This is another one of those interesting articles that looks at psoriasis from the side of the people that treat us, it suggests that 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition.

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Objectives:
Individuals’ illness representations, including beliefs about psoriasis (a complex immune-mediated condition), and their emotional responses to the condition guide self-management behaviour. It is also plausible that health care providers’ illness representations guide their own management of psoriasis. Patients commonly report poor health care experiences related to psoriasis, and the role of health care providers’ beliefs, emotions, as well as their knowledge, experiences and behaviours (‘personal models’) in this is unexplored. This study aimed explore health care providers’ personal models of psoriasis.

Design and methods:
Qualitative analysis of 23 semi-structured interviews with health care professionals providing care for psoriasis patients was performed. Purposive sampling achieved maximum variation regarding participant discipline, level of experience, gender and age. The self-regulatory/common sense model informed data collection and initial data analysis. Principles of framework analysis were used to generate predetermined and emergent key issues related to practitioners’ personal models.

Results:
Three types of personal model emerged. Sophisticated–Linear Model: 70% of practitioners recognized psoriasis as a complex condition but managed it as a skin condition. Mixed Model: 17% of practitioners recognized/managed some elements of psoriasis as complex and some as a skin condition. Sophisticated–Sophisticated Model: 13% recognized and managed psoriasis as a complex condition. Across the data set, five themes emerged illustrating key patterns underpinning these different models including Recognising complexity, Putting skin first, Taking on the complexities of psoriasis with the patient, Aiming for clearance, and Affective experiences within psoriasis consultations.

Conclusions:
Health care providers recognized psoriasis as a complex condition but commonly reported managing psoriasis as a simple skin condition. Providers’ beliefs and management approaches varied in the extent to which they were consistent with one another; and their emotional experiences during consultations may vary depending upon their personal model. Findings could inform future dermatology training programmes by highlighting the role of health care providers’ illness representations in clinical management of the condition.

 This looks like a great group to belong to, I've been peeking around a bit.
I've had plaque psoriasis for 30 years, as well as a few bouts with guttate and palmo-plantar.
I have tried just about every cream, lotion and potion plus UV, nothing really works for very long though.
So I have lately decided to go au naturel, and just live around it.
Eh, could be better, but it certainly could be worse so I'm a happy camper!

Hello everyone using Cosentyx.   Any updates from you all?    I just posted mine and look forward to hearing about your Cosentyx journies!!   

This cohort study looked at whether patients with psoriasis have an increased risk of arrhythmia, arrhythmia also known as cardiac dysrhythmia or irregular heartbeat, is a group of conditions in which the heartbeat is irregular, too fast, or too slow.

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Background:
Psoriasis is associated with cardiovascular morbidity and mortality. However, the association between psoriasis and arrhythmia has not been adequately studied.

Objective:
We sought to investigate whether patients with psoriasis have an increased risk of arrhythmia.

Methods:
This population-based cohort study identified 40,637 patients with psoriasis and 162,548 subjects without psoriasis matched by age, sex, history of coronary artery disease, hypertension, and diabetes in the Taiwan National Health Insurance Research Database during 2004 through 2006.

Results:
After adjusting for medical history and medication use, patients with psoriasis were at increased risk of overall arrhythmia (adjusted hazard ratio [aHR] 1.34; 95% confidence interval [CI] 1.29-1.39). The risks of arrhythmia were higher in all subgroups, including patients with severe (aHR 1.25; 95% CI 1.12-1.39) and mild (aHR 1.35; 95% CI 1.30-1.41) psoriasis, and in patients with (aHR 1.46; 95% CI 1.22-1.74) and without (aHR 1.33; 95% CI 1.28-1.39) psoriatic arthritis.

Limitations:
The National Health Insurance Research Database did not contain information regarding Psoriasis Area and Severity Index, cigarette smoking, or alcohol consumption.

Conclusion:
Patients with psoriasis were at higher risk of developing arrhythmia, particularly for those with psoriatic arthritis, independent of traditional cardiovascular risk factors.

My dermotologist added another cream to my already endlessly supply. The cream is called Tazorac and is to be applied at nighttime. I'll keep this thread update with my thoughts.

DMF acts slowly, but I have had continuous improvement in my arthritis (less pain and greater flexibility), so the overall effect has been very substantial. A bit of tummy upset a few times a week is no big deal, but to each his own.

Cheers,

Bill

Anyone heard of being given statins by the derm to help psoriasis drugs? It's not me, but I heard about it today and was surprised because I've not heard anything about this before.
I did a bit of reading and it seems they can give you psoriasis or help it, all very confusing.

I'm new here, and a new psoriasis patient. I was diagnosed a few months ago. We've tried creams/lotions, but the plaque psoriasis keeps coming back, so now I've been prescribed Methotrexate. I hate taking medications, but I hate long sleeves more, so I'm going to give it a shot. I'm here to connect with others who are dealing with this condition and am looking forward to participating.

