I thought it would be interesting to have a poll asking what people thought is the worst part of the body to have psoriasis. I don't think it's worth making the poll multi choice as we will probably tick all the boxes, so I have made it single answer.

Obviously anywhere to have psoriasis is a bad thing, but if you had to pick one what is the worst part of the body for you to have psoriasis ?

The poll is open to members and guests with no closing date.

Members are also welcome to post in this thread if they wish.

This study looked at the economic burden of psoriasis in German patients.

Quote:

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Background:
Though psoriasis poses a substantial chronic socio-economic burden, few studies have addressed the economic impact in Germany.

Objectives:
The objective was to evaluate the annual costs of psoriasis in Germany from the societal perspective.

Methods:
A cross-sectional study was performed in randomly selected German dermatology practices and clinics in 2013/2014 using standardized questionnaires of illness-related costs. Costs were grouped by perspective and category as well as analysed by sex and age. Group differences were tested by non-parametric tests.

Results:
Complete data were obtained from 1158 patients in 132 centres. Annual average costs for patients with psoriasis: total costs € 5543 ± € 8044, systemic treatment costs (paid by the statutory health insurances [SHI]) € 3733 ± € 7322, out-of-pocket costs € 224 ± € 406, total SHI costs € 4940 ± € 7533, direct costs € 5164 ± € 7581 and indirect costs € 379 ± € 2087. Significant higher costs in male and significant lower costs in 65+-year-old patients were found.

Conclusions:
Psoriasis induces a considerable economic burden. Between 2003 and 2014, costs have markedly shifted from hospital, out-of-pocket and indirect costs towards systemic drug costs.

This study suggest that smartphone overuse could speed up the possible development of psoriatic arthritis.

Quote:

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Background:
Distal interphalangeal (DIP) arthritis is a frequent form of psoriatic arthritis being often linked to nail psoriasis. Modern society is characterized by overuse of smartphones. Indeed, literature has recently focalized on research into smartphone addiction and health-related problems.

Objectives:
As smartphone addiction is able to determine overuse and repeated movements of DIP joints and nails, the aim of this study was to evaluate the impact of smartphone use on hand joints of young psoriatic patients.

Methods:
An observational study involving four different groups such as non-smartphone-addicted (SA) psoriatic patients, SA psoriatic patients, non-SA controls and SA controls was performed. Each subject underwent an ultrasound examination of both hands by three independent and blinded to group assignment radiologists. A specific score was used to evaluate the inflammatory state of the analysed joints.

Results:
The total ultrasound score was statistically significantly higher in SA controls respect to non-SA controls (3.4 vs. 1.4; P < 0.05) as well as in SA psoriasis patients compared to non-SA psoriatic subjects (15.2 vs. 6.7; P < 0.01). Higher mean of ultrasound score was found for left hand in controls (both SA or not) and for right hand in psoriatic subjects (both SA or not), however without reaching statistical significance.

Conclusions:
Smartphone overuse was found to be linked with higher signs of inflammation of musculoskeletal structures of hands joints in both psoriasis and controls through ultrasound examination. Therefore, smartphone overuse may be a factor which facilitate or speed up the possible development of psoriatic arthritis.

This study looked at the impact of Taltz (ixekizumab) on facial psoriasis and related quality of life measures in moderate-to-severe psoriasis patients.

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Background:
Facial psoriasis was reported in 17–68% of patients with psoriasis and shown to have a negative impact on patients’ personal and health-related quality of life (HRQoL).

Objectives:
To explore the association of facial psoriasis with patients’ HRQoL and to assess the relationship between ixekizumab (IXE) and improvement in facial psoriasis and changes in HRQoL.

Methods:
This work reports the combined results of two phase III multicentre, randomized, double-blind, placebo-controlled, active-comparator trials in patients with moderate-to-severe psoriasis. Patients received placebo, etanercept (ETN; 50 mg twice weekly) or IXE [80 mg every 4 weeks (Q4W) or every 2 weeks (Q2W)] for up to 12 weeks following an initial 160-mg dose. HRQoL parameters were analysed based on facial psoriasis status at baseline using analysis of covariance models. Improvement was assessed as percentage of patients with no facial psoriasis.

