Monthly Archives: February 2021

Op-ed | Space weather bill will fizzle without funding – SpaceNews

Posted on by

On Oct. 21, 2020, the Promoting Research and Observations of Space Weather to Improve the Forecasting of Tomorrow (PROSWIFT) Act was signed into law. This act culminates a multiyear bipartisan effort championed by Sens. Gary Peters (D-Mich.) and Cory Gardner (R-Colo.), and Reps. Ed Perlmutter (D-Colo.) and Mo Brooks (R-Ala.). It directs government agencies (including NOAA, NASA, NSF, and the Department of Defense), as well as academia, the commercial sector, and international partners, to coordinate efforts to predict space weather events and mitigate their impact. The PROSWIFT Act is a major step forward in developing a coordinated national space weather plan. But to fully realize the objectives in this authorizing legislation, and so protect humanity from potentially devastating space weather events, will require a commensurate appropriation of funds to ensure the necessary advances in our understanding of the sun.

Our world is increasingly and irrevocably reliant on a complex system of ground-based and space-based technology infrastructure. Yet this infrastructure exists on a planet immersed in a cloud of million-degree gas originating at the sun, and so is at a constant threat from the effects of space weather. Space weather consists of streams of energetic particles, intense ultraviolet and x-ray radiation, and magnetic disturbances, constantly bombarding our planet. Like terrestrial weather, its usually mild but can occasionally turn nasty. A rare, large space weather event releases more energy than 10,000 Category 5 hurricanes. It can send billions of tons of material hurtling through space at millions of miles per hour sometimes right at Earth.

The effects of such a drastic disturbance in the near-Earth space environment include billions of dollars of damage to our communications and power distribution architectures; interruption of GPS services; radiation exposure for passengers and crew on aircraft; and deadly radiation doses for astronauts in Earth orbit and on the moon. In 1989, a geomagnetic space weather storm unleashed by the sun caused much of the Canadian province of Quebec to lose electric power for hours. In 2012, a solar eruption that would have wreaked economic havoc 20 times worse than Hurricane Katrina missed Earth by just a week. Think of the catastrophe of such an event in the midst of the current COVID-19 pandemic, as unprecedented numbers of people depend on the very technologies that are at risk from space weather to enable remote learning, work, and health treatment.

The PROSWIFT Act places considerable emphasis on the importance of research into the underlying causes of space weather. Just like hurricane prediction requires satellite imagery and in situ measurements coupled with an understanding of atmospheric dynamics, space weather prediction relies on observations from ground- and space-based observatories coupled with a deep understanding of the physics of the sun and near-Earth space. This fundamental science discipline heliophysics is interwoven with all things space: planetary science, astrophysics, and Earth science.

Heliophysics is many exciting things. Its amazing photographs of auroral displays, from the ground and from space. Its the discovery of the mysterious STEVE (Strong Thermal Emission Velocity Enhancements) by amateur citizen scientists. Its using ground-based solar telescopes, like NSFs Daniel K. Inouye Solar Telescope, to probe the dynamics of the sun. Its exploring the intense radiation belts around Earth with NASAs Van Allen Probes. Its developing advanced computer simulations of the near-Earth, solar, and interplanetary space environments. And its launching NASAs Parker Solar Probe to touch the atmosphere of our sun.

The passage of the PROSWIFT Act is an important milestone for science and for our nations security. It summons the United States to muster its considerable resources to lead and protect society from potentially devastating space weather events. On behalf of the membership of the scientific societies we represent the Space Physics and Aeronomy Section of the American Geophysical Union and the Solar Physics Division of the American Astronomical Society we call upon the White House Office of Management and Budget and the White House Office of Science and Technology Policy to request, and Congress to support, robust funding levels for heliophysics research and space weather infrastructure. As this pandemic has highlighted, our personal lives, national security, and economy are all at risk without such an investment.

Dr. Ian Cohen, Senior Professional Staff at The Johns Hopkins University Applied Physics Laboratory, and Chair of the AGU Space Physics and Aeronomy Section Advocacy Committee

Dr. Gordon Emslie, Professor of Physics & Astronomy, Western Kentucky University, and Chair of the AAS Solar Physics Division Public Policy Committee

The rest is here:

Op-ed | Space weather bill will fizzle without funding - SpaceNews

Life on Venus? The Picture Gets Cloudier – The New York Times

Posted on by

A team of astronomers made a blockbuster claim in the fall. They said they had discovered compelling evidence pointing to life floating in the clouds of Venus.

If true, that would be stunning. People have long gazed into the cosmos and wondered whether something is alive out there. For an affirmative answer to pop up on the planet in the orbit next to Earths would suggest that life is not rare in the universe, but commonplace.

The astronomers, led by Jane Greaves of Cardiff University in Wales, could not see any microscopic Venusians with their telescopes on Earth. Rather, in a paper published in the journal Nature Astronomy, they reported the detection of a molecule called phosphine and said they could come up with no plausible explanation for how it could form there except as the waste product of microbes.

