle (P = 0.02).

Finally, the proportion of lesions achieving total or partial clearance (ADSI score ≤ 2.0) at day 28 was 52% for lesions treated with AN2728 compared to 16% for lesions treated with vehicle and 48% for lesions treated with AN2898 compared to 33% for lesions treated with vehicle.

In this multicenter, randomized, double-blind, vehicle-controlled, bilateral comparison study, 46 patients with mild-to-moderate dermatitis were randomized (1:1) to receive either AN2728 Ointment, 2% vs. Ointment vehicle or AN2898 Ointment, 1% vs. Ointment vehicle, applied twice daily to two similar target lesions on the trunk or extremities for six weeks. Lesion severity was measured by the ADSI score which is the sum of the severity scores of five clinical features (erythema, pruritus, exudation, excoriation and lichenification) from 0 (none) to 3 (severe) for each feature, for a total score of 0 to 15.

AN2728 Regulatory Update

Anacor requested a Special Protocol Assessment (SPA) from the U.S. Food and Drug Administration (FDA) for the Phase 3 trial design of AN2728 in psoriasis and has reached concurrence on the major parameters of the Phase 3 trial design.

AN2728 Development Plan Update

Given the safety profile exhibited by AN2728 in 13 clinical studies, the positive outcome from the atopic dermatitis trial, and the large unmet medical need in atopic dermatitis relative to psoriasis, Anacor intends to focus its AN2728 development activities on atopic dermatitis in 2012 and will defer the start of the Phase 3 trial in psoriasis. Anacor will provide more specific information on these activities in a future communication.

Source: anacor.com

Results from a large study carried out in US women suggest that people with psoriasis have increased risk for venous thromboembolism (VTE).

"Recently there has been considerable interest in whether systemic inflammation is a risk factor for VTE, as inflammation is associated with a procoagulant state," explain Pamela Lutsey (University of Minnesota, Minneapolis) and colleagues in the Journal of Thrombosis and Haemostasis.

This interest extends to investigations into associations between VTE risk and medical conditions characterized by chronic systemic inflammation, such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease.

In the present study, Lutsey and team used data from the Iowa Women's Health Study to investigate whether psoriasis in particular is associated with an elevated risk for incident VTE.

The analysis included data from 38,608 women, aged a mean of 68.1 years at baseline, who were followed-up for a median of 11.3 years.

During the follow-up period, 859 (2.2%) women developed psoriasis. Women who developed psoriasis were more likely to be young, highly educated, be smokers, have higher body mass index (BMI), be diabetic, and be using hormone therapy than women who did not develop the condition.

There were 1825 VTE events recorded during the course of the study, 37 of which were preceded by a diagnosis of psoriasis.

Age-adjusted multivariate analysis showed that women who developed psoriasis had a 40% increased risk for VTE compared with those who did not. Additional adjustment for education, smoking status, BMI, diabetes, and hormone use attenuated the risk by just 1%.

The researchers say that their findings are in line with those of other recent studies, which have suggested that psoriasis is associated with an increased risk for VTE.

However, the current results extend previous work because they controlled for lifestyle and anthropometrics, and included outpatient psoriasis cases, they add.

Lutsey et al say that while their findings contribute to ongoing discussions about whether chronic systemic inflammation causes VTE, they are probably of little clinical impact.

"Given the modest hazard ratio and relatively low incidence of VTE, a diagnosis of psoriasis would not justify special VTE prevention," they write.

Furthermore, since individuals with moderate and severe psoriasis have an increased risk for atherosclerotic cardiovascular disease, they may already be targeted for cardiopreventive therapies, such as weight loss and statins, which may also lower VTE risk, the team concludes.

Source: medwire-news.md

Hi,
I was going to add a poll to a post but it doesn't work for me.
I see the add a poll checkbox,but no place to go further.
No biggie but wanted to let ya know.