Results:
The combined database included 1133 patients with facial psoriasis and 1437 without. Patients treated with IXE whose facial psoriasis cleared had improved Dermatology Life Quality Index 0.1 responses (P < 0.01) compared with patients with facial psoriasis at Week 12. At Week 12, clearance of facial psoriasis compared with the presence of facial psoriasis was independently associated with significantly better improvement in Psoriasis Skin Appearance Bothersomeness scores in the IXE Q2W treatment group (P < 0.01). At Week 12, facial clearance and overall Psoriasis Area Severity Index (PASI) improvement were observed in significant numbers of patients treated with IXE compared with ETN and placebo. Facial psoriasis clearance at Week 12 in patients treated with IXE or ETN was positively associated with PASI75 and PASI90 achievement.

Conclusion:
Facial psoriasis had a larger negative impact on HRQoL than no facial psoriasis. Facial psoriasis clearance was associated with improved HRQoL. Significantly more IXE-treated patients had rapid facial clearance vs. ETN and PBO, which led to better clinical outcomes.

I got the call today that I will able to get Stelara. I'll get a call soon to set up the appointment. For some reason they will not let me self inject and said it would be done in the doctor's office, however, due to insurance (more on that later in another thread so as not to take this one off topic) it will be done at the hospital. The dermatologist will still do the follow ups and be the one primarily taking care of things.

I'm excited and a teeny bit nervous ( but not of the injection.) So, I'll be joining the Stelara Bandwagon soon and I'll post injection dates with reactions to them and progress made (or not) in this thread.

hi 
i just want to share my exp with  Exemptia Adalimumab mad in india

i am on first month now with exemptia since humira is cost 1900 usd  7000 aed
tell i got exemptia
i am now in exemptia with almost 50% recovery and its only 1 month and half 
if u cannot go for humira ask your doc about the exemptia  cost 245 usd 900 aed  i think u can find it in dubai  not sure
but for me its workeing  like a charm
ask your doc about it and i hope its worked for you

Hi

I'm not quite sure how I go about deleting an account on this forum?  Anybody know how it can be done?

Cheers

Kit

This multinational dermatologist and psoriasis patient study looked at the burden of psoriasis.

Quote:

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Background:
Psoriasis is a chronic, immune-mediated disease, characterised by symptoms that include itching and skin pain and is often associated with comorbidities. Patients have a substantial detriment to quality of life (QoL) and work productivity with associated cost burden.

Objective:
To investigate the incremental burden of comorbidities, itch, and affected body areas among systemic eligible patients with psoriasis, using a multinational survey of dermatologists and their psoriasis patients.

Methods:
Multinational data from the Growth from Knowledge (GfK) Disease Atlas global real-world evidence programme were used. Eligible patients were identified as those who were currently having or had ever had moderate-to-severe psoriasis, and must have been receiving prescription treatments at the time of the survey. Multivariable regression analyses were conducted to assess the incremental burden among psoriasis patients with physical and psychological comorbidities, itch, and affected visible and sensitive body areas versus psoriasis patients without these conditions, respectively.

Results:
The study enrolled 3,821 psoriasis patients, from 9 countries, with an average Psoriasis Area and Severity Index score of 6.4. The presence of comorbidities was associated with a significant increase in the likelihood of skin pain, lower QoL, greater work impairment and increased usage of medical resources (except in psoriasis patients with obesity and type II diabetes). Psoriasis patients suffering from itch and those with visible and sensitive affected body areas also had impaired QoL versus those without these conditions.

Conclusion:
Psoriasis patients with physical and psychological comorbidities, itch and, affected visible and sensitive body areas had lower QoL, and greater work impairment compared to those without these conditions.

