Hey all – I have inverse genital psoriasis. I have tried everything under the sun on it. Tea Tree oil, coconut oil, hydrocortisone, steroid creams, etc. I’ve been getting the Xtracs laser treatment for at least four months and no major changes. I have huge flare ups and it even bleeds and crust over. My Xtracs technician thought it could be infected most recently.  It is very painful and embarrassing when you are trying to be intimate.  I’ve been using the condom idea also (filling it up with ointment). Any thoughts? Anyone else used the Xtracs laser and had any luck? Anybody have any luck with anything working

Hey all – I have inverse genital psoriasis. I have tried everything under the sun on it. Tea Tree oil, coconut oil, hydrocortisone, steroid creams, etc. I’ve been getting the Xtracs laser treatment for at least four months and no major changes. I have huge flare ups and it even bleeds and crust over. My Xtracs technician thought it could be infected most recently.  It is very painful and embarrassing when you are trying to be intimate.  I’ve been using the condom idea also (filling it up with ointment). Any thoughts? Anyone else used the Xtracs laser and had any luck? Anybody have any luck with anything working???

My Ps  has really gotten worse lately. I am wondering if I could get some help with all new drugs?

Help with the names, what they do, how good/bad they are, cost, how they are administered etc...

Thanks!

Just a quick question about Stelara.
I have been monitoring any side effects over the last 4  Stelara injections and at week 8 in the 12 week cycle I have had a migraine. This has happened every time in the last 4 injections,has anyone else had this problem.

This study suggests that children with psoriasis should be screened for psoriatic arthritis.

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Background:
National Institute for Health and Care Excellence (NICE) guidelines recommend annual screening for psoriatic arthritis (PsA) in all patients with psoriasis. Currently, no validated assessment tools have been recommended for screening for juvenile PsA (JPsA).

Aim:
To determine dermatologists' practice when assessing children's joints and explore the challenges dermatologists experience when looking for joint disease, in order to inform future strategies to improve early detection of arthritis.

Methods:
Structured telephone interviews were undertaken with dermatologists identified through the British Society of Paediatric Dermatology. Percentages for binary and categorized responses were calculated. Thematic content analysis was used to generate a set of core themes across the interview data.

Results:
Of the 41 consultant dermatologists contacted, 23 agreed to be interviewed. Of these, 78% (18/23) reported they routinely ask about joint disease. Only 13% (3/23) routinely examine the joints of children with psoriasis. Overall, assessment for JPsA lacked a structured, evidence-based approach. The average confidence rating for assessing joint disease was low (score of 3). The two key barriers described for detecting arthritis were a lack of experience and training, and subtle or difficult to detect signs. The two main suggestions for improving detection were the introduction of an assessment tool/guideline and increased clinical experience and training.

Conclusion:
There is a clear need for dermatologists to use a standardized approach for screening and to increase their confidence in paediatric musculoskeletal examination. In this article, we provide guidance on screening for psoriatic arthritis in children based on our clinical experience.

This study looked at the occurrence of metabolic disorders in children with psoriasis.

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Background:
The prevalence of cardiovascular and metabolic disorders in paediatric patients with psoriasis is not well established.

Aim:
To conduct a meta-analysis of previously published studies dealing with the occurrence of metabolic disorders in children with psoriasis.

Methods:
Data from 7 studies with a total of 965 children with psoriasis were analysed using a random effects model.

Results:
Prevalence of metabolic syndrome (MetS) was significantly higher in patients with psoriasis than in healthy controls (HCs). In most studies, significantly decreased levels of high-density lipoprotein (HDL) cholesterol were found in children with psoriasis. Mean level of HDL cholesterol in patients with psoriasis was 2.05 mg/dL lower than in HCs. Patients with psoriasis and HCs did not differ significantly in their mean triglyceride levels, although the difference was at a threshold of statistical significance. Mean level of fasting glucose in children with psoriasis was 5.75 mg/dL higher than in HCs (P < 0.01). The two groups did not differ significantly in mean waist circumference or in systolic and diastolic arterial pressures.

Conclusions:
Decreased levels of HDL cholesterol and increased concentrations of fasting glucose may represent very early stages of MetS in children with psoriasis. However, a large population-based study is needed to establish the relationship between psoriasis and MetS in children, including the environmental, genetic and immunological factors leading to their co-occurrence.

Hi,

After battling with Psoriasis for many, many years and after trying Acitretin which seemed to make my skin worse, I have finally been put onto Fumaderm which I am going to start taking on Saturday.

