wentnto the hosp today. For my usual appt, been taken off Toctino which made my skin worse, now on myfenox. 2  500 mg twice a day. So will see how we go. Any one got any feed back about these tablets. Was told be about 3 weeks if they will agree with me.

Nice are about to recommend Otezla again. there is a final meeting on 24 August.

For now NHS are making decisions locally using a discounted patient scheme funded by the manufacturer.

So it's available now in some areas and could be more widely available later.

Not sure if anyone used this, but just to make you all aware Polytar shampoo has now become available within the UK again! I know this was a treatment my dad had been disappointed they had discontinued.

This study looked at the frequency of Th17 cells and related cytokines in peripheral blood of patients with psoriasis, and analysed their association with disease severity.

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Background:
Recently, a new population of IL-17-producing CD4 T helper (Th) cells, named Th17, was identified and shown to be involved in various inflammatory and autoimmune diseases, including psoriasis.

Aim:
To determine the frequency of Th17 cells and related cytokines in peripheral blood of patients with psoriasis, and to analyse their association with disease severity.

Methods:
This was a prospective study comprising 34 patients with psoriasis and 24 healthy controls. Clinicoepidemiological details of patients were recorded, and severity of psoriasis was assessed by means of the Psoriasis Area and Severity Index. Circulating Th1 and Th17 cells in untreated patients with psoriasis and healthy controls were quantified by flow cytometry. In sera collected from patients with psoriasis and healthy controls, concentrations of IL-17A and IL-23 were examined by ELISA.

Results:
Increased frequencies of CD4+ IL-17A+ T cells were seen in peripheral blood of patients with psoriasis vulgaris (P < 0.001). Although serum IL-17A and IL-23 concentrations were higher in patients with psoriasis than in controls, the results did not reach statistical significance. We could not find any correlation between the studied T cells or related cytokines and the disease severity.

Conclusion:
Increased serum levels of circulating Th17 cells and related cytokines may contribute to the cutaneous pathology of psoriasis, as well as the inflammatory process that is a hallmark of psoriasis.

I though I would write a few words about why I joined the club and what it means to me

I joined the forum in October 2013 When I had problems with my psoriasis medication, I didn't know where to get impartial advice, I searched the Internet but was unable to find any answers until I stumbled onto this site..

I had never been on a forum before and found it difficult to pluck up the courage to post my first question and was pleasantly surprised by the fast friendly response I received......it certainly encouraged me to return and reply to the answers I got....up until I joined this club, I had managed alone through my life with this awful disease trying to keep it hidden, ashamed of the flaky trail I left wherever I went....I always felt that I was alone even when in company the psoriasis is always your dark secret ....family try to understand but can't know how it feels to live with the disease

So coming here was a revelation to me that I wasn't alone and there were people out there with the same problems as me
I find the site very helpful as there are updates on a regular basis of the latest developments of psoriasis treatments, and the members generally keep us updated on their progress ...enabling me to understand more about the disease and the best way to treat it, as told by members,

I like the fact there are very few rules and those that there are are to keep the site safe from spammers and advertisers. Most of the rules are just common sense and easy to abide by. I would sometimes like to give an outside link to some information, but I understand the reasons we don't allow it. The site is totally independent and privately funded, giving all members free access to all the information without requests for donations

I'm of the opinion that if the site has been successful since 2011 it must be doing something right.

I love he ease of navigation and how if lost someone will always help.

I have found it rewarding to be able to talk with new members and try to help them deal with the disease and tell of my experience.....

I would say that although this was the first forum  I ever joined I have visited many since but I find this one the most useful and friendly which is why I keep coming back, and am glad that I was made a forum helper

I have watched the forum flourish over the three years I have been here with a steadily growing friendly membership from around the world

After I joined I was soon posting jokes in the off topic section, and after a while started to post photos in the members photos section .....The off topic section is filled with all manner of topics from gardening to pets ..Railways to holidays you name it it's probably there

In summary this is more than just another psoriasis forum ( although in my opinion the best) it is also a place to forge friendships and comradeship with others with the disease

An interesting article is currently available in the Daily Mail ( a UK newspaper) regarding Enstilar foam. Although it doesn't make it sound like a miracle cure it does give it a big build up. I do get the feeling that the article is written by someone that doesn't have the disease though as I feel they down play the effect of Ps on sufferers a little.