Suzy

Hi there,grumpy gertie alias brigantia here.Have had a sunshine holiday in Lanzarote.I am sorry to say it did not do the trick and did not make it any better.I knew it would not take it away.But i thought it might ease it a little.It is still my head i am having bother with.Paid to see a specialist Dermatologist.He put me on Synalar for my head.I have never heard of that for years.I remember we used to use in for patients at the hospital i was a staff nurse in.But he sent a letter to my Dr to ask him to refer me to a hospital that gives you Light treatment.Only two here in the North East of England.Wot a bummer the waiting list is about two miles long.You cannot go private and you cannot buy one.So i guess i will just have to scratch my head like a mad women.I sent to the USA for some cream someone advisd on your site and wot a load of rubbish.I will not say the name of it so do not ask.Sorry about that

The Original Singing Detective is starting a Rerun tonight on BBC4 22:00 GMT.



The Singing Detective is a BBC television miniseries written by Dennis Potter, which stars Michael Gambon, and was directed by Jon Amiel. The six episodes were "Skin", "Heat", "Lovely Days", "Clues", "Pitter Patter" and "Who Done It".

The serial was broadcast in the United Kingdom on BBC1 in 1986 on Sunday nights at 8pm from 16 November to 21 December with later PBS and cable television showings in the United States. PBS at that time considered it too risqué to be shown in prime time, delaying its programming until 11pm.

Plot:
Mystery writer Philip E. Marlow is suffering writer's block and is hospitalised because of his psoriatic arthritis, and is at a chronic stage forming lesions and sores over his entire body, and partially cripples his hands and feet. As a result of constant pain, a fever caused by the condition, and his refusal to take medication, Marlow falls into a fantasy world involving his Chandleresque novel, The Singing Detective, an escapist adventure about a detective (also named "Philip Marlow") who sings at a dance hall and takes the jobs "the guys who don't sing" won't take. As well as its dark themes, the series is notable for its use of 1940s-era music, often incorporated into surreal musical numbers.

Dennis Potter suffered from psoriatic arthritis himself, and he wrote with a pen tied to his fist much in the same fashion Marlow does in the last episode.

Went to the rheum Tuesday,

My skin has cracks in it ...which has happened for years.. He said I could get a bacterial infection. If anyone has had that occur would they please, time permitting, send me a PM.

I am curious to know more besides a web article. I did not like seeing the list of co-occuring things for P and PA on the Webex from NPO. It is hard enough to accept the skin condition, I dislike the word disease....In my ignorance, I like to believe a disease is something you catch.

I am not subscribing or being hypervigilant about waiting for all the possible health conditions that I might get. If I chose to catastrophize I would never leave the house and be agoraphobic.

Happy hour isn't soon enough.
Fred not sure where this goes and not savvy with website navigatgion.

Background: 
Scratching an itch is perceived as being pleasurable. However, an analysis of topographical variations in itch intensity, the effectiveness of scratching to provide itch relief and the associated pleasurability has not been performed at different body sites.

Objective: 
To examine the role of scratching pleasurability in providing itch relief by investigating whether itch intensity is perceived differently at 3 different sites and to assess a potential correlation between the pleasurability and itch attenuation induced by scratching.

Methods: 
Itch was induced on the forearm, ankle and back using cowhage spicules in eighteen healthy subjects. These sites were subsequently scratched by an investigator with a cytology brush immediately following itch induction. The intensity of itch with and without scratching at these sites and the pleasurability of scratching were recorded by taking VAS ratings at 30 seconds intervals.

Results: 
Average itch intensity and scratching pleasurability ratings at the ankle and back were significantly higher than on the forearm. For the forearm and ankle, the higher the itch while scratching, the higher was the pleasurability. A higher baseline itch was linked to a higher itch reduction secondary to scratching in all tested areas. Pleasurability paralleled the curve of itch reduction for the back and forearm, however scratching pleasurability at the ankle remained elevated and only slightly decreased while itch was diminishing.

Conclusions: 
There are topographical differences in itch intensity, the effectiveness of scratching in relieving itch and the associated pleasurability. Experimental itch induced by cowhage was more intensely perceived at the ankle, while scratching attenuated itch most effectively on the back.

The new findings may explain why patients with eczema and psoriasis commonly have itching on their back and ankle. "We never understood why those areas were more affected, and now we better understand that itch in these areas is more intense and pleasurable to scratch," Yosipovitch said.

