Hi everyone,
i'm Yossi and i was diagnosed with psoriasis almost a year ago after two years with false diagnosis of seborrheic dermatitis.
I live in Israel (Dead Sea yeah!) so my English isn't the best.
I'm still working with myself on how to deal with this disease, what treatment is the best for me. i strongly believe diet has a big impact on the skin so i'm trying to cut off sugar and gluten (not so successful for now ). 
Anyway, hope i can learn new things here and meet nice people.

Yossi.

Spain asks The European Medicines Agency (EMA) to look at dosing errors with methotrexate in the treatment of arthritis and psoriasis.

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The European Medicines Agency (EMA) has started a review of the risk of dosing errors with methotrexate medicines.

When used for inflammatory diseases, such as arthritis and psoriasis, methotrexate is taken once a week whereas for some types of cancer, the dose is higher and the medicine is used more frequently. Mistakes have led to some patients incorrectly receiving a dose every day instead of every week. As a result, patients have received too much of the medicine, with serious consequences in some cases.

The risk of dosing errors with methotrexate has been recognised for many years and several measures are already in place in some EU countries to reduce this risk, including the use of visual reminders on the medicine packs. However, a recent assessment found that serious adverse events related to overdose, including fatalities, are still occurring. The Spanish medicines regulator, AEMPS, therefore asked EMA to further investigate the reasons why dosing errors continue to occur in order to identify measures to prevent them.

EMA’s Pharmacovigilance Risk Assessment Committee (PRAC) will now examine the available evidence and recommend whether further measures are needed to minimise the risk of dosing errors. The PRAC will also take into account the work of bodies specialising in patient safety.

well just had my first injection of stelara. even had to inject myself, but all went well. now fingers crossed n hope for the best 

Hello everyone,

Very happy to have found this site. Frenchy from Quebec Canada

So, I have been using topical steroids (1%) for skin under my eyes for a week, stopped now. I wanted to use concealer on it, but noticed it would cause flakiness or skin cells to come off, get stuck to my skin and caught up in the concealer. Now, I have stopped the concealer, stopped the creams and been putting coconut oil and moisturizer on that part of my face, for the last 2 or 3 days.
Now, my question is... when i run my finger over it, I noticed that the skin feels ever so slightly more raised, rougher and dryer, oppose to the other side under my other eye where its softer, smoother etc. 


Can someone enlighten me as to what this may be? Is it psoriasis coming back (despite no burning or itching sensation). Is this how the skin heals? is it just dry left over skin because it's thinner? Will it return to it's normal smoothness so I can apply concealer again? 

I have also been using the steroid cream above my eyelid too, as I have problems there and I did the same test... not quite the same, but did notice it was a little rougher and dry in comparison. So perhaps it's normal?

Not being able to hide my dark circles causes huge grief.

Been using Stelera for a while now and Im prettig impressed with the results. However, my toenails are manky. Disgusting as it sounds, I end up picking at them and pulling bits of nail out. This results in my toes often being painful where its uncomfortable to wear shoes or even walk sometimes.
I was condidering having my toenails removed. Has anyone else done this. Will my toenails ever recover.
Has anyone any tips or suggestions.

I like to use a concealer under my eye's to hide the dark circles, now, as I have developed psoriasis there I was wondering if it was possible to use to hide the psoriasis too.

More from the perspective of making it worse. I only use the concealer and nothing else.

I went to the beach almost 3 weeks ago and woke up with a swollen-ish red eyelid the next day. I have had a little bit of psoriasis on that eye previously, but the next day I developed an extra fold and my eyelid was red.
I put on the 1% cream for a bit of time but it didn't do anything... if anything, it got worse. I used it on and off, then one night I put 1% ointment on and the next day it was like 60% better. 

I then continued using it on and off for about 5 or so days and it was stagnant. 

Following this I had a big flare-up on my face.

I saw the dermo and she said continue using the 1% ointment until it gets better.

Now my problem is, I keep using it, but the extra fold is still there and theres a red line above my eyelid in the hollow of my eye that won''t go away. Luckily, it's not noticeably red unless I lift my eyebrows.

I am a bit worried.

Any help or ideas or experience?
Will my eye just naturally heal over time? I also am scared to use too much of the ointment for excess steroid use.

Hey!

I am a 23 year old from Australia. I have had psoriasis under my arms and on my hairline since 2015, but as of last week (25/3/18) I was officially diagnosed with psoriasis after a flare-up.
I have it on my hairline, behind my ears, scalp, on my eye lid and now under my eyes.

I am self conscious about it, despite it being relatively minor, I am doing well-ish to keep it under control with 1% corticosteroids. 

Outside of Psoriasis I am working for one of Australias biggest utilities in their innovation department and am studying a masters of entrepreneurship.

