Hey friends, just signed up for the club. Not the happiest thing I've ever done, but it seems there is so much support and knowledge on this site. I've had P for about a year now. Steadily getting worse and worse. It is causing a good amount of stress in addition to the normal everyday stress of studying wars, climate change, ecological collapse, mass extinction, ect... Can'twait to get to know yall more and hopefully I'll be a positive addition to the community. Stay frosty my friends!   

 

so just recently got the diagnosis- 66 years old newly retired Registered Nurse now with flaking scalp & some inverse psoriasis- now my toenails are showing some major issues- had my thyroid removed for cancer about 5 years ago- endocrinologist super conservative- advised me not to take Biotin & limit my intake of Vit D- says it binds to the Synthroid & is crazy about increasing my dose- I can't lose weight and am feel so down - Dermatologist wanted to start me on Taltz but now being on Medicare I have a part D (pharmacy) plan that is not great with coverage- will cost me over $3,000.00 out of pocket- too expensive & don't qualify for the patient assistance program- wanted to see if anyone has had good results from dietary restrictions and supplements 

Thanks all 

Hi I'm curious to hear if anyone else has had the same experience as I have

I was on Fumaderm tablets through the UK national health service ....this was a drug that was not approved by NICE and was prescribed by dermatology departments at their discretion.
I was on Fumaderm for over six years with never a sign of the psoriasis emerging apart from a very small patch (to remind me to take the tablets )
However around six months ago the dermatologist switched me to Skilarence which was not a worry to me as it was basically the same drug. However since transfering I have noticed the psoriasis slowly returning to my scalp to the extent that I now use a topical to reduce the scales when I need a haircut

I was wondering if others have been switched as I have from Fumaderm to Skilarence and what their experience is

Probably not going to get many if any answers, but has anyone tried both Taltz and Cosentyx ?

We have a lot of threads on both, but I'm interested in those that have tried both. Also preferable those that have psoriatic arthritis.

I'm thinking of going for the switch from Cosentyx to Taltz so on the off chance I thought why not ask here first.

Anyone used both ?

This abstract concludes: We need more un‐biased and well‐designed studies to improve our diagnostic procedure in inflammatory skin diseases. In the future, diagnostic decision‐making will most likely be guided by artificial intelligence‐driven image analysis as well as by molecular diagnostics.

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Abstract:

Therapeutic developments have profoundly changed our understanding of the pathogenesis of inflammatory skin diseases, and with it our treatment aims. In particular, the newest generation of biologics in psoriasis, namely antibodies targeting either the IL‐17 or the IL‐23 signalling cascade, comes with a good chance to relieve the patient completely from disease symptoms. However, diagnostic tools have not been co‐developed with these therapeutic options, and our disease classification is partially old‐fashioned and cuts off numerous patients from access to these new therapeutic options. Furthermore, it is currently impossible to predict which patients benefit from a given therapy as well as to stratify patients according to their risk to develop aggravating disease and/or comorbidity.

These facts demand progress in the field of inflammatory skin diseases. First, a modern classification of inflammatory skin diseases that is based on molecular events and with it immune response patterns is needed and second, objective biomarkers that improve our diagnostic power have to be identified. Such biomarkers can improve diagnostics, mirror disease severity,4 stratify patients according to the risk of aggravating disease course or developing comorbidities or predict therapeutic response. Numerous efforts are currently undertaken to assess the quantity of target biomarkers in serum or skin. In parallel, the potential of specific genotypes to stratify patients is investigated.