The reason for difference in itching pleasurable may lie in the way that sensory nerves are distributed throughout the body, the researchers say. The findings may have implications for itch treatment. "If we could translate this to a treatment that induces a pleasurable relief sensation without damaging the skin, we may be able to help itchy patients," he said.

Source: onlinelibrary.wiley.com

Background: 
Patients with psoriasis who had raised IgG and/or IgA antigliadin antibodies showed clinical improvement in a trial with a gluten-free diet. The selection of patients for the diet treatment was based on the presence of specific antibodies, i.e. the result of humoral immunity.

Objectives: 
As psoriasis is now considered to be a T cell-mediated disease we decided to challenge peripheral blood mononuclear cells (PBMCs) in vitro from randomly selected patients with well-defined wheat proteins/peptides to explore the possibility of identifying a specific antigen with T cell activating properties in a subgroup of patients.

Methods: 
PBMCs from 37 patients (20 female and 17 male; mean age 49 years) and 37 healthy controls (12 female and 25 male; mean age 57 years) were included. Not all patients participated in all experiments. The PBMCs were exposed in vitro with the following wheat proteins/peptides in various concentrations: total albumins, 0·28 α-amylase inhibitor and the synthetic peptides, p31–43, p57–68 and p62–75, based on coeliac-active sequences of α-gliadin. The proliferative response was measured as counts per minute after the cells had been pulsed with methyl-3H-thymidine.

Result:  Albumin, α-amylase inhibitor, p31–43 and p57–68 elicited a significant response in both patients and controls but showed no differences between the groups. The response induced by the α-amylase inhibitor was higher than that induced by the albumin fraction and the p31–43 and p57–68 peptides. At a concentration of 25 μg mL−1, five of 36 patients with psoriasis responded positively to the p62–75 peptide and none of the 33 controls, using a stimulation index of 2·4 as the cut-off level (P < 0·05). These five patients did not show clinical features that differed from the remaining patients. Among the responding patients the relative number of CD4+ cells increased in some but not all after in vitro challenge with the albumins, 0·28 α-amylase inhibitor, and p62–75. These antigens could also induce in vitro the expression of the homing antigen cutaneous lymphocyte antigen (CLA) in a few patients and controls.

Conclusions:  The wheat protein antigens, especially the p62–75 peptide, might be of interest in a subgroup of patients with psoriasis.

Source: British Journal of Dermatology onlinelibrary.wiley.com

Researchers at Linköping University are launching a plan to effectively treat psoriasis.

An important component is the psoriasin protein (S100A7), which are abundant in psoriasis-affected skin but rarely in normal skin. The same protein is also assumed to be a factor in the development of breast cancer. The research team, led by associate professor Charlotta Enerbäck, have now illustrated that, in a study on cultured skin cells, the interaction between psoriasin, oxygen free radicals and vascular endothelial growth factors (VEGF) leads to significantly increased cell division and growth of new blood vessels (angiogenesis). When we blocked the formation of psoriasin, the expression of VEGF also decreased.

“We want to examine the ability of psoriasin as a target for therapy. By inhibiting psoriasin, we believe we can reduce vascular formation and thus the proliferation of the disease’s magnitude and intensity,” says Charlotta Enerbäck.

Previous studies in mice have shown that angiogenesis inhibitors reduce not only neovascularization but also inflammation and excessive cell division. Attempts to inhibit the growth factor VEGF have resulted in unwanted side effects because it exists in normal tissue where it contributes to wound healing.

“Since psoriasin expresses itself specifically only in the diseased psoriatic skin, we expect that inhibitors against this are highly selective and effective against the disease, and that the risk for side effects is minimal,” says Charlotta Enerbäck.

Presently, palliative treatments with vitamin D, cortisone, light and low doses of chemotherapy are used. More recently, some "biological", antibody-based drugs arrived on the market, however they are very expensive and not free from side effects.

Source: liu.se

Variants in a disintegrin and metalloproteinase 33 gene (ADAM33) are associated with psoriasis in Han Chinese people, suggest study results.

Many previous studies have isolated variants on several genes, such as the interleukin 23 receptor gene, that are significantly associated with psoriasis.