My Dermotologists said he has patients without arthritis that has tendon issues. He was suggesting that it was a separate disease. Just curious how many people with psoriasis (not arthritis) have tendon problems? Also, what works for it? So far nothing has helped much besides the TNFs, and even those are not that great.

Hello I decided to join after reading this. Welcome Guest

Margo

Hi everyone!   I got my first 2 injections yesterday morning!  I am using the pen and it hardly hurt at all!   Am excited and scared at the same time, of course.   No real side effects yet....did have to run to the potty one time unexpected.  lololo    This is a side effect that I have heard about.  I felt achy last night but that has also subsided.   My health insurance that I have through my company has EXCLUDED this drug.  So I have started the 5 week start up program and then I believe I was told I can then get an additional six months of medication.  What happens beyond that is unknown.   That is what is so scary too!  I am taking pictures and will post them as I get further into my treatment.  Thanks for your support and any additional input!  

Another new Bio in the pipeline for treating psoriasis has just beaten Humira (adalimumab) in it's phase 2 trial, guselkumab from the makers of Stelara (Janssen) is designed to block interleukin-23 and not IL-12.

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Background:
Little is known about the effect of specific anti–interleukin-23 therapy, as compared with established anti–tumor necrosis factor therapies, for the treatment of moderate-to-severe plaque psoriasis.

Methods:
In a 52-week, phase 2, dose-ranging, randomized, double-blind, placebo-controlled, active-comparator trial, we compared guselkumab (CNTO 1959), an anti–interleukin-23 monoclonal antibody, with adalimumab in patients with moderate-to-severe plaque psoriasis. A total of 293 patients were randomly assigned to receive guselkumab (5 mg at weeks 0 and 4 and every 12 weeks thereafter, 15 mg every 8 weeks, 50 mg at weeks 0 and 4 and every 12 weeks thereafter, 100 mg every 8 weeks, or 200 mg at weeks 0 and 4 and every 12 weeks thereafter) through week 40, placebo, or adalimumab (standard dosage for psoriasis). At week 16, patients in the placebo group crossed over to receive guselkumab at a dose of 100 mg every 8 weeks. The primary end point was the proportion of patients with a Physician’s Global Assessment (PGA) score of 0 (indicating cleared psoriasis) or 1 (indicating minimal psoriasis) at week 16.

Results:
At week 16, the proportion of patients with a PGA score of 0 or 1 was significantly higher in each guselkumab group than in the placebo group: 34% in the 5-mg group, 61% in the 15-mg group, 79% in the 50-mg group, 86% in the 100-mg group, and 83% in the 200-mg group, as compared with 7% in the placebo group (P≤0.002 for all comparisons). Moreover, the proportion was significantly higher in the 50-mg, 100-mg, and 200-mg guselkumab groups than in the adalimumab group (58%) (P<0.05 for all comparisons). At week 16, the proportion of patients with at least a 75% improvement in Psoriasis Area and Severity Index scores was significantly higher in each guselkumab group than in the placebo group (P<0.001 for all comparisons). At week 40, the proportion of patients with a PGA score of 0 or 1 remained significantly higher in the 50-mg, 100-mg, and 200-mg guselkumab groups than in the adalimumab group (71%, 77%, and 81%, respectively, vs. 49%) (P<0.05 for all comparisons). Between week 0 and week 16, infections were observed in 20% of the patients in the guselkumab groups, 12% in the adalimumab group, and 14% in the placebo group.

Conclusions:
The results of this phase 2 trial suggest that guselkumab may be an effective therapy for plaque psoriasis and that control of psoriasis can be achieved with specific anti–interleukin-23 therapy.

Hello everyone.
I've recently been told to stop taking MTX until I've had more bloods. It may be a blip in my results but who knows? I don't mind admitting, all the messing about has pi**ed me off and been getting me down.
Anyway, I've been putting my insomnia to good use by doing some research and have been chatting with Toby Hadoke. He's an actor, writer and Dr Who geek (amongst other things). My partner Nick met him last year at a Dr Who event. Toby also suffers with psoriasis.
After checking out Toby's blog and commenting, we've been tweeting & messaging.
The upshot is that he has had counselling with a psycho-dermatologist to help with the psychological effects of psoriasis and is also involved in a campaign called See Psoriasis, Look Deeper.
I wont post links, it can be easily googled, but I thought this information might be useful to someone. It's very interesting and they're trying to make more Dermatologists aware of the emotional impacts.

This might be a stupid question but I see threads where people say they had psoriasis over 70% 80% or 90% of their body.

Now I probably have psoriasis over arms, legs, back, bottom, face, scalp and a little on my torso. 

So that equates to about 60% of my body but as a total of my skin surface area its only a small amount as its lots of patches and I have a lot of skin.

My consultant said that I rated about 3 out of 10 on a "how bad is my psoriasis scale" which is ok, well I don't want to be a 10 out of 10.