Hi.  I have psoriasis on my penis and have been using hydrocortisone cream to treat it for 5 months now.  I'd say the cream has cleared up 20% of the area.  I noticed something form on my forearm.  I thought I had been cut by a plant or maybe got poison ivy but it didn't go away. Little white spots started to form and then I realized, maybe this is psoriasis.  I was on vacation and in hot sun for several days and I noticed the area on my arm completely cleared up and is 100% gone.  It wasn't a big area but I virtually cannot see any of it still there.  

I have heard that sunlight helps psoriasis.  Being that I've had it on my penis and been using the cream for 5 months now with only a 20% success rate, I am thinking I may need some sun.  

My question is, how well does sunlight typically help psoriasis?  Could it be that what was on my arm was psoriasis and it cleared up the whole area in a few days?  Does it work that well, or does it typically take many sessions of sunbathing... 10, 50?  If not that many and it can clear it up in a few sessions I may need to make the trip to the local nude beach.  Lol.

Hi.  I am wondering if psoriasis once treated leaves a scar?  I have it pretty bad on my penis.  Once treated should I expect for there to be scarring?

Hi there, today is 24 hours into my Cosentyx journey! Excited to say the least! 24 hours since very first injections and the small dots are already much less angry and itchy! And the thick thick plaques are starting to break down a little-can't wait to see the results in a week or a month! I have had psoriasis since 11 years old but got out of hand in early 20's. I've used all the topicals a, UV, Mtx, cyclosporine, humira, infliximab, stellara and now on  Cosentyx. The only thing to ever clear me was infliximab many years ago but after a year of infusions I developed drug induced lupus from it! I'm genuinely so excited to give Cosentyx a try! Love to hear any stories if anyone has any of Cosentyx? How do I post photo's? Would love to share my journey/results ongoing

Hi all, my name is Belinda and I'm 38 from Aus! I have severe psoriasis plaque, nails,scalp and psoriatic arthritis. Have had since 11 years old. I have used all the creams and all the biological and just yesterday started on Cosentyx. Looking forward to being part of the group. No idea how to attach photos but happy to keep you all in loop of Cosentyx progress if someone can advise  as I know it's new and interest is high

This study investigated the expression and tissue distribution of Th9-related cytokines in patients with psoriatic arthritis (PsA)

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Objective:
To investigate the expression and tissue distribution of Th9-related cytokines in patients with psoriatic arthritis (PsA).

Methods:
Quantitative gene expression analysis of Th1, Th17, and Th9 cytokines was performed in intestinal biopsy samples obtained from patients with PsA, HLA−B27−positive patients with ankylosing spondylitis (AS), patients with Crohn's disease (CD), and healthy controls. Expression and tissue distribution of interleukin-23 (IL-23), IL-17, IL-22, IL-9, and IL-9 receptor (IL-9R) were evaluated by immunohistochemistry and confocal microscopy. Flow cytometry was used to study the frequency of Th9 cells among peripheral blood, lamina propria, and synovial fluid mononuclear cells. The functional relevance of IL-9R expression on epithelial cells was assessed in functional in vitro studies. Th9 cells in synovial tissue from patients with PsA were also studied.

Results:
Subclinical gut inflammation in PsA patients was characterized by a clear Th17 and Th22, but not Th1, polarized immune response. Unlike AS and CD, a strong and significant up-regulation of IL-9 was observed in PsA gut, especially among infiltrating mononuclear cells, high endothelial venules, and Paneth cells. IL-9−positive mononuclear cells were demonstrated to be in large part Th9 cells. IL-9 overexpression was accompanied by significant Paneth cell hyperplasia. Paneth cells strongly overexpressed IL-9R, and stimulation of epithelial cells, isolated from PsA patients, with IL-9 resulted in overexpression of α-defensin 5 and IL-23p19. Peripheral and synovial expansion of α4β7+ Th9 cells was also observed in patients with PsA. Increased expression of IL-9 and IL-9R was also found in synovial tissue.

Conclusion:
Strong IL-9/Th9 polarization seems to be the predominant immunologic signature in patients in PsA.

This study assessed if Cosentyx (secukinumab) is associated with sustained inhibition of radiographic progression inhibited radiographic progression in patients with psoriatic arthritis.

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Objective:
To assess whether secukinumab treatment in patients with active psoriatic arthritis (PsA) is associated with sustained inhibition of radiographic progression.