In a landmark paper published in this issue of the JEADV, Vugt and colleagues demonstrated that therapeutic response to IL‐17 inhibitors is not associated with genetic variation in the IL‐17 gene region. Even though reporting negative data, this study underlines how important well‐designed multi‐centre approaches are to prove hypothesized biomarkers. As it is straight forward to investigate the target region itself for the potential to predict therapeutic response, it is also promising. In the field of melanoma and checkpoint inhibitors, levels of PDL‐1 in tissue have been proposed to stratify response to PD‐1 antagonists as they predict overall survival in combination with the quantity of tumour‐infiltrating lymphocytes. Furthermore, while parallel studies confirm there is no association of IL‐17 genetic variants with response to IL‐17 there is also evidence that the genotype predicts therapeutic response in psoriasis. Namely, the PSORT registry recently published that polymorphisms in HLA‐cw6 are associated with therapeutic response to ustekinumab as compared to TNF inhibitors.

The study of Vugt and colleagues also illustrates how difficult it is to identify reliable biomarkers of therapeutic response. Beyond the detection method (nucleic acids or protein in serum or skin versus genotype), choosing the optimal readout is challenging. This refers both to the time point and to the chosen endpoint – is 24 weeks long enough to determine therapeutic response? Is it primary or secondary non‐responders that are more interesting to investigate? Is skin severity/PASI the ideal readout or should it be a patient‐related outcome or rather an indicator of inflammation/comorbidity?

This is why we need more un‐biased and well‐designed studies to improve our diagnostic procedure in inflammatory skin diseases. In the future, diagnostic decision‐making will most likely be guided by artificial intelligence‐driven image analysis as well as by molecular diagnostics. The latter will determine (a combination of) biomarkers ranging from genotype over serum factors to cutaneous determinants. With time, assessment of such objective biomarkers will become more and more easy and minimally invasive. The future starts now, and it will result in true precision medicine in inflammatory skin diseases.

This study evaluated the effects of patient demographic and disease characteristics on Ilumya / Ilumetri (tildrakizumab) efficacy using phase 2b/3 trial data.

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Background:
Tildrakizumab is a high‐affinity, anti–interleukin‐23p19 monoclonal antibody approved for treatment of moderate to severe plaque psoriasis.

Objectives:
To evaluate the effects of patient demographic and disease characteristics on tildrakizumab efficacy using phase 2b/3 trial data.

Methods:
Data from patients who received placebo, or tildrakizumab 100 or 200 mg, in P05495 [NCT01225731], reSURFACE 1 [NCT01722331] and reSURFACE 2 [NCT01729754] were analysed. Patient subgroups were defined by age, sex, race, weight, self‐reported psoriatic arthritis, failure of ≥1 traditional systemic treatment, and prior biologic use. Percentage of Psoriasis Area and Severity Index (PASI) 75 and 90 responders at Week 12 were compared across treatment arms in each subgroup. Absolute PASI at Weeks 0 and 12 were also determined for each subgroup.

Results:
Among patients randomised in P05495 (N = 355), reSURFACE 1 (N = 772) and 2 (N = 1090), percentage of PASI 75 and 90 responders were significantly greater for each tildrakizumab dose vs. placebo (P<0.0001). PASI 75 and 90 responder percentages were numerically greater in patients <65 years of age, body weight ≤90 kg, without psoriatic arthritis, and with no prior biologic exposure (only PASI 90), vs. their counterparts in corresponding subgroups. There were no clear or consistent differences in efficacy between the other subgroups. Absolute PASI scores were generally similar across subgroups.

Conclusions:
Small numerical differences in tildrakizumab efficacy were observed between subgroups defined by patient age and weight, presence of psoriatic arthritis, and prior biologic use. These differences were not clinically meaningful; however, analyses of long‐term data may be of value. Tildrakizumab efficacy did not differ with respect to patient sex or race, or number of prior failed conventional systemic treatments. Overall, these results suggest tildrakizumab may be appropriate for treatment of moderate to severe plaque psoriasis in patients with a range of demographic and disease characteristics.

This study suggests Taltz (Ixekizumab) may help to improve the well-being of patients with genital psoriasis (GenPs)

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Background:
Epithelial surface disruption in genital psoriatic lesions may manifest as erosions, fissures and/or ulcers, causing pain and significantly impacting a patient’s sexual health.

