I have a home narrow band UVB box and the mfr recommends 14" distance. If I go closer is it really bad or does the 14" distance just allow for proper diffusion?

The unit has a protective cage on the exposure side and I rest my hands on it, so my hands are only a few inches from the UVB bulbs.

Hey everyone ?
So .. I have been taking methotrexate since around the 21st of July and have only gone up by 5mg's ? My Derm is completely useless ! I started on 5mg for around 4 weeks and the for the remainder I have been on 10mg's . Side effects are fine to be fair ?
My problem is it's not working .. not even a little ! In fact if anything it's getting worse . I spoke to my derm as I have an appointment on the 31st of this month and told her I'd took 15mg's last week instead of the 10 they had prescribed me and why .. she wasn't happy ! She said that if they increase they only increase at 2.5mg's a time and appointments to get that are 12 weeks apart !!!  Think where they have kept me on a low dose for so long my body has maybe just got used to it and now a few patches that had started to calm a little have gone back to how they were with extra bits added and my scalp is worse than ever ?
Really not sure what to do .. part of me thinks stuff it and come off .
They won't consider anything apart from acitretin ( already tried that and didn't like it at all )  or ciclosporin ( majority don't seem to clear on that and it's quite harsh at 1st so quite unsure on that one too ) help ?

This snippet suggests γδ T cells and IL-9 as new players in the pathogenesis of psoriatic arthritis.

Quote:

---

Cytokines such as tumour necrosis factor (TNF)-α, interleukin (IL)-12, interferon (IFN)-γ, IL-23 and, more recently, IL-9, have been implicated in the initiation/maintenance of inflammation in psoriasis and psoriatic arthritis (PsA). In the present study we aimed to characterize the role of γδ T cells in peripheral blood and synovial fluid of PsA patients and to investigate their response to in-vitro stimulation with antigen or cytokines (IL-9 and IL-23). γδ T cells isolated from peripheral blood mononuclear cells and synovial fluid were analysed by flow cytometry to evaluate the phenotype and cytokine production. IL-23R and IL-9R gene expression were also evaluated by reverse transcription–polymerase chain reaction (RT–PCR). Peripheral blood mononuclear cells (PBMC), sorted γδ T cells and γδ cell lines were also stimulated in vitro with isopentenyl pyrophosphate (IPP), recombinant IL-9 or recombinant IL-23. Our results show an expansion of γδ T cells with a predominant effector memory phenotype in peripheral blood and synovium of untreated PsA patients, which reverses significantly after treatment with anti-TNF-α or anti-IL-12/IL-23R monoclonal antibodies (mAbs). Moreover, in PsA patients γδ T cells activation is driven prevalently by IL-9/IL-9R interaction, and not only by IL-23/IL-23R. Together these findings indicate γδ T cells and IL-9 as new players in the pathogenesis of PsA.

This study evaluated myocardial scintigraphy as a screening method in patients with psoriasis.

Quote:

---

Background:
In recent years, cardiac comorbidities in psoriasis patients have increasingly moved into the focus of clinical research. The objective of the present study was to evaluate myocardial scintigraphy as a screening method in patients with psoriasis.

Patients and methods:
Assessment of various comorbidities in 50 psoriasis patients without clinical symptoms of cardiac disease. Myocardial scintigraphy was employed to detect cardiac risk/exercise-induced ischemia.

Results:
Twenty-eight patients (56 %) had pathological findings on myocardial scintigraphy. Fourteen individuals showed evidence of small-vessel disease (cardiac syndrome X). Other comorbidities included obesity, arterial hypertension, nicotine and alcohol abuse, as well as elevated CRP levels. Frequencies largely corresponded to those reported in the recent literature. There was no significant correlation between the severity of psoriasis or any comorbidities and pathological findings on myocardial scintigraphy.

Conclusions:
Myocardial scintigraphy seems to be a very sensitive, noninvasive method for the early detection of cardiac comorbidities in psoriasis patients. However, determining its true diagnostic value will require larger studies with control subjects and control methods such as coronary angiography.