"However, the combined effect of certain susceptibility loci cannot entirely account for the observed genetic predispositions to psoriasis, suggesting that psoriasis susceptibility is largely polygenic," write Yuzhen Li (Harbin Medical University, Heilongjiang, China) and colleagues in Dermatology.

Variants in ADAM33 have been linked to several immune-mediated disorders including asthma.

To test whether mutations in ADAM33 are also associated with psoriasis, Li and team recruited 400 Han Chinese patients with psoriasis and 398 controls without the condition to take part in their study.

The participants were genotyped for six single nucleotide polymorphisms (SNPs), rs2787094, rs512625, rs528557, rs597980, rs612709, and rs677044, in ADAM33 that have been putatively linked with psoriasis susceptibility in European and American populations.

As reported in Dermatology, the team found that C allele carriers (CC and CG genotypes) of the rs2787094 and rs528557 SNPs had increased risk for psoriasis compared with GG homozygotes.

The strongest association was for people with the CC genotype of rs2787094 who had a significant 2.54-fold increased risk for psoriasis compared with people with the AA genotype.

Of twelve haplotypes constructed from each patient's genotype for the six SNPs, three (H1, H3, and H5) were observed significantly more often in psoriasis patients versus controls and were therefore associated with an increased risk for the condition.

Li and team also found that people with the AA genotype for rs512625 and A-allele carriers (AA and GA genotypes) of the rs612709 SNP seemed to be protected against psoriasis. Haplotype H8 also showed evidence of being protective against the disease.

The strongest protective effect associated with an individual SNP genotype was for the rs612709 AA genotype which reduced risk for psoriasis by a significant 41%.

"This study suggests an association between ADAM33 gene polymorphisms and psoriasis in the northeastern Chinese Han population, providing new information regarding diagnosis and therapeutic strategies for psoriasis," say Li et al.

"Further association and functional studies of additional ADAM33 SNPs and other genes are required in diverse ethnic large-sample populations to identify the genetic factors associated with psoriasis," they conclude.

Source: medwire-news.md

Treating psoriasis patients earlier in life could help prevent later physical and psychological problems, according to Dr. Alexa B. Kimball.

"We used to think that we should save our therapies until our patients really needed them, because we were afraid that toxicity might accumulate," Dr. Kimball said at the annual Caribbean Dermatology Symposium. However, that thinking has changed, thanks in part to the availability of safer treatment options.

But of equal importance, "treating patients early in their disease may have an impact that affects the rest of their lives," including jobs, education, socioeconomic status, and curbing the development of health problems like obesity, cardiovascular disease, and psychiatric disorders, she said.

The quality of life issues associated with psoriasis are well known, but recent data confirm that physical and mental comorbidities start in childhood.

According to recent data from the National Psoriasis Foundation, 38% of children with psoriasis reported being bullied because of their condition, noted Dr. Kimball of Massachusetts General Hospital and Harvard Medical School, both in Boston.

Another study found that approximately one-third of children aged 4-17 years with psoriasis had a body mass index greater than the 95th percentile Conditions such as childhood obesity are not easily managed, and have significant implications for future health, she said.

In a retrospective study of 7,404 psoriasis patients younger than 18 years and 37,020 healthy controls, children with psoriasis were significantly more likely than controls to develop any psychiatric disorder (5% vs. 4%), depression (3% vs. 2%), and anxiety (2% vs. 1%), Dr. Kimball and her colleagues found.

And the likelihood of comorbidities in psoriasis patients continues as they grow up, she said. "Chronic disease interacts with psychosocial and health events in a complex and ongoing manner throughout a person’s life."

Comorbidities in psoriasis patients appear to accumulate over time. Dr. Kimball cited data from the Nurses’ Health Study II, a cohort including more than 100,000 women who were aged 27-44 years in 1991. In a subset of 1,813 women with psoriasis, the risk of diabetes was approximately 60% higher, and the risk of hypertension was almost 20% higher, compared with women without psoriasis.

In a case-control study conducted by Dr. Kimball and her colleagues, cardiovascular disease, diabetes, depression, hyperlipidemia, hypertension, and obesity all increased significantly in psoriasis patients, compared with healthy controls, over a 4-year follow-up period.