Methods:
In this phase III, double-blind, placebo-controlled study, 606 patients with PsA were randomized to receive intravenous (IV) secukinumab at a dose of 10 mg/kg (weeks 0, 2, 4) followed by subcutaneous secukinumab at a dose of 150 mg or 75 mg (the IV > 150 mg and IV > 75 mg groups, respectively) or placebo. Patients were stratified according to prior anti–tumor necrosis factor (anti-TNF) exposure (71% were anti-TNF naive). At week 16, placebo-treated patients who had at least a 20% reduction in the tender and swollen joint counts (responders) continued to receive placebo until week 24; nonresponders were re-randomized to receive secukinumab at a dose of 150 mg or 75 mg. The modified total Sharp/van der Heijde score (SHS) was determined at baseline, week 16 or 24, and week 52.

Results:
In the overall population, radiographic progression was inhibited through 52 weeks; efficacy was demonstrated for both erosion and joint space narrowing scores and in patients who switched from placebo to secukinumab at week 24. Subgroup analyses showed that secukinumab reduced radiographic progression at week 24, regardless of previous anti-TNF treatment. Among anti-TNF–naive patients, the mean changes from baseline to week 24 in the modified total SHS were 0.05 in the pooled secukinumab group and 0.57 in the placebo group; among patients with an inadequate response or intolerance to anti-TNF treatment, the mean changes were 0.16 and 0.58, respectively. Anti-TNF–naive patients showed negligible progression through week 52. Inhibition of structural damage was observed through week 52 irrespective of concomitant methotrexate use. A high proportion of patients receiving secukinumab showed no progression (change in SHS of ≤ 0.5) from baseline to week 24 (82.3% of the IV > 150 mg group and 92.3% of the IV > 75 mg group) and from week 24 to week 52 (85.7% of the IV > 150 mg group and 85.8% of the IV > 75 mg group).

Conclusion:
Secukinumab inhibited radiographic progression over 52 weeks of treatment in patients with active PsA.

Today I have been to the hospital to see the rheumatologist we had a frank discussion and I informed her again that I was reluctant to come off my psoriasis drug ( Fumaderm ) as it works so well . I'm on 4x 120mg tablets a day

But have noticed joint pain recently and have been diagnosed with psoriatic arthritis, the hospital are passing me between dermatology and rheumatology

The rheumatologist wanted me back on methotrexate but I have refused that.

I asked about Cosentyx and Otezla and was told to suggest something she could prescribe ....I mentioned Humira but I haven't got three swollen joints and haven't failed enough oral treatments to get them

Now I'll get to the point I have also been offered leflunomide or Sulfasalazine ....now as I've never been on a DMARD I have no experience of what to expect, and I'm hoping for some guidance here

Ok, so I am not sure if I am posting in the correct place or not.... My name is Deborah and I am 50 years old.  I was diagnosed with PA back in 1997 and for the most part have been on Enbril or a long time.  Unfortunately for me the side effects outweighed the benefits and last November I stopped taking all meds.. ON a plus, I have not been  sick with an upper respitory infection since January and I use to get them 3-5 times a year, down side, my psoriasis and arthritis is at an all time high and I feel horrible.  I am welcome to any advice or suggestions that you all have and I am glad to have finally found a group of people who all have what I do.... Nice to meet you

RHi - my name is Margot. I've had Psoriasis since I was six (I'm now 49) and have never really looked for other people to talk to about it before despite the massive effect it has had on my life. I have been through ups and downs with it and I am lucky that although at times it has been bad, there are people around who have had it much worse than me. I think this is a fantastic idea as peer support and being able to connect with people who really get what you are talking about is so important. I don't know why I haven't looked into something like this before. I'm off to a holiday in the sunshine tomorrow, which really helps, but am looking forward to being part of the forum and hearing from others who 'get it'. Thanks

Hi all this is my first post.  Just found this site today and am really enjoying reading the comments posted.  My question to all of you is this:  (sorry ahead of time for the length).
My daughter 22, Sam has recently (since March 2016) developed gutate psoriasis. She has coverage over 80% of her body and is MISERABLE.  My first question is what are the stages this condition goes through?  She was on a topical cream that was  doing very little, but she was going through the large jar of cream very quickly.  She has not had the cream for several weeks and it has come back with a vengence.  She is moisturizing, but nothing else medically and her skin has very little scaling (except her scalp), but the patches are raw and red and hot and painful.  I am at a loss as how to help her and was wondering if this "stage" is a bad sign of worse things to come or just a stage before the scaling starts.  Is there anything naturally we can use right now to shrink some of the sores or is this it for her?  I am worried about her being able to afford medication, biologics etc. when she is too old to be on my insurance, so I was trying to treat this naturally for her pocketbook's sake.  Any suggestions would be welcome.  Thanks again for this site; it is very comforting to know there are other sufferers out there although I wouldn't wish this on my worst enemy.