Hi, I have been reading the forum as a guest for a few years now and decided it was time to try and add something to the debate. I am a 59 year old man and have have plaque and nail psoriasis for around 20 years.
I noticed there is not much history of Apremilast (Otezla) use and I have recently started on it so might be able to add something. 
For what it's worth a short history of my treatments is as follows; 
Various creams - not very effective.
PUVA - worked quite well and I got a home lamp made from an old sunbed which was effective but eventually the Dermatologist decided I had had enough sunlight for one lifetime.
Accitretin - made the psoriasis worse and made my lips peel! Awful stuff (for me anyway).
Ciclosporin - very effective after about 3 months use but had to come off it due to raised blood pressure.
Methotrexate - seemed to work but I only stuck it for a month as I felt run down and slightly ill all the time.
Fumaderm - I have been on and off this for around 2 years, it was very effective clearing nearly everything but my nails, but eventually had to come off due to very low blood count which wasn't recovering. I never quite got over the stomach problems with Fumaderm, never straying too far from the loo until after 11.00 am, but I felt it was worth the discomfort.
Otezla - started 3 weeks ago, no real side effects so far, felt a bit nauseous in the mornings but that's gone now. Hard to tell if it's working yet but it hasn't made it any worse!
I'll try and update on the Otezla in a few weeks time.

As far as I understand it the Bio is absorbed under the skin slowly and spread around the body over a period of time, but could it help psoriasis better or quicker if it was injected nearer to the psoriasis ?

I always inject in the belly, but today I have injected in my legs as that is where Cosentyx seems to be struggling. I doubt it will make any difference but thought it may be worth a try.

I know you should never inject directly into the psoriasis but does anyone have any thoughts on if there are indeed any benefits of injecting nearer the site of the problem  ?

Just started Orencia.  I chose the weekly injection over the infusion.  I just prefer the shorter half life in my body.  Injection was no biggie.  So far I feel absolutely nothing which is kind of good since most of the stuff makes me feel worse.  I'll chime in with more input on how this plays out.  But has anyone else done Orencia.  I know its more for PA, but just curious your thoughts.
Thanks

Hi Folks,
Just wondered if anyone has been on or is using Apremilast (Otezla tablets).
How are you doing on this medication and any 'nasty' side effects.
Thanks. 

Im suffering from psoriasis since 2014..im worried cpz my hair became thinner and my skin is not good anymore as before ive flawless skin..i visited 4 dermatologist anymore they are all giving me almost same treatment but my last dr.gave me dermovate scalp anf skin ointment..but it always comes back..what im gonna do im thinking about the injection cosentyx is that good???

Hey guys.

After 30+ sessions of light therapy not making a bit of difference to my skin and after not being eligible for methotrexate (didn't really fancy taking it anyway) and really not being keen on acitretin (due to reading about the side effects and how much it actually iimprovemprovrs psoriasis) my dermatologist has offered my Fumaderm. Currently waiting for it to arrive at the hospital.

Just got a couple questions for those that have been on it.

I've researched the side effects and I reckon I'll be able to stick them but I just have a question about the flushing...  does the flushing occur at about the same time after taking your dosage and if so how long after is this? I work a 9 to 5 job and would rather avoid the flushing at work if possible. I imagine that's possible on the early doses but may be impossible to avoid once you're taking a few tablets a day?

So, read some experiences here, but could not finder the answer I wanted; Which bio cleared you the fastest?

I don't know which one i Will start or if I have to go through a certain protocol again, but I just would like to know 

As I am taking a break from systemic treatment, I thought I might try some topical, Here are the ingredients:



I dissolve a 7 gram block of camphor in tea tree oil, then add the petroleum jelly, chest rub, 12 crushed aspirin, 50 grams of tar, and a bit of eucalyptus oil. Mixed together it looks like this:



As well as using it on a few spots behind my ears, I will apply it to a spot on my knee:



before applying a waterproof bandage.



I will change this every few days and record my progress. But what about my DMF? I do have a nice ardenium:



but another one has been badly afflicted with root rot:



So I have mixed in a bit of DMF with the soil as well as applying a bit to the infected part of the plant. DMF is a good inhibitor of mold, so fingers crossed.