Hi all, 

So I had a day yesterday. I went to my rheumatology referral and the doctor literally said, "I don't treat psoriasis; I treat psoriatic arthritis, but you don't have that." However, she said the awful outbreak and heard me tell her I have limited time to see doctors due to my job. She was the University of Tennessee group, and she got me into a UT dermatology clinic that afternoon. They tried to draw blood that morning, but I was severely dehydrated because I had bottomed out the night before due to low sugar and my ex had to come stay the night with me to make sure I was ok. So they couldn't get any blood; they said the derm would get it. 

So i get to the dermatologist--he understands how severe this is--however, he said he couldn't start me on anything until the blood tests came back and made sure everything was OK. He did say he believed I needed a biologic treatment, and in order to get that, I needed to see him at his other practice. He tried to get me in Monday, but it's Wednesday. Derm nurse couldn't get blood and told me to go back to rheumatology to get it drawn. Drove back across town, begged and pleaded, told them I could not return Monday because of my job, and they called a nurse who got it the first stick and drew 8 vials. 

Not sure what they will put me on, but the dr also said he saw the severity of the situation and asked if I could make it downtown 3 days a week for light treatment... I'm assuming he meant UV, he said it was like a tanning bed... I told him no, I can't do that because of my job. 

they also told me the ER should never have put me on predisone because it can actually make psoriasis worse! I told them it didn't, it actually cleared it up. Then they gave me a scrip of topical steroid OINTMENT, not cream, to use until I start actual treatment. 

So.... knowing they are looking at the biologic route, depending on bloodwork, etc. ... can anyone tell me a little more about that? Is it oral, or injections? If you have taken biologics, how effective have they been? Are there multiple different biologics? Has anyone experienced more help with one versus the other? etc.

I appreciate any pointers... I told the dr thanks to the board here I knew about biologics and he said "Sounds like you have done your research," which I thought was funny since I actually don't know exactly what a biologic is or how it's taken! but... excellent derm. Am still shocked my PCP kept sending me to rheumatology then I got there and the rheumatologist was like, "I don't treat this." I think she saw I was on the verge of a breakdown, hence the same-day appt with a derm. 

thanks for all you guys advice and support....

Hello all,

My name is Adam Broomfield.

I've been suffering with psoriasis since 2008. I've had my fair share of treatments like most of you probably have.

The treatments I've tried so far are:

UV sessions
Dovobet
Revitol
Various moisturizers
Methotrexate

I'm currently on Acitretin. I've been on it for roughly 2 months now. There is no visual change at the moment. I have one more month on this treatment before I'm back to the dermatologist.

I'm looking forward to speaking with some of you people.


Many thanks,

Adam.

This study suggests using short term narrowband ultraviolet B (NB‐UVB) can benefit the effect of Fumaric acid esters (FAE) in the treatment of psoriasis.

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Background:
Fumaric acid esters (FAE) are safe and effective in patients with moderate‐to‐severe psoriasis but have a slow onset of action. A short‐term combination with narrowband ultraviolet B (NB‐UVB) may substantially accelerate the therapeutic response in the induction phase of treatment.

Objectives:
To assess the synergistic effect of a 6‐week course of NB‐UVB phototherapy in addition to FAE in adults with moderate‐to‐severe plaque psoriasis.

Methods:
In this randomized, assessor‐masked trial, patients with a Psoriasis Area and Severity Index (PASI) of ≥ 10 and a body surface area affected of ≥ 10 were randomized either to monotherapy with FAE (n = 16) or a combination of FAE with NB‐UVB (n = 14). The primary outcome parameter of the study was the mean PASI reduction after 6 weeks of treatment. In addition, the PASI 75 response (≥ 75% improvement from baseline PASI), the Psoriasis Log‐based Area and Severity Index (PLASI) and the Dermatology Life Quality Index (DLQI) were assessed as secondary outcome measures.

Results:
In total, 30 patients (19 men, 11 women; median age 52 years, interquartile range 36–56) were analysed. The mean reduction in PASI after 6 weeks was significantly greater with the combination treatment than with FAE monotherapy (P = 0·016). This was paralleled by a much faster improvement in the DLQI in the combination group than in the FAE‐monotherapy group.

Conclusions:
Adding a 6‐week course of NB‐UVB to FAE both accelerates and augments the therapeutic response during the early phase of treatment and increases quality of life in patients with moderate‐to‐severe plaque psoriasis.

Hello everyone, I’m new at this so I might get it wrong so bear with me. I’ve been reading about the Methotrexate, I was given the leaflet yesterday by the derm, I hadn’t seen her before but I originally went to say I would start the Fumaric acid Easter’s, I think that’s spelt right . I came home and researched Methotrexate and I didn’t like the side effects it gave ie, stay out of sun, very little alcohol and also hair thinning or loss!, my hair isn’t very thick any way so I don’t want that added embassesment. Can anybody throw any more light on this please?.