So how do I measure my psoriasis. I have seen the scoring methods but then I have to decide whats good bad or indifferent and it varies every few days on how itchy, angry or generally pee'd off I get.

Even more good news for Cosentyx (secukinumab) after it goes head to head against it's main rival Stelara (ustekinumab), and after the 52-week, double-blind study of 676 subjects Cosentyx won the head to head battle.

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Background:
Secukinumab, a fully human anti-interleukin-17A monoclonal antibody, has shown superior efficacy to etanercept with similar safety in moderate to severe plaque psoriasis (FIXTURE study).

Objective:
We sought to directly compare efficacy and safety of secukinumab versus ustekinumab.

Methods:
In this 52-week, double-blind study (NCT02074982), 676 subjects were randomized 1:1 to subcutaneous injection of secukinumab 300 mg or ustekinumab per label. Primary end point was 90% or more improvement from baseline Psoriasis Area and Severity Index (PASI) score (PASI 90) at week 16.

Results:
Secukinumab (79.0%) was superior to ustekinumab (57.6%) as assessed by PASI 90 response at week 16 (P < .0001). The 100% improvement from baseline PASI score at week 16 was also significantly greater with secukinumab (44.3%) than ustekinumab (28.4%) (P < .0001). The 75% or more improvement from baseline PASI score at week 4 was superior for secukinumab (50.0%) versus ustekinumab (20.6%) (P < .0001). Percentage of subjects with the Dermatology Life Quality Index score 0/1 (week 16) was significantly higher with secukinumab (71.9%) than ustekinumab (57.4%) (P < .0001). The safety profile of secukinumab was comparable with ustekinumab and consistent with pivotal phase III secukinumab studies.

Limitations:
The study was not placebo-controlled and of short-term duration.

Conclusions:
Secukinumab is superior to ustekinumab in clearing skin of subjects with moderate to severe psoriasis and improving health-related quality of life with a comparable safety profile over 16 weeks.

Hi , i i just found this place. its great to see that many people are sharing a lot of information .

about me - today was my first STelara injection and i am a bit afraid ....

dont know what to tell you , but i gonna send some post here about how it works with me ...

you are wellcome to ask me , i gonna share my expirience with my dear psoriazis 

Hi. New to this, usually suffer alone drenched in self pity. Had a bout of above disgusting disease in 1993 till 1997 which inexplicably disappeared when my son was born only for it suddenly to return in all its glory last year. Im 58 yrs old, been taking acetretin this time round and its been a miracle drug, at least on the outside, i can walk (though not as far as i could when i didnt have ppp) and use my hands fairly normally. Thats such a blessing, but i still feel like a monster. How i envy those who can take all this in their stride. Side effects are many but mostly light and livable with. Anyone else hate with a vengeance bloody zipzok. So...i dread if i ever have to come off the medication. Hoping for another remission but dont know why it happened in the first place. Anyway this is me. Just wanted to introduce myself xxx

Hey all

Been dealing with psoriasis now for over 10 years, always trying new things, products, diets etc to try to find something that would alter my condition.
At the beginning of this year I started a (not due to psoriasis) low fat diet, which indirectly led me to go full vegan. I kept this up for about 1½-2 months and to my surprise this actually affected my rashes. It took a while for it to be noticeable, but today about 80-90% of all my rashes are gone and it has been pretty bad.
I have noticed that for example, a week or so ago I eat crackers several days in a row that contained milk powder and butter. Not in any large quantities at all, but this was apparently enough to flare up. Initially, when I first started the low fat diet I though it was the fat that was the issue, but after eating cod that only has 1% fat it I am sure it is animal protein that is the problem. Be it eggs, milk, butter, meat or fish, I seem to react the same to them all.

I know that not all psoriasis are the same, but if you are looking for an alternative way to handle your psoriasis and you have not tried this, perhaps going full/strict vegan for a couple of months would be worth giving a shot.

Cheers!

Hi Everyone,

Hope life is treating you all kind.. I am a male in my mid thirties and had been suffering now for a few years... I have been put on Acitretin since yesterday and feeling very depressed as heard a lot of bad things about it. I have tried every thing from  moisturisers  to oral steroids and light therapy but nothing seems to working and now Acitretin..I would appreciate if  any one can share their  experience with Acitretin. Currently I am on a 25 mg tab..

Thanks

Hi Everyone! 

Thrilled I found this forum!  Looks fantastic!       Can't wait till I have time to sit and browse through it!   I have plaque psoriasis and started it in about 2007.  Have done at home phototherapy and most prescription topicals.  Sick of it all!   Start Cosentyx next week and can't wait.   Have health care coverage through my company, but of course this new drug is EXCLUDED!   Has me a little worried to say the least.....    Most of my psoriasis is located on my legs, arms, but now developing on my eyelids and lips.  Very painful and not pretty!  Glad to be part of a support group, finally!!  Take care!