I've had a flare up, mostly ears and neck, few spots here and there.  I did buy an over the counter tar shampoo, didn't really help and I have problems with how those shampoos really seem to dry out my hair.  Anyway, other than breaking down and trying the shampoo, I saved my money on the over the counter stuff as I've already been there/done that.  The ONLY relief I got while waiting to see my doctor was virgin coconut oil.  

I took two bowls and filled the bottom one with hot but not quite boiling water.  I then put a bit of coconut oil in a smaller bowl and set in inside the bowl with the water.  This dissolved the oil into a liquid form (plus made it a bit warm which I found soothing)

I then used a cotton ball to dab the oil on.  I found this worked better for me than rubbing it on.  This helped a lot when the scaling was dry and crusted.  It softens the scales and even helped with the itchiness for a small amount of time.  It's not a miracle thing..... but wanted to mention how I used it and how it helped offer me some small amount of relief.

About 3 weeks ago, I flared back up with psoriasis. I spent the first week in denial... thinking okay it's just a flare up and will settle back down. This past year or so I had a few "mini flares" that settled down but I knew this one was much worse than those. I think it kept getting worse by the minute. My ears and neck have always been my problem areas and this was no exception. Both ears were pretty bad and I was fairly miserable with it, I even have it in the outer corner of both eyes this time. I finally got in to the dermatologist this past Wednesday. They are looking at starting me on Stelara (which I will start a post about once it happens) so they took blood, sent me for a chest exray and checking with insurance (U.S. here, it's all about the insurance!) The derm also said I needed to get to primary doc to see if I had an ear infection as both ears had been hurting and felt "stopped up" (I managed to get into primary doc that day, both ear canals were swollen shut and with the psoriasis down in my ears he is sending me to ear specialist, but did give me ear drops which are helping with some of that.) Anyway, the dermatologist gave me Taclonex to use for now while I'm waiting on test results etc. I thought I'd write about it, pros and cons.

So the pharmacy had to order the Taclonex and I didn't get it until yesterday. I got 2 bottle of 60 g each. My cost was $40 after insurance. The directions were to apply once per day at bedtime. I found that a bit odd as putting this all on my scalp with nothing covering it sounded like a disaster for my pillow case at night. But I do like to follow direction so figured I'd try it and if too messy then I'd be using it in the daytime.

The consistency was very "oily" which actually turned out well as it wasn't very runny at all. I had many raw spots and it didn't burn which was an added bonus. I did put it on lightly with it being the first time and also with going to bed shortly after. I had to be careful not to get it inside my ears as I have the ear drops (also containing a steroid) but I was still able to coat my ears fairly well without worrying about it dripping into my ear canal. Application was fairly easy, I did have to get my daughter to help with the back of my head. Once it was applied, I did get that "itchfest" feeling of wanting to scratch. I heroically ( ) resisted the urge! After about half an hour, things settled down. By settled down, I mean about the same as when applying coconut oil, it was soothed a bit.

Woke up this morning and I can actually tell a small difference! The skin where the Taclonex was applied is still a bit soft and the scales were "moist" so came off easily. Of course I still itched, but I think it's a bit less itchy than it has been in the mornings. This is after one use so only time will tell how much it is helping (or not) I'll keep this post updated but my hope is that I at least get some marginal relief from this while waiting. I can use this until "clear" or up to 8 weeks. With the holidays, that's about how long the derm expects before I could start Stelara.

Starting Ciclosporine on Friday after dr checks my labs.  Has anyone on here tried it?  Side affects?  I am told kidney and high blood pressure are the most serious and are monitored closely.  This makes me nervous but at a point I have to do something. My hands are so bad I can hardly use them.  My feet are raw so I can barely walk... very painful.  The talz alone is not working.
Kinda new to this sight so also looking for advice on how to use it effectively.? Not sure if I am posting/ replying to the right thread or not

I have 3 out of 10 fingernails plus my big toenail that are lifting off thanks to my dear friend psoriasis.

Are there any ways to prevent or reverse this? I have a 6 tube NB UVB unit, and I expose my fingernails to it, but I assume the light cannot get through the nails.

I don't like steroids, as I find they rebound and other nasty stuff.

Thanks