Now I am somewhat of a hypercondriac (slight understatement) and so I'm now worrying that when I start taking the medication I am sure to get PML, which I have read is a fatal brain disorder.

I know how rediculous that sounds but I don't normally get regular illnesses, I get the rare ones. I know PLM is a rare side effect but what are the odds of me actually getting it?

Is this something I should be worrying about because it's playing on my mind to the point of, even with my psoriasis as bad as it is, wondering whether to actually take the medication or not.

I'll be happy for you to tell me to stop being silly.

Hello from FL. I'm a 55 yo female and still work part time as a RN case manager.  I've had Psoriatic Arthritis, Psoriatic nails and skin Psoriasis for 7 years. I'm currently taking MTX, Otezla, prednisone and getting ready to start Cosentyx. I've been on many different Biologics over the years. My hands, feet,sternum and SI joints are mainly affected and have just 1% skin involvement. I'm here to learn more about PsA and how to slow progression.   Julittle

Hello
I am new to the group, I am looking for alternative medication for my psoriasis (its bad at this stage) .....  I have been in Dubai, where it was easy to get my treatment (Humera)
- being back in UK for 3 month it has gone bad, bad bad - without medication as there is a very long waiting process to get to a doctor here

I have been doing salt baths - not sure if it is doing better or aggravating it

Any help welcome please

Tom

Hi Folks - I've recently started with Fumaderm now on 120 mg X 3 times per day .....see my consultant on 18 th Jan.....with upping the dosage I assume ........not real visible improvement yet but some of the " anger " has gone from the soreness on both calfs.

Just a question /advice from you that have used this medication .....I shall be out of the U.K. early April until abt 26 June ......so I will not be able to have blood tests during this period ......will this be ok or any suggestions thanks Vince

I've been on Acitretin for about 2 years and my psoriasis has never been better.  The worst side-effect I am experiencing, and it has become almost an obsession for me, is my dry lips.  It's not even so much that they are dry, it's as if the skin cells are overproducing.  I have taken to trimming the excess dry skin cells carefully with a small pair of scissors, but an hour or two later, it needs done again.

I have tried every kind of lip balm, even "Acnibex" which is supposedly specifically for the dry lips caused by retinoids, but nothing brings them under control.

How is everyone else dealing with this?  It's getting to the point that I feel like giving up on the Acitretin, even though I know the psoriasis would come back.

So,
If like me you have had the joy of blood tests over and over due to the meds you have been taking, I wonder if like me your iron levels were on the lower end of the scale?
Yes being female does tend to play about with iron levels, but through my time on meds and then pregnancies I have always been anemic or close to it.
I have read in a book, (sorry can't remember the name of it, but if anyone is intrested I shall try to find out) that psoriasis and anemia are linked!
I also found it intresting that over my many blood tests, pregnancies and general life as a psoriasis suffer that only one GP has ever flagged up this link to me.
If my tiredness levels are still a bit rubbish as my 5 month old starts to wean then I think I may discuss my iron levels more with my GP and pick his brains on it a bit more.
(Im waiting to see if I get called in soon because of the vast amount of moisturiser Im requesting)

This study suggests anxiety may be missed using the Dermatology Life Quality Index (DLQI) test on psoriasis patients.

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Background:
National Institute for Health and Care Excellence guidance recommends assessment of psychological and social well-being in people with psoriasis.

Objectives:
To screen systematically for depression and anxiety in patients with psoriasis in routine clinical practice and to identify at-risk groups for psychiatric morbidity.

Methods:
Consecutive patients attending a single, tertiary centre over a 10-month period were invited to complete the Patient Health Questionnaire Depression Scale (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Dermatology Life Quality Index (DLQI) as part of IMPARTS: Integrating Mental and Physical Healthcare: Research, Training and Services. Information on demographics, treatment and clinical disease severity was collated from electronic patient records. Regression models were used to identify at-risk groups for psychiatric morbidity.

Results:
Of 607 patients included (56·2% on biologics), 9·9% (95% confidence interval 7·5–12·3%) screened positive for major depressive disorder (MDD) and 13·1% (79/604) (95% confidence interval 10·4–15·8%) for generalized anxiety disorder (GAD; GAD-7 score > 9). Suicidal ideation was reported in 35% of those with MDD; DLQI was < 10 in 38·3% and 45·6% cases of MDD and GAD, respectively. After adjusting for covariates, the risk of MDD or GAD was significantly higher in women and those with severe clinical disease, psoriatic arthritis and previous depression/anxiety. The risk of GAD was significantly increased with Asian ethnicity and use of topical treatments only.