Hello everyone.  I have had psoriasis for about 4 months now.  It was isolated to my eyelid for the first three months, but here lately it has appeared along my hairline, my chin and now my other eyelid is inflammed.  After doing some research I believe this popped up due to my getting a yeast infection from bathing in a bath tub.  I always take showers, but I thought I would give a shot at a "detox bath," and unfortunately for me the bath tub must have not been clean.  Right away I started having symptoms of a yeast infection.  I haven't had one for over 20 years, but when you get one, you know it immediately.  At the time I did not realize the correlation, but at some point after that, my eyelid starting flaring up.  I thought it was a reaction to make-up, but I hadn't made any cosmetic changes.  The skin started to peel off so then I started thinking it was something else, which led me to psoriasis.  

My research has led me to conclude that the yeast infection went "wild" (candida) compromised my gut, giving me leaky gut, allowed pathogens into my bloodstream, which were then emitted via my skin and caused psoriasis.  So therefore my goal is to kill the candida, heal my gut and hopefully the psoriasis will go away.

My plan will start with a 2-3 day bone broth cleanse.  To the broth I can add a combination of broccoli, cauliflower, onions, garlic and spices such as turmeric, rosemary, sea salt and black pepper.  The bone broth has amino acids which helps to heal the gut and also to help remove toxins built up in the digestive tract.  Dr. Pagano suggests colonics and/or enemas, which I am adverse to, so I will go with the food inducing cleanse instead.  

After the cleanse, I will then begin what amounts to a candida diet program.  I will also eliminate the nightshade family of foods which Dr. Pagano suggests are possible psoriasis triggers.  Nightshade foods include: white potatoes, tomatoes, okra, eggplant, tobacco, peppers (excluding black pepper), paprika and cayenne.  



Here is my food list (I will try to do organic when possible):

vegetables: artichokes, zucchini, asparagus, avocado, spinach, broccoli, brussel sprouts, cabbage, onions, garlic, cauliflower, celery, collard greens, kale, romaine lettuce, olives (no white vinegar)

meat: grass fed beef, chicken, turkey, eggs, sockeye salmon, lamb

nuts/seeds: almonds, flax seeds, hazelnuts, pine nuts, sunflower seeds, pumpkin seeds

grains: quinoa, millet, buckwheat, almond flour, coconut flour

herbs/spices: basil, black pepper, cilantro, cinnamon, cloves, cumin, dill, ginger, nutmeg, oregano, rosemary, thyme, turmeric, sea salt

oils: extra virgin olive oil, sesame oil, virgin coconut oil, grass fed butter

seasonings: lemon juice, raw organic unfiltered apple cider vinegar, coconut aminos, organic chicken bone broth

beverages: filtered water, unsweetened almond/coconut milk, peppermint tea, ginger tea, pau d'arco tea, licorice tea

sweeteners: stevia that does not have maltodexterin, dextrose or sugar alcohols.  Whole leaf stevia.  

dairy: unsweetened grass fed yogurt, unsweetened grass fed kefir.


I also plan on taking daily:  

Supplements:  fish oil, collagen, ashwagandha, probiotics

Vitamins: C, D, E, folic acid, biotin

Minerals: Zinc

Help.  I posted my first comment on a thread, but found a few mistakes that I need to correct.  How can I edit a post after it has already been posted?  Thanks.

Ilumya (tildrakizumab-asmn) has been given U.S. Food and Drug Administration (FDA) approval for the treatment of adults with moderate-to severe plaque psoriasis.

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Sun Pharma today announced that the U.S. Food and Drug Administration (FDA) has approved ILUMYA (tildrakizumab-asmn) for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

ILUMYA selectively binds to the p19 subunit of IL-23 and inhibits its interaction with the IL-23 receptor leading to inhibition of the release of pro innflammatory cytokines and chemokines. ILUMYA is administered at a dose of 100 mg by subcutaneous injection every 12 weeks, after the completion of initial doses at weeks 0 and 4. ILUMYA is contraindicated in patients with a previous serious hypersensitivity reaction to tildrakizumab or to any of the excipients.

The FDA approval of ILUMYA for the treatment of adults with moderate-to-severe plaque psoriasis was supported by data from the pivotal Phase-3 reSURFACE clinical development program. In the two multicenter, randomized, double-blind, placebo-controlled trials (reSURFACE 1 and reSURFACE 2), 926 adult patients were treated with ILUMYA (N=616) or placebo (N=310). Both Phase-3 studies met the primary efficacy endpoints, demonstrating significant clinical improvement with ILUMYA 100 mg compared to placebo when measured by at least 75 percent of skin clearance (Psoriasis Area Sensitivity Index or PASI 75) and Physician’s Global Assessment (PGA) score of “clear” or “minimal” at week 12 after two doses.