These findings suggest that medical comorbidities associated with psoriasis accumulate over time; therefore, aggressive treatment of psoriasis in younger patients could improve their psychological and physical quality of life, Dr. Kimball said. Although there are no recommendations for additional health screening for psoriasis patients beyond the age-recommended preventive health measures, "younger patients especially need to be monitored for psychiatric issues," she said. And these patients should be kept up to date on vaccinations, particularly the annual flu vaccine and the human papillomavirus vaccine.

Source: familypracticenews.com

Some people are having problems receiving E-Mails from Psoriasis Club.

The emails are sent for account activation, new post notifications, PM notifications, Important announcements, Etc.

Please make sure you check your Spam Folder to see if there are any messages from Psoriasis Club, and mark them as not spam. Also make sure you have the relevant box's ticked in your User CP > Edit Options.

Any problems let me know.

Malignancy rates in psoriasis patients treated with Stelara (ustekinumab) did not increase significantly over 4 years of follow-up, based on pooled data from 3,117 patients enrolled in ustekinumab clinical trials.

Ustekinumab has shown effectiveness for treating moderate to severe psoriasis, but due to the potential of increased risk for cancer associated with its use, patients from several clinical trials (including PHOENIX I, PHOENIX II, and ACCEPT) are still being followed, said Dr. Kim A. Papp, director of research at Probity Medical Research, Waterloo, Ont., and colleagues.

The cumulative rates for nonmelanoma skin cancer in patients treated with ustekinumab for psoriasis remained low and stable throughout the follow-up period. A total of 0.57 cancer events per 100 person-years were reported in 2009 and 0.62 cancer events per 100 person-years were reported in 2010. The findings were presented at the annual Caribbean Dermatology Symposium.

In the complete analysis that included 6,791 patient-years of follow-up, 41 patients treated with any dose of ustekinumab developed at least one nonmelanoma skin cancer, and 3 patients developed both basal cell carcinoma and squamous cell carcinoma.

Another 42 patients developed at least one other malignancy, including 4 patients with melanoma in situ. However, no cases of invasive melanoma were observed during the study period. The other most common malignancies were prostate cancer (12 patients), colorectal cancer (4 patients) and breast cancer (3 patients).

By comparison, 39 individuals in the general population (based on the National Cancer Institute’s Surveillance, Epidemiology, and End Results database) developed at least one malignancy.

The findings were limited by the inclusion of several studies of varying lengths and by the inclusion criteria that can make comparison with the general population difficult, the researchers noted. The results suggest that rates of nonmelanoma skin cancer and other malignancies in psoriasis patients taking ustekinumab do not increase over time.

However, "additional long term data from clinical trials, observational registries, and postmarketing reporting databases will continue to define the ustekinumab malignancy risk profile," they wrote.

Source: skinandallergynews.com

Well, I have now been on the MTX now for almost 5 month's and so far it's not going badly at all.
For the majority of my scaled patches, the treatment is doing a pretty good job, but on a couple of small patches it is not performing quite so well.
Don't get me wrong, it is working, but not as effectively as some other area's.
I recently went back for a Consultant check at the hospital, I was told that I could increase the dose to 12.5 or 15mg, but I chose to stay on the current dosage, simply because I am not getting any side effects at all.
I have also stopped smoking within the last 2 weeks, but whether this benefits me treatment wise, I have yet to find out.
To summarise: The treatment all seems to be going well with no apparent side effects, so Happy days.
Hope this helps, any queeries just ask or PM.
Regards to all
Micky

My name is Sarah. I was diagnosis with plaque psoriasis in 1991 when I was 12 years old.

Genentech Inc. is facing the first trial of patients’ claims that its withdrawn Raptiva psoriasis drug spawned fatal infections in some users.

Officials of Genentech, a unit of Basel, Switzerland-based drugmaker Roche, are readying for a Jan. 30 jury trial in state court in California over allegations that Raptiva caused Stephen Johnson’s death. The 46-year-old Louisiana businessman took the drug to treat a skin condition. Genentech withdrew the medication from the market almost three years ago after it was linked to fatal brain infections.

“Psoriasis isn’t life-threatening and his wasn’t even that horrible,” Mark Lanier, a lawyer for Johnson’s family, said in an interview. “This drug was never about the patients. This drug was about the money.”