Conclusions:
Systematic screening for anxiety and depression identifies clinically important levels of depression and anxiety that may be missed using DLQI data alone. Women and those with severe disease, psoriatic arthritis and/or a prior history of psychiatric morbidity may be at particular risk.

I've got a really stubborn bit of psoriasis on my ear.  It's not inside the ear but on the little nobbly bit at the entrance of the ear right above where you'd get your ear pierced. 

Nothing seems to work in removing it. Even the brilliant Enstilar foam doesn't seem to be having much of an affect on it. Yes I know steroid creams shouldn't be used on the face but it was just a test for 2-3 days and I've stopped now. 

Any recommendations? Thanks

This study looked at the association between the germline MTHFR polymorphisms C677T and A1298C with psoriasis risk in a Turkish population.

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Background:
Psoriasis is a common chronic inflammatory skin disease caused by genetic and epigenetic factors. There are conflicting results in the literature about the association between psoriasis and the methylenetetrahydrofolate reductase gene (MTHFR), ranging from strong linkage to no association.

Aim:
To investigate the association between the germline MTHFR polymorphisms C677T and A1298C with psoriasis risk in a Turkish population.

Methods:
The study enrolled 84 patients with psoriasis and 212 healthy controls (HCs) without any history of psoriasis. DNA was extracted from peripheral blood samples of patients and HCs, and real-time PCR was used for genotyping. Results were compared by Pearson χ² test and multiple logistic regression models.

Results:
The frequency of both the MTHFR 677TT and A1298C (homozygous) genotypes was statistically significantly different from HCs. Point mutations were detected in all patients with early-onset psoriasis (before the age of 20 years). The T allele of MTHFR 677 and the C allele of MTHFR 1298 increased psoriasis risk by 12.4- and 17.0-fold, respectively, in patients compared with HCs.

Conclusion:
A possible association was detected betweengermline MTHFR 677 C>T and 1298 A>C genotypes and psoriasis risk in a Turkish population. These results need to be confirmed in further studies with larger sample sizes.

This study looked at arterial inflammation and subcutaneous inflammation in psoriasis patients.

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Background:
Psoriasis is associated with cardiovascular disease; it has been proposed that increased cardiovascular risk is caused by low-grade systemic inflammation involving organs and tissues other than the skin and joints.

Objectives:
To investigate signs of vascular inflammation in untreated patients with moderate-to-severe psoriasis assessed by 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography. A secondary objective was to assess signs of subcutaneous adipose tissue inflammation.

Methods:
This was an observational, controlled clinical study including patients with psoriasis (n = 12, mean ± SD age 61·4 ± 4·1 years, 83% men, mean ± SD Psoriasis Area Severity Index score 14·5 ± 4·3) and matched controls (n = 23, mean ± SD age 60·4 ± 4·5 years, 87% men). Vascular inflammation was measured using aortic maximal standardized uptake values (SUVmax) and the target-to-background ratio (TBRmax) of the whole vessel and aortic segments. Subcutaneous adipose tissue inflammation was assessed and compared with regard to SUVmax and TBRmax.

Results:
Arterial inflammation was increased in patients with psoriasis vs. controls (mean ± SD whole vessel TBRmax 2·46 ± 0·31 vs. 2·09 ± 0·36; P = 0·005). In patients with psoriasis, higher FDG uptake values were observed for all aortic segments except the ascending aorta. Subcutaneous adipose tissue FDG uptake was increased in patients with psoriasis vs. controls (mean ± SD TBRmax 0·49 ± 0·18 vs. 0·31 ± 0·12; P = 0·002). Associations remained significant after adjusting for body mass index and age.

Conclusions:
Global arterial inflammation and subcutaneous inflammation were significantly increased in patients with moderate-to-severe psoriasis compared with controls.

This study looked at the differences in serum metabolomic profiles in psoriasis patients.

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Background:
Recent studies have shown that dysregulated metabolic pathways are linked to psoriasis pathogenesis. However, an extensive, unbiased metabolic analysis in patients with psoriasis has not been completely explored. The metabolome represents the end products of proteomics or cellular processes that may be closely associated with the pathogenesis of psoriasis.

Objectives:
To determine the differences in serum metabolomic profiles among patients with psoriasis and healthy controls with the goal of identifying potential biomarkers in patients with psoriasis.

Materials and methods:
Serum metabolomic profiles from 29 subjects (14 patients with psoriasis and 15 sex- and age-matched healthy controls). The serum metabolites were analysed by gas chromatography-mass spectrometry based on a combined full scan and selected-ion monitoring mode.