Hi,

Sorry for being out of touch there for a while. Had a lot going on with my new business and took me all over the country on a weekly basis.
History so far:

Been put on Acitretin (25mg/day) since July 2015. First 8 months, significantly flared up to a point where I wanted to stop. (No real side effects apart from the fact that I started to look like a lizard )

Derm advised after 9 months to increase to 75mg. All my psoriasis cleared after a couple weeks but, then all my other problems started:
Dry lips - I had never used any lip balm in my life as I did not believe in them. Suddenly my lips were so cracked and sore, I had to start using them. To a point where I would use a tube of 15mg in a couple days time.
Insomnia - Not sure if that is a side effect but during the time I was on 75mg - my sleep pattern was severely disrupted. (Coincidence?)
Hair Loss - lost about 70% of my hair on my head, including my eybrows and beard. Lost 100% of hair on my legs and arms. Looked like I was shaving them.
Sore finger tips - This is the one thing that is really getting me down. Feels like I have ingrown fingernails all the time. (Nails are kept short and tidy). Some days it's a real struggle just to put my wristwatch on. The thing is, I work with my hands - tried gloves but that just makes me bump my fingers even more. At this point I just push through the pain and work. (being self employed does that to a person   )
Peeling on palm and feet - yeah, painful is all I can say about that.

Three months ago, I told the Derm that I am changing my dose to 50mg a day. Still have sore fingertips. Hair has started to grow back. Some patches have come back on my arms (I can live with that - Long sleeves!). Lips still very dry but manageable. Peeling of feet and palms are now minimal.

Feeling better about myself but I still think that there are better stuff out there. Acitretin is poison!

Derm has cancelled my latest appointment now three times and still do not have a rescheduled date for another appointment . Going to phone them on Monday to find out what is going on? I need to change my medication.

Sorry for the negativity but this is just what my experience was/is.

Hello all, 

I just joined the forum because I'm hoping to find some help and support for dealing with this frustrating condition.  I'm currently breast-feeding so I'm very limited on what I can take. For a while it seemed to get better, but I started getting a period again after giving birth and it seems that every time I get my period the psoriasis get way worse. I don't know if anyone else experiences this. If so I don't know if there's anything I can do to help. Also, does anyone know of any natural treatments I can use while breast-feeding that will not harm the baby?  Why is it that the condition seems to get worse when I get my period?  How can I prevent it from happening?   Any and all suggestions are welcome.  Thank you in advance.

This snippet from Clinical and Experimental Dermatology may make you think again about the use of topical vitamin D3 analogue calcitriol.

Quote:

---

A 55-year-old man with severe plaque psoriasis presented with a 2-week history of feeling generally unwell with lethargy and thirst. His symptoms had developed 6 weeks after commencement of the topical vitamin D3 analogue calcitriol. Investigations revealed hypercalcaemia and acute-on-chronic kidney injury, probably directly induced by systemic absorption of vitamin D3 following extensive topical use. Topical calcitriol had been started as a steroid-sparing agent to reduce the patient's liberal potent corticosteroid usage during anti-tumour necrosis factor-alfa therapy. Topical vitamin D analogues are commonly prescribed in dermatological and general practice, with hypercalcaemia being a rare but potentially serious adverse effect. This case serves to outline key factors that may predispose to hypercalcaemia, such as disease extent, quantity of drug applied, comorbidities and concurrent medications, and it highlights the importance of considering these factors when prescribing topical therapies.

Hi everyone, just found your group whilst trawling around the internet checking up on the headlines in the press today about 'miracle cure' - otezela , its been interesting reading some of the posts regarding otezela  and for me I'll wait and see before I charge down to the doctors to see if its available and suitable for me. 

As a long term sufferer you can guess I have tried most potions and lotions but now I tend to just put up with it and make the most of the sunshine to ease it back.

Whilst I have some hefty patches on my legs, arms and strangely on my butt (difficult to get the sunshine there without being arrested) , for me the biggest problems are when my scalp flares up and when it comes up under my nails.  Its like having bamboo slivers driven in, not nice at all.