Objective:
To evaluate the impact of erosions, fissures and/or ulcers in genital psoriatic lesions on pain and sexual activity in patients with moderate‐to‐severe genital psoriasis (GenPs) and treatment responses to ixekizumab versus placebo until Week 12.

Methods:
This post‐hoc subgroup analysis of patients presenting with and without erosions, fissures and/or ulcers in genital lesions from a phase IIIb multicentre, randomised, double‐blind, placebo‐controlled study (IXORA‐Q; NCT02718898) in 149 adults with moderate‐to‐severe GenPs treated with subcutaneous ixekizumab (80 mg every 2 weeks; n = 75) or placebo (n = 74) evaluated outcomes for clinician‐rated GenPs severity (static Physician’s Global Assessment of Genitalia; sPGA‐G) and patient‐reported genital pain and itch (Genital Psoriasis Symptoms Scale; GPSS) and sexual health (Genital Psoriasis Sexual Frequency Questionnaire; GenPs‐SFQ).

Results:
At baseline, 38% (n = 57) of patients presented with genital erosions, fissures and/or ulcers independent of overall body surface area involvement (<10% or ≥10%). These signs were associated with higher scores for disease severity (sPGA‐G) and pain (GPSS) but not sexual health (GenPs‐SFQ). Complete resolution of these signs was observed in 62% of ixekizumab‐treated patients (25% for placebo) at Week 1 and 83% (21% for placebo) at Week 12. Patients treated with ixekizumab reported significant improvements in pain, itch, disease severity and sexual health over 12 weeks compared to placebo and irrespective of the presence/absence of genital erosions, fissures and/or ulcers at baseline.

Conclusion:
Ixekizumab led to rapid and sustained resolution of erosions, fissures and/or ulcers and significant improvements in GenPs severity, genital pain and sexual health. Ixekizumab may help to improve the well‐being of patients with GenPs.

So, this thread is for everybody who wants to follow my new journey with trying to heal psoriasis through diet and supplements. Also for myself; to follow my progress.
After failing on both Humira ( depression, a much reported side-effect ) and Stelara ( floored for a week per month with heavy flu symptoms, not to mention recuperation time )

on the 22th of july 2019 I began leaving out nightshade foods ( tomato, peppers and potatoes ) and gluten ( grains, pasta ).
But I did eat a lot of ricecakes, nuts and seeds )  
This is the Pagano diet; Healing Psoriasis the natural way. Supplements; slippery elm bark tea and Safflower Petal tea.

Lost weight quickly but the psoriasis didn't subside; it just got worse.

on the 25 of september 2019 I've started doing the AIP Paleo diet. That's like Paleo only stricter. All the known allergens are left out ( tho shellfish is allowed ) 
no seeds
no nuts
( no glory )
no nightshades, grains or oils based on seeds and nuts )
Anyway, you can easily look this up. Heaven knows I did just that bordering obsession   

took a standard probiotic, stopped the Slippery Elm but still continuing the Safflower Petal tea. Slippery Elm is supposed to create a muceous barrier on your intestinal walls. The AIP Paleo diet says no to this. 
Other supplements; some Vitamine D, Fish oil capsules and digestive enzymes.

AIP Paleo is all about not letting food particles ( those on the no list ) not slip into your bloodstream. The idea is that you eliminate those foods as it is said that the intestinal walls of a person with a autoimmune disease are compromised. Or you can call it Leaky Gut, or hightnened permeability of the intestinal walls.

This is all in what is called the 'elimination stage'  after which some foods can be reintroduced slowly and properly monitored. I have no idea how to do that yet, because symptoms are not immediately like in painfull autoimmune diseases like Psoriais Arthritis and such. 
In the USA such diets are already being prescribed, albeit slowly and science is only just taking this more seriously.