Of the patients in the reSURFACE 1 study 74 percent (229 patients) achieved 75 percent skin clearance at week 28 after three doses, and 84 percent of patients who continued receiving ILUMYA 100 mg maintained PASI 75 at week 64 compared to 22 percent of patients who were re-randomized to placebo. In addition, 69 percent of the patients receiving ILUMYA 100 mg who had a PGA score of “clear” or “minimal” at week 28 maintained this response at week 64 compared to 14 percent of patients who were re-randomized to placebo.

Has anyone here gotten worse on biologics?  I just started cimzia about a month ago and I feel like things are getting worse.  Is this common?

This is a study of the first-in-man intravenous implantation of stromal vascular fraction in a patient with severe psoriasis.

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Background:
Stromal vascular fraction (SVF) is a mixture of adipose-derived stem cells/mesenchymal stem cells, endothelial/progenitors, pericytes, fibroblasts, and other cells obtained from fat tissue. A small sample of fat or adipose tissue can be obtained under local anesthesia using a cannula. After an enzymatic digestion and centrifugation, the adipocytes (fat cells) are removed to obtain an SVF. Here, we describe the rationale and, to our knowledge, the first clinical implementation of SVF intravenously in a patient with severe psoriasis.

Methods:
Adipose tissue (60 mL) was collected under local anesthesia via a mini-lipoaspirate procedure. The SVF was separated from the adipocytes via centrifugation after an enzymatic digestion. The cells were resuspended in normal saline and injected via bolus push intravenous. The subject was monitored over a period of 12 months for safety (adverse events), medication changes, and quality of life parameters.

Results:
The patient did not report any safety concerns and did not experience any severe adverse events. The patient demonstrated a significant decrease in symptoms with a noticeable difference in skin quality appearance. Psoriasis area and severity index score went from 50.4 at baseline to 0.3 at 1 month follow-up.

Conclusion:
Overall, the patient reported improved quality of life and willingness to continue treatments. This successful initial case study demonstrates that this may be a feasible treatment plan for patients suffering from psoriasis.

Lupin Pharmaceuticals announced that it has received final approval for its Desoximetasone Topical Spray, 0.25%, 30 ml, 50 ml, and 100 ml from the United States Food and Drug Administration (FDA) to market a generic version of Taro Pharmaceuticals U.S.A Inc.’s Topicort Topical Spray, 0.25%.

Lupin’s Desoximetasone Topical Spray, 0.25%, 30 ml, 50 ml, and 100 ml is the generic equivalent of Taro Pharmaceuticals U.S.A Inc.’s Topicort Topical Spray, 0.25%. It is a corticosteroid indicated for the treatment of plaque psoriasis in patients 18 years of age or older.

Patients using topical corticosteroids should receive the following information and instructions:

1.This medication is to be used as directed by the physician. It is for external use only. Avoid contact with the eyes.
2. Patients should be advised not to use this medication for any disorder other than that for which it was prescribed.
3. The treated skin area should not be bandaged or otherwise covered or wrapped so as to be occlusive unless directed by the physician.
4. Patients should report any signs of local adverse reactions, especially under occlusive  dressings.
5. Other corticosteroid containing products should not be used with desoximetasone cream 0.25% without first consulting with the physician.

As with other corticosteroids, Therapy should be discontinued when control is achieved. If no  improvement is seen within 4 weeks, contact the physician.

Hi. I am Duncan. I live in the Uk and have had Psoriasis for 8 years.
It started after taking a drug to stop smoking. My sister took the same drug and shed a full body of skin. The drug was shampix. My wife is a midwife and though asking people, found a definite link to both.
I started with one small patch on my arm. I now have patches everywhere. I had a large burn scar on my calf which it loves.
I tried all the creams with minimal success, I was then put on light treatment. It did just start working as treatment ended. You are only allowed so many treatments, even though the exposure was low due to me burning.
I was then offered the drug, but I am leaving that as the last resort. Side effects of drugs aren't good with me.
I am using Enstilar spray, as it absorbs easy. I find it less greasy than Dovobet. I also use Dipsalic as an alternative. They all contain betamethasone.
Everywhere I read, they say don't use Dovobet long temp. My dermatologist isn't bothered.
My hands and feet over the past year have got quite bad. My knuckles look like boxers.
My scalp comes and goes. Not too bad.
I am also using moisturiser on my hands. I use dermal 500 to wash in shower with.
Are there any other things I could try. I keep reading about coconut oil?
DO they sell light treatment machines for hands only?
Thanks Duncan