Consultant recommended  Dovobet for both which seems to help but as ever it always comes back and usually a little worse.  When its really bad over the winter periods I get out to dermalight that I had had for years

I'll keep an eye on posts and hopefully I will pick up a few ideas that may help in the future

cheers everyone

If you use methotrexate for psoriasis and drink beetroot juice you may be interested in this snippet from an early view in Clinical and Experimental Dermatology.

Quote:

---

Methotrexate is extensively used in the treatment of psoriasis. Although safe and effective, its use may inadvertently lead to intoxication. We report a 50-year-old woman being treated with methotrexate for psoriasis who developed methotrexate intoxication after drinking beetroot juice as a herbal remedy. Patients should be warned about the potential adverse effects of herbal therapies during methotrexate treatment.

This study suggests that the -2518 A/G MCP-1 and -403 G/A RANTES promoter gene polymorphisms may be risk factors for psoriasis and may influence its clinical presentation.

Quote:

---

Background:
Polymorphic variants of the genes encoding monocyte chemoattractant protein-1 (MCP-1/CCL2) and regulated upon activation normal T-cell expressed and secreted (RANTES/CCL5) and their protein serum levels have not been widely explored in psoriasis.

Aim:
To clarify the effect of the MCP-1 (-2518 A/G) and RANTES (-403 G/A) promoter gene polymorphisms on the risk and clinical manifestation of psoriasis.

Methods:
We enrolled 160 unrelated patients with psoriasis vulgaris and 160 healthy, unrelated, age- and sex-matched volunteers. The promoter gene polymorphisms were analysed using amplification refractory mutation system (ARMS)-PCR and single specific primer (SSP)-PCR. Serum levels of cytokines were measured using ELISA.

Results:
The presence of the MCP-1–2518 GG genotype was statistically more frequent in patients and it was associated with an increased risk of psoriasis (OR = 1.94; P = 0.04). In patients with late-onset (≥ 40 years) psoriasis, the presence of the RANTES -403 AA genotype was statistically more frequent (OR = 3.65; P < 0.01) while -403 GG was less frequent (OR = 0.44; P < 0.01). Moreover, the A allele (AA or AG) in the -403 RANTES polymorphism was associated with an increased risk of developing severe psoriasis (OR = 2.02; P = 0.03). Serum levels of both chemokines were elevated. RANTES serum concentration was significantly higher in patients with Psoriasis Area and Severity Index > 15.

Conclusions:
The results of our analysis suggest that the -2518 A/G MCP-1 and -403 G/A RANTES promoter gene polymorphisms may be risk factors for psoriasis and may influence its clinical presentation.

This study suggests immune cells from patients with psoriasis have a defect in upregulating Indoleamine 2,3-dioxygenase (IDO) in response to inflammation associated with the severity of psoriasis.

Quote:

---

Background:
Indoleamine 2,3-dioxygenase (IDO) is an inducible enzyme that suppresses the immune response. The role of IDO as a negative regulator of inflammatory responses has been documented in several experimental autoimmune diseases.

Objectives:
To explore the regulation of IDO by immune cells in psoriasis and its relation with disease severity.

Methods:
The expression and activity of IDO were assessed by reverse-transcriptase polymerase chain reaction, flow cytometry and high-performance liquid chromatography in peripheral blood of patients with moderate-to-severe plaque-type psoriasis. The ability of immune cells to express IDO in response to inflammatory stimuli was studied. The functional role of IDO expression was evaluated in a regulatory T cell (Treg) differentiation assay, using cocultures of immature monocyte-derived dendritic cells with autologous peripheral CD4+ T cells.

Results:
Analysis of the kynurenine-to-tryptophan ratio in serum samples indicated higher IDO activity in patients with psoriasis than in healthy controls. However, correlation studies showed lower IDO activity in those patients with higher Psoriasis Area and Severity Index (PASI). Although myeloid dendritic cells from patients with psoriasis expressed higher levels of IDO than those from healthy controls, these cells did not upregulate IDO in response to a combination of tumour necrosis factor-α, interleukin (IL)-1β and IL-6 cytokines. The defective expression of IDO correlated with PASI. Immature monocyte-derived dendritic cells from patients with psoriasis also expressed low levels of IDO and induced CD4+ Treg differentiation poorly.