Also, alcohol is not allowed in the 'elimination stage'  
This was a hard one for me but I've managed not to drink since the first of January this year. And boy do I looooove my wine and cider.

So basically you could say I've begun this journey in earnest as of the first day of 2020.

I'm now down 9,5 kilo, which is nice.

As of today I'm taking an exta supplement; the probiotic Bacillus Coagulens. I read some interesting scientific reports on 'rheumathoid arthritis and this probiotic, where the results reported where mentioned as "borderline statistically improvement" Apparantly it takes care of harmfull intestinal bacterial growth and because it's spore forming will survive stomach acid and manages to do it's magic in your intestines.

Did I mention I lost weight?   Not that I was much overweight but occurance and severity of psoriasis is higher in overweight people, I've read in my googling.

P scale; not so good yet. Daily showering, steel wire brush and calcipotriol salve to ease the scaliing.

Anyway, this is the first post, let me know if there are any questions and I'll update here when I get a chance.

Hi everyone
My son (who is 16) was diagnosed with psoriasis over a year ago. After finding our way through many doctors we have finally found a dermatologist that has started him on Stelara. First does was on November 16th and his next injection is scheduled for December 14th.
No sign of immediate improvement as of yet. Scalp is flaking very badly and making it difficult for him to attend school. We struggle with the emotional issues that psoriasis can cause, especially when you are a teenager.

Time for another experiment. I have had a plaque on my right knee in some form for at least 25 years. I would treat it with topical and cover it in band aids, but I invariably develop an irritation to the band aid adhesive before the thing heals. After reading a bit of research relating to b vitamins and psoriasis, I thought I'd try a 5mg a day folic acid supplement along with a b complex supplement. This did bugger all, but a little more reading alerted me to a 1963 paper by some British researchers who claimed a 75% positive response (not sure what they mean) to subcutaneous b12 injections directly into plaques.

I don't have b12 for injections, but I do have injectable b12/folic acid (500micrograms/15mg per ml) and sterile insulin syringes suitable for subcutaneous injections. I have been injecting the plaque on my knee daily since Saturday (30/11/2019), initially with 0.075ml, and 0.15ml from Sunday. Below is an image I took of my knee at the start of treatment.



The response has been positive and quite rapid. I will post an updated pic tomorrow as I want to use natural light.

Cheers

Saw a lovely Dermatologist today. Managed to see him privately though he told he I need to get into the NHS system for dermatology at my local hospital. Anyway he was talking about different ways of trying to manage my psoriasis - topical, injections and oral. He said injections wouldn’t help and then said oral would but comes with a lot of side affects. To be honest, I’m not bothered about the side affects at the moment. Just wondering what oral medication anyone is taking and if it’s been successful or if the side affects have been awful - I’m happy to have good and/or bad stories!  My psoriasis gets so sore due to friction from my clothes plus I have them in all the crevices in the body! I’ve got to wait for a letter from him, then I need to go and see my GP to get referred into the system and I go back and see the chap I saw today on 27/1/20 with my research done and ideas of how I want to move on. After 15 years of suffering today has been the first day where I’ve felt someone may be able to give me help and hope!

hi andrews from india

Hello All .... fellow psoriasis sufferer here … have had it since a teenager – now late forties and it has decided to go crazy  ……..got pityriasis rosea in April which really assisted in kicking things south …

went to a dermatologist who is proposing Skilarence – but not too sure I’ll be up for the side effects ive read so doing the usual and trying every other thing else ...
 
ie this month I’m off wheat / taking iodine drops and Astaxanthin ……………………you have to do something ---
Hello .