Results:
Multivariate statistical analysis of metabolomics data revealed altered serum metabolites between the patients with psoriasis and healthy individuals. Compared with healthy individuals, patients with psoriasis had higher levels of amino acids including asparagine, aspartic acid, isoleucine, phenylalanine, ornithine and proline; higher levels of lactic acid and urea; and lower levels of crotonic acid, azelaic acid, ethanolamine and cholesterol.

Conclusions:
It appears that the glycolysis pathway and amino acid metabolic activity are increased in patients with psoriasis. These metabolic perturbations may stem from increased demand for protein biosynthesis and keratinocyte hyperproliferation. Our findings may help to elucidate the pathogenesis of psoriasis and provide insights into early diagnosis and therapeutic intervention.

Hello!

My name is Kristen, I'm in my early 20's and I was diagnosed with psoriasis ever since I was a junior in high school. Throughout the years I have been using all sorts of products whether it be OTC or from the dermatologist. What sucks is that every single time I find a product that seems to work, my body will start adjusting to it and It Wil no longer work. My psoriasis started on my scalp and has now spread to my back, arms (on my tattoos), middle my chest, and is mostly now on my face. 

I was just wondering what are YOUR products/remedies you use to help or if you have any tips for my psoriasis. (Like if going into the ocean really does help your skin) I know everyone's body is different! 

Any feedback helps

This study looked at the risk of cardiovascular and cerebrovascular morbidity in patients with psoriatic arthritis and it doesn't make good reading.

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Objective:
To assess the magnitude of risk of cardiovascular and cerebrovascular morbidity in patients with psoriatic arthritis (PsA) compared with the general population through a systematic review and meta-analysis of observational studies.

Methods:
We searched the Medline, Embase, and Cochrane databases, as well as abstracts archives from rheumatology conferences. Observational studies that included a PsA diagnosis, cardiovascular or cerebrovascular outcomes, and a comparison group of individuals without psoriasis and rheumatic diseases and were case–control, cross-sectional, or cohort studies, were assessed by 2 researchers. We calculated weighted pooled summary estimates of the maximally adjusted effect size estimates for cardiovascular and cerebrovascular diseases using the random-effects model, and tested for heterogeneity using the I2 statistic.

Results:
Eleven studies, comprising 32,973 patients with PsA, met the inclusion criteria. There was a 43% increased risk of cardiovascular diseases in patients with PsA compared with the general population (pooled odds ratio [OR] 1.43 [95% confidence interval (95% CI) 1.24–1.66]). The risk of incident cardiovascular events was increased by 55% (pooled OR 1.22–1.96). Morbidity risks for myocardial infarction, cerebrovascular diseases, and heart failure were increased by 68%, 22%, and 31%, respectively (pooled OR 1.68 [95% CI 1.31–2.15], pooled OR 1.22 [95% CI 1.05–1.41], and pooled OR 1.31 [95% CI 1.11–1.55], respectively). We identified significant heterogeneity in all main analyses (P < 0.001).

Conclusion:
Cardiovascular and cerebrovascular morbidity are increased by 43% and 22%, respectively, in patients with PsA compared with the general population.

Hello,

My name is Daniel and I am trying Taltz again.  I first tried it in June 2016 and got really sick a couple days after starting.  I don't know if it was related to Taltz, but I was sick 4-5 days.  A couple of those days I couldn't even stand up.  Good times.

My psoriasis has been bothering me a lot more lately so I wanted to try giving it another shot (no fun intended).  I met with my doctor and he was skeptical that Taltz would have made me that sick so we decided to try again.

I took the first two injections tonight about an hour ago (Happy Christmas to me).  I am off work this coming week so if I do get sick again, I at least won't have to worry about that.

The first time I tried Taltz the injections REALLY hurt.  I don't have a high pain tolerance but this was really bad, especially compared to every other biologic injection I've tried over the years.  This time I made sure to take the injectors out at least 30 minutes prior (I can't remember if I did it that long last time) and also used ice packs for 5+ minutes on the injection areas.  It still hurt a lot but it was slightly more tolerable than the first time.

I really hope that getting sick last time was an anomaly and that things go much better this time around.  The week or two after my initial try, it did seem like some of the patches were starting to be less thick but with not continuing the treatment, it came back as before.  I've tried most every biologic available and with the exception of Raptiva, which was pulled years ago, none have worked.  I tried Otezla at the beginning of this year but that didn't work either.  It did improve things slightly but after a couple months, it went back to the way it was.

Here's hoping.  Thanks.

-Daniel