Conclusions:
Immune cells from patients with psoriasis have a defect in upregulating IDO in response to inflammation associated with the severity of psoriasis.

Howdy everyone:

I ran across this website when trying to research about coverage for Stelara.  Does anyone have any information about Stelara costs and hidden problems with Janssen's co-pay program?   It seems too good to be true.  Has anyone had any bad experiences with the co-pay plan?  Please read below and help if you can.

The patient here is my wife--her English is limited enough that I do most of the medical research and talk to most of her doctors.

Background:
About 4 months ago wife finally a diagnosis of psoriasis for skin problems on her feet. The dermatologist asked a few follow-up questions about eczema and hand stiffness, gave a prescription for Methotrexate, and referred to a rheumatologist.
The rheumatologist didn't think much of the psoriatic arthritis possibility but said that Methotrexate is a treatment for it so see what happens.  He brushed off the mild osteoarthritis in her knees that has been bothering her for 14 years--no treatment seems to help with that--at least nothing the insurance will cover like Hylagan.

Wife didn't have much improvement for two months so the dermatologist increased the dose for a month.  Wife had some marginal improvement at the higher dose but nothing to get excited about.  So the dermatologist suggested Stelara.  We stopped the Methotrexate.  The feet symptoms and hand stiffness got worse rather quickly.  I am thinking that a lot of her chronic health problems are actually psoriasis and psoriatic arthritis.

I know from reading that Stelara has helped a number of people here.  My concern is the cost.  Our insurance denied the authorization request.  Even if it was authorized we probably couldn't afford the 20% copay.  The drug manufacturer has some co-pay program where the medicine may be free for a year but my wife and I have trouble believing this and are paranoid about getting hit with catastrophic medical bills.  The plan says $10.00 per dose for $10,000.00 annual maximum benefit.  The street price is $10,000 per shot.  At that price we could afford 1 shot.  Even if, somehow, we only had to pay $10 per dose for all six annual doses we can't afford to continue treatment after that.  What's next?  I know there is no cure--just treatment.  We just don't want to go bankrupt getting treatment. 

Any advice or information from anyone in the know would be greatly appreciated.
I'll keep posting updates.  We see the rheumatologist in two days and the dermatologist is offering the starter shot free while they wait for approval from Janssen.  We really aren't sure about this.

Thanks.  Sorry for the novel.

Hello everyone,

I am a new member here, thank you for this club it is a nice forum
My name is Erar, I am from Saudi; I have plaque psoriasis since 2006
I am fine and and have experience to how live with it, 

The main reason, I become member to be part of my people
And support them. Sadly we don't have in Saudi psoriasis group
Or maby I don't know about it. 

I would like to find psoriasis group that traveling together
Sharing experience etc. 
always thinking to travel to natural spa for example but I don't think
Is good idea to go alone. Maybe with group more benefit and 
Even good for many things from cost to many things maybe we can
Find it. 

I am happy to be here and hope I can help 

Regards

Hi all

So basically I've had psoriasis since I was 14 (30 now), at one point it had taken over my legs, back, stomach and scalp. Been using the creams, gels, ointments and solutions provided by my gp which did help but never got rid of it. So I've never been free of psoriasis since I've had it and I've even had uv treatment and methotrexate at one point but still no luck so I basically decided to stop using everything except the dovobet gel for my scalp and just came to terms with the fact that I will never get rid of it. Anyway I decided to join a gym to loose a little weight and get in shape somewhat, there was no change in my diet when I started and continued like this for the first 3 months still looking the same but my psoriasis did improve slightly. Then I went on a low carb diet for 8 weeks which was definitely the game changer, I lost and stone and more importantly 90% of the psoriasis had disappeared and whatever remained I used to steriod based treatment and for the first time in 16 years I was free of psoriasis. I never heard or read that diet could help psoriasis until after I had noticed changes on my body, guys I cannot stress this enough, it actually works. Plz plz plz try it, for your own benefit. It wasn't a easy 8 weeks but it was definitely worth it.