Mary - Mom of Sam

This is a small study looking at the efficacy and safety of Acitretin in childhood and adolescent psoriasis patients.

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Background:
Acitretin is licensed for and is most commonly used to treat psoriasis. Little information exists about its efficacy and safety in childhood and adolescent psoriasis.

Methods:
Retrospective analysis of a group of children and adolescents (<17 years of age) with moderate to severe plaque psoriasis treated with acitretin between 2010 and 2014 at Italian dermatology clinics. Patients were identified through databases or registries.

Results:
The study population consisted of 18 patients with a median age of 9.5 years at the start of therapy. The median maintenance dosage per day was 0.41 mg/kg. Eight patients (44.4%) achieved complete clearance or good improvement of their psoriasis, defined as improvement from baseline of 75% or more on the Psoriasis Area and Severity Index at week 16. Three had three or more courses of treatment with short disease-free intervals. In three patients, acitretin treatment was ongoing at the time of data collection. The mean total duration of treatment in responders was 22.7 months. One patient discontinued treatment because of arthralgia. The remaining nine patients (50%) discontinued treatment because it was ineffective. Mucocutaneous adverse effects occurred in all patients, but did not affect therapy maintenance.

Conclusions:
In this retrospective case series, acitretin was a moderately effective, well-tolerated treatment in children with moderate to severe plaque psoriasis. Given the small number of patients, statements about long-term safety are not possible.

Hello, and I hope today was better than the last. I am waiting to hear about patient assistance, but I'm wondering, is Novartis generous, is your insurance amazing, or are you paying out of pocket? Because I am literally falling apart head to toe and don't see how I can afford this until 2020. 

This Danish study suggests there is an increased risk of periodontitis in psoriasis patients.

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Background:
Psoriasis and periodontitis are chronic inflammatory disorders with overlapping inflammatory pathways, but data on risk of periodontitis in psoriasis are scarce and a possible pathogenic link is poorly understood.

Objective:
We investigated the association between psoriasis and periodontitis in a nationwide cohort study.

Methods:
All Danish individuals aged ≥18 years between 1 January 1997 and 31 December 2011 (n = 5,470,428), including 54 210 and 6988 patients with mild and severe psoriasis, and 6428 with psoriatic arthritis, were linked through administrative registers. Incidence rate ratios (IRRs) were estimated by Poisson regression.

Results:
Incidence rates of periodontitis per 10 000 person-years were 3.07 (3.03–3.12), 5.89 (1.07–6.84), 8.27 (5.50–12.45) and 11.12 (7.87–15.73) for the reference population, mild psoriasis, severe psoriasis and psoriatic arthritis respectively. Adjusted IRRs were (1.66; 1.43–1.94) for mild psoriasis, (2.24; 1.46–3.44) for severe psoriasis and (3.48; 2.46–4.92) for psoriatic arthritis. Similar results were found when a case–control design was applied.

Conclusions:
We found a significant psoriasis-associated increased risk of periodontitis, which was highest in patients with severe psoriasis and psoriatic arthritis.

This German study suggests psoriasis patients do better on Bio treatments.

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Background:
Psoriasis is associated with significant patient burden. Few studies have specifically measured patient preferences and benefits.

Objectives:
Outcomes assessment using the Patient Benefit Index (PBI) in nationwide psoriasis surveys comparing health care in 2007 and 2014.

Methods:
This was a non-interventional, cross-sectional survey conducted in 2007 and 2014 in randomly selected dermatological practices and clinics recording by a) physicians: comorbidity, clinical severity (PASI, GCA), and b) patients: quality of life (DLQI, EQ-5D), patient-relevant therapeutic benefits (PBI) and previous and curent treatments.

Results:
In 2014, a total of n = 1265 patients (43.4% female, mean age 51.9 ± 14.3 years.; mean disease duration 21.6 ± 15.4 years.) were included. Overall PBI was 2.8 ± 1.1. A total of 91.6% of patients showed a more than minimum clinically relevant benefit (PBI>1). Patients treated with biologics and biologics combined with conventional systemics showed the highest benefit compared to patients with conventional systemic treatment and patients treated with topical steroids. In comparison with the 2007 survey (n = 2009), there was an increase in PBI from 2.5 ± 1.1 to 2.8 ± 1.1 and a gain of patients with high benefits (PBI ≥3) by 30% (38.5% vs. 49.4%).

Conclusion:
In German routine care, psoriasis patients have shown increased therapeutic benefits over time with highest benefits deriving from biologics combined with systemics.