Genentech, based in South San Francisco, California, began withdrawing Raptiva from U.S. and European markets in April 2009 after three psoriasis patients were diagnosed with progressive multifocal leukoencephalopathy, or PML, a rare, incurable brain infection. The month before the withdrawal, Roche completed a $46.8 billion buyout of the biotech company.

Nadine O’Campo, a Genentech spokeswoman, declined to comment on the upcoming Raptiva trial. “Given this litigation is ongoing, we are not commenting,” she said in an e-mailed statement.

Psoriasis is a disease that leaves sufferers dealing with red, itchy skin lesions, lawyers for Johnson’s family said in court filings. Johnson had taken the drug for almost five years before his death in January 2009, the filings show.

Damages Sought
Genentech officials estimated in 2009 about 2,000 U.S. patients were taking the drug when the company began pulling it from shelves. The medication, which generated $108 million in sales in 2008, had been used by an estimated 46,000 patients worldwide. The psoriasis treatment was approved for sale by the U.S. Food and Drug Administration in 2003.

Johnson’s case is the first of about 100 Raptiva suits that have been consolidated before Judge Steven Brick in state court in Oakland, California. Lanier said there are other cases in federal and state courts in Texas and Massachusetts.

The family is seeking $15 million in compensatory damages over Johnson’s death along with “several hundred million dollars” in punitive damages, Lanier said.

Weakened Immune System
Johnson’s wife contends the businessman, who owned a medical-supply store in a suburb of New Orleans, was healthy when he started taking Raptiva to treat his psoriasis and the drug weakened his immune system to the point that he developed a fatal infection.

Doctors at an emergency room in Kenner, Louisiana, noted that Johnson’s death was likely caused by “overwhelming sepsis complicated by the fact that patient was relatively immunosuppressed from his Raptiva,” according to a Jan. 5 court filing.

Lanier and other lawyers for former Raptiva patients contend in the cases that Genentech officials downplayed the medication’s health risks and failed to alert regulators about a patient’s death in 2004 from the same kind of infection that claimed Johnson’s life five years later.

To boost the drug’s prospects, Genentech officials hired an FDA regulator who was responsible for with monitoring Raptiva’s development and discussed “paying the official up to $30,000 to buyout out his contract,” Susanne Scovern, another lawyer representing Johnson’s family, said in a court filing.

The former FDA official, Dr. William Schwieterman (CHTP), later left Genentech and now serves as a consultant to biotech and pharmaceutical makers, Scovern said in an interview.

The biotech company also failed to disclose an internal 2007 analysis that found Raptiva users were five times as likely to get types of pneumonia infections as the general population, Scovern said in the filing.

The case is Johnson v. Genentech Inc., RG 10-494957, California Superior Court, Alameda County (Oakland).

Source: bloomberg.com

Introduction.  Psoriasis is associated with systemic metabolic and cardiovascular disorders, both of which share risk factors with erectile dysfunction (ED). However, few studies have investigated the association between ED and psoriasis.

Aim.  This study set out to estimate the association between ED and having previously been diagnosed with psoriasis by using a population-based dataset with a case-control design.

Methods.  This study used administrative claim data from the Taiwan National Health Insurance program. We identified 4,606 patients with ED as the study group and randomly selected 13,818 patients as the comparison group. Conditional logistic regression was used to examine the association between ED and having previously received a diagnosis of psoriasis.

Results.  Of the sampled patients, 136 (0.7%) had been diagnosed with psoriasis before the index date: 77 (1.7% of the cases) were from the study group and 59 (0.4% of controls) were from the control group. Conditional logistic regression analysis revealed that after adjusting for the patient's monthly income, geographic location, hypertension, diabetes, hyperlipidemia, coronary heart disease, obesity, and alcohol abuse/alcohol dependence syndrome status, patients with ED were more likely to have been diagnosed with psoriasis before the index date than controls (odds ratio = 3.85; 95% confidence interval = 2.72–5.44).

Conclusion. This study revealed an association between ED and prior psoriasis even after adjusting for potential confounding factors. The results of this study highlight a need for clinicians dealing with psoriasis patients to be alert to the possible development of ED.

Source: onlinelibrary.wiley.com