So my diet and gym plan

Mon and Tuesday gym
Wednesday rest
Thursday and Friday gym
Saturday and Sunday rest

1 hour intense sessions of cardio and weights

My diet was simple and easy

8am Breakfast boiled eggs or oats or porridge with low fat milk and a protein shake

11am apple

1pm lunch chicken or beef or fish with a green salad

3 pm pear

6pm dinner chicken or beef or fish with vegetables

And plenty of water throughout the day

Saturday I had 1 cheat meal ?

All foods cooked healthy, touch of olive oil only if I had to. No bread, fizzy drinks or juices, and no junk food at all.

Please try it and I hope it helps you the way it helped me

Hi, new to this forum malarkey so apologies if this is in the wrong place. I have searched this site for opinions on Sorion creme but can't find anyone using it. Anyways, I stumbled across this while reading some other rubbish and looked at the reviews on Amazon. I was surprised to find that almost all of the reviews were positive and sufferers were raving about it. God knows how much cash I have wasted over the years on lotions and potions but against my better judgement I again parted with £17 for a (small) tube of this stuff. It came three days ago and I have started to use it religiously. I think it takes a while to take effect but I'm sure my elbows are calming down a bit.   They do stuff for the scalp as well but I'll see how this goes first before I part with any more cash. I
I'll keep you all informed of any progress but would love to know if anybody else has tried this and what were the results?

Hello,

I don’t normally talk about my condition. Well, not unless it is to a doctor. Actually, I lie, I have not talked to a doctor in six years. When I used to talk to them I used the minimum number of words to describe my condition and then spent the rest of the time staring at them foolishly and trying to keep my anxiety under control.  Come to think of it, I did the exact same thing with dentists, pharmacists, grocery store owners and random tourists asking for directions.

Two days ago, I caught a cold and now my whole body feels so tight I wish I were a snake so that I could shed this skin and get some relief. But, since I couldn’t do that and since I’m typing this at four in the morning, my best next course of action was to do what I’ve done for years, go to uncle Google and see if there are any new treatments and tricks to ease this discomfort. Through a circuitous route of adverts, websites requiring registration before you read them and clinical journals, Uncle G eventually sent me here.

I always knew I wasn’t alone in this. I read about others suffering from the same thing and sometimes, on a crowded train or bus, spotted one or two with very clear signs. Sadly, they didn’t return my “kindred spirit” looks and probably thought me very creepy. Now I find there is a whole forum of people with the same condition and, even if this is my last ever post on here, know that I could read their postings and occasionally mutter to myself “that’s exactly how it is.  The irritating unreachable spot under the shoulder blade, right?”

In fact, it’s not only the shoulder blade. It’s in the bits that clothes can hide and the bits it can’t. I have a black face but the constant use of those strong creams in the early days have made me look like one of Theresa May’s favourite leopard skin heels (all pigmented and multi-coloured). The bits on my arms and legs are as if I walked into a tattoo parlour and demanded they paint bits of poppadum all over me. I could swear I have one in the shape of a heart.

Beards are trendy these days.  I would love to grow one and know that mine would be great.  I can actually grow a full beard if I wanted to, there are no missing bits of dry islands on my face (well other than the plaque). But, like buying a Ferrari when you’re banned from driving, growing a beard that you can’t stroke is pointless.

I once was having lunch with two female friends. One of them started praising my hands and the other laughed. Then both took a hand each and went on and on about how great and smooth and glowing my hands were, how shiny my nails were and how beautiful my skin was.  I asked them to volunteer any positive comments on the rest of me but they were only interested and fascinated with my hands.  When the condition started and found its way to my (allegedly) lovely nails, I kept my hands in my pockets whenever I met those ladies again.

I used to have hair. I am not sure if I lost it naturally or because of the condition. Incidentally, I refer to it as the “condition” because I don’t really like its name.  I once had an idea that the reason all the medications were never a full cure was because psoriasis was never a full word. That ‘P’ gives me the same itch as the plaque itself.