Hi everyone,

I've posted before on using fumeric acid esters(fumaderm and skilarence) before. I've had great success with these over the last number of years, however they have stopped working 

Seen my derm last week and I've been put on stelera. Nurse is due to call today to help me with my first dose. I'll try to keep this post updated so you can follow the effects 

Let's hope it's as successful as fumaderm was to begin 

Hello everyone I hope you are all well as can be and had a lovely summertime.   Today at dermatology appointment I was told my treatment is changing because the cosentyx has stopped being as effective after almost three years.   I am due to start stelara in a month or so.  I was told a nurse will come to my home to administer my injection every time! With cosentyx this only happened on the first occasion so I’m a little confused at this.   Anyway I’m looking forward to possibility of having clear skin once more.  I also thought stelara was an older biologic but I guess the dr has good reason for making that choice.   I would be interested to hear how others have done with the same switch in treatment too, along with side effects.  I’m concerned about any potential weight gain as I’m no lightweight but I did lose weight when I started cosentyx.  This is important to me because I have reduced mobility and find exercise more difficult.    Other news is we moved house a few months ago into a bungalow and it was very stressful so I think it probably had an effect on my psoriasis.   Thanks for reading !

I started Amgevita (Adalimumab) 4 weeks ago. All the tablet treatments upset my tummy. No side effects as yet other than feeling a little lightheaded on a very few occasions (lasts seconds)
They are free filled injection pens. Brilliant. I feel nothing. It says to nip the injection site skin together, or stretch out. Now when I had to give my wife injections, I was told not to nip the skin. She said it stressed the skin or something, causing bruising.  So I looked up why they nip skin and its to it absorbs in the fat slower. Stretching the skin does the opposite, so I don't get it.
It also says to inject the belly or top of legs. WHY. Yes, the belly is full of fat but not the upper legs?

Hello everybody ,

Today , friday 8th November i have received the first shot ( 45 mg ) of Stelara.
All made in hospital where a kind nurse showed me how to do the injection ( made on the belly ).
More easy than i expected.
My derm explained me all about that Bio drug including possible side effects.
After some hours all ok.
Let's hope that everything will be ok.

Fingers crossed !!

Hi everybody,

Joined the group several years ago. Talked about some of my problems but that is still hard to do. But the website means a lot to me although I m not responding a lot. I hope you will understand.

I have had DMF, light therapy and MTX the past few years and am now progressing to the biologicals. I read Maryam's journal and discovered that people favour humira to stelara? Or is it the other way around. What should I consider? My intake is at November 18 at the AMC Amsterdam.

This study suggests Cosentyx (secukinumab) could help multiple sclerosis in patients with psoriasis.

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Background:
According to the literature, a significant association between multiple sclerosis and psoriasis has been reported. Among the various drugs used to treat psoriasis, tumor necrosis factor (TNF)‐α inhibitors seemed to increase the incidence of demyelinating diseases while IL‐17A inhibitors seemed to reduce the activity of multiple sclerosis.

Objectives:
The aim of this study is to find out if the use of Secukinumab in patients with psoriasis and multiple sclerosis would be both beneficial and safe.

Methods:
A 45‐years‐old woman affected by psoriasis and psoriatic arthritis was diagnosed with multiple sclerosis during the treatment for psoriasis. She performed follow‐up visits at the Dermo‐Rheuma Center of Spedali Civili Hospital in Brescia and, after several different therapies, was finally treated with Secukinumab. Outpatient follow‐up visits were performed every two months valuating PASI, joint involvement with CASPAR and DAPSA score and the neurological state with a clinical evaluation and magnetic resonance imaging.

Results:
A significant improvement of both psoriasis and psoriatic arthritis was observed with Secukinumab 300 mg administered monthly. PASI 75 was reached at 4 weeks of therapy, PASI 90 at 6 weeks and PASI 100 at 12 weeks. At 24 months of treatment PASI 100 was still maintained, no neurological symptoms were reported and multiple sclerosis remained stable over time.

Conclusions:
The blockade of IL‐17A with Secukinumab could be a safe and very promising therapeutic option for patients with psoriasis and multiple sclerosis.

Hi hoping to find likeminded people how understand what it like to suffer with psoriasis and the day to day humdrum that’s involved so to all hope to chat soon ?