Anyway, I’m forty-five, a father of four and had this condition for over 20 years.  I apologise if I bored you with my whinging but I really have a cold and my skin really feels tight and I wanted to vent to (what I hope are) like-minded people.

p.s
I know I should probably go see a doctor and I will.  I probably should also go to sleep but will try to keep an eye on the site on a daily basis. Glad to be a member of you’ll have me.

Hi all, am so pleased to find somewhere I can get some support. My story briefly..........I have always had a tiny patch of scalp psoriasis which was annoying but no big deal. Around 2 years ago I lost my job in stressful circumstances and immediately (and for the first time) I had plaques appear on my lower legs. This was kept reasonably well in control via some steroid creams (prescribed) but in the last few months (and again stress related I think) the plaques have spread quickly and I now have much of my legs, arms and some of my back fairly covered in plaques. My GP had prescribed Dovobet which initially helped but then seemed to stop working and after a few weeks use I came off and was prescribed Dovobex as an alternative. This has proven to be difficult as although the original plaques have calmed and smoothed a little, I am still getting further spread of new plaques and I have intense periods where my legs and arms are incredibly itchy. I have been using the Dovobex for around 2 weeks so maybe a bit early to tell if effective. I guess my questions are as follows:

1. How long does the Dovobex typically take to work?
2. Is the spread of new plaques unrelated to the use of Dovobex / Dovobet?
3. Can anyone recommend how to calm the intense itchy hours I get?? 
4. Are there any tricks to control the spread of plaques to parts of my body that are unaffected?

I am very grateful for all offers of help.

Dunc

All I want is real people to converse/interact with who have a similar condition. I hate feeling judged on my outside appearance for plaque psoriasis. I have this 'joke' I tell the people who try to understand me when most people treat me badly. I say God made my outsides match my insides- calloused. That is not true. But its something to say that they will try to understand. That's why I'm giving this site a try. If this doesn't work... then, yeah... I really am as alone as I feel.

First off, I'd like to say that I feel happy I can type out one of my "Dear Diary" entries I type on Word 2016 (then erase immediately afterward) here and maybe get feedback. I always wrote about my psoriasis and how it affects my life and life decisions. 

This feels weird. I'm sorry but I think it would be easier if I write how i'm used to. Be warned that I am not a grammar genius or a writer. 

Dear Diary,
     I have psoriasis. Plaque psoriasis. I was diagnosed in 2015. I didn't know it then, but in 2009, during the pregnancy of my third, and last child, I noticed a 'spot' on the back of my right calf. It was about the size of a dime. I didn't know what it was. I used make-up to hide the spot, thinking it was a part of pregnancy and would go away. It didn't go away. 

    I don't know when it happened. I was so unaware of what I had. In 2013 I had small strips of white 'scabs' on my shins and smalls blotches on my elbows. I found out through Googling that I had psoriasis. I was devastated. Little did I know that that was nothing compared to what I have now. And right now I feel blessed that I have learned how much worse my condition could be but is not. 

    Right now I have psoriasis on my scalp (no hair loss), my elbows are covered in plaques with dime to quarter sized spots on both arms (I'll NEVER go out in public uncovered),worse, my legs covered almost 90% (my biggest issue, explain later on), I have a lot of pencil eraser spots on my back, and i have a small spot developing on my face. 

    My legs. I used to love wearing capris. Back then, my self conscious issues were the size of my calves. Now they're covered in thick, yellow-gray-silvery plaques that itch horrendously. I've scratched myself soooo raw once that I caught a staph infection which led to sepsis then necrotizing fasciitis. I was in I.C.U. and the amputation of my leg was very real. Luckily, I still have my leg. 

    Right now, I'm at a loss for what I can do to help me live a more satisfying life. I've tried Triaminocolone, Clobetasol, Methotrexate, and now I'm preparing to try the Humira pen injections. From what I've read, they're not so effective on plaque psoriasis and that they HURT. I am so nervous. 

    Also, I should add that I have PCOS and have recently been diagnosed with type 2 diabetes. 

    I feel so defeated. Beaten. I couldn't take another blow...  but maybe I could. 

    Ugh... I do not know. But I'm pretty sure I will not give up.