Five months later, after unexpected twists and nagging doubts, scientists are not quite sure what to make of the data and what it might mean. It might spur a renaissance in the study of Venus, which has largely been overlooked for decades. It could point to exotic volcanism and new geological puzzles. It could indeed be aliens. Or it could be nothing at all.

Dr. Greaves and her colleagues remain certain about their findings even as they have lowered their estimates of how much phosphine they think is there. I am very confident there is phosphine in the clouds, Dr. Greaves said.

Clara Sousa-Silva, a research scientist at the Center for Astrophysics in Cambridge, Mass., and one of the authors of the Nature Astronomy paper, said, I think the team in general still feels pretty confident that its phosphine, that the signal is real and that there are no real abiotic explanations.

But, Dr. Sousa-Silva added, theres a lot of uncertainty in all of us.

In the wider circle of planetary scientists, many are skeptical, if not disbelieving. Some think that the signal is just a wiggle of noise, or that it could be explained by sulfur dioxide, a chemical known to be in the Venus atmosphere. For them, there is so far no persuasive evidence of phosphine let alone microbes that would make it at all.

Whatever it is, its going to be faint, said Ignas Snellen, an astronomer at Leiden University in the Netherlands who is among the skeptics. If the signal is faint, he said, its not clear whether its real, and, if its real, whether its going to be phosphine or not.

The debate could linger, unresolved, for years, much like past disputed claims for evidence of life on Mars.

When the observation came out, I was like, Oh, thats interesting, said Martha S. Gilmore, a professor of geology at Wesleyan University in Middletown, Conn. Dr. Gilmore is the principal investigator of a study that has proposed to NASA an ambitious flagship robotic mission to Venus that would include an airship flying through the clouds for 60 days.

I think were skeptical, Dr. Gilmore said. But I dont personally feel yet that we want to throw out this observation at all.

The surface of Venus today is a hellish place where temperatures roast well over 800 degrees Fahrenheit. But early in the history of the solar system, it could have been much more like Earth today, with oceans and a moderate climate. In this early era, Mars, which is now cold and dry, also appears to have had water flowing across its surface.

Potentially, four billion years ago, we had habitable environments on Venus, Earth and Mars all three of them, said Dirk Schulze-Makuch, a professor at the Technical University Berlin in Germany. And we know that there is still a viable, thriving biosphere on our planet. So on Venus, it got too hot. On Mars, it got too cold.

But life, once it arises, seems to stubbornly hold on, surviving in harsh environs. You could have potentially, in environmental niches, microbial life hanging on, Dr. Schulze-Makuch said.

For Mars, some scientists think it is possible that life persists today underground, in the rocks. But the subsurface of Venus is too hot, said Dr. Schulze-Makuch, who two decades ago scrutinized whether any parts of that planet were still habitable.

Instead, he said, Venusian life could have moved up, to the clouds. Thirty miles up are short-sleeve temperatures about 85 degrees Fahrenheit. Microbes in that part of the atmosphere would stay aloft at that altitude for several months, more than long enough to reproduce and maintain a viable population.

But even the clouds are not a serene, benign place. They are filled with droplets of sulfuric acid and bathed in ultraviolet radiation from the sun. And it is dry, with only smidgens of water, an essential ingredient for life as we know it.

Still, if that was the environment that Venus microbes had to survive in, it was possible that they had evolved to do just that.

Phosphine is a simple molecule a pyramid of three atoms of hydrogen attached to one phosphorus atom. But it takes considerable energy to push the atoms together, and conditions for such chemical reactions do not seem to exist in the atmosphere of Venus.

Phosphine could be created in the heat and crushing pressure of the interior of Venus. Even with the lower amounts of phosphine that Dr. Greavess group now estimates, it would be unexpected and surprising if Venuss volcanic eruptions turned out to be so violently voluminous that they spewed out enough phosphine to be detected where Dr. Greavess team said it was: in the clouds, more than 30 miles up.

We cant easily rule in or out volcanism to explain this new, lower phosphine abundance, said Paul Byrne, a professor of planetary science at North Carolina State University in Raleigh, who pointed to the many unknowns about the planet and its geological system. Its probably not volcanism. But we cant say for sure.

On Earth, phosphine is produced by microbes that thrive without oxygen. It is found in our intestines, in the feces of badgers and penguins, and in some deep sea worms.

In 2017, Dr. Greaves found indications of phosphine using the James Clerk Maxwell Telescope in Hawaii. Different molecules absorb and emit specific wavelengths of light, and these form a fingerprint that enables scientists to identify them from far away. The measurements found what scientists call an absorption line at a wavelength that corresponded to phosphine. They calculated that there were 20 parts per billion of phosphine in that part of Venuss air.

Follow-up observations in 2019 used the Atacama Large Millimeter Array, or ALMA, a radio telescope in Chile that consists of 66 antennas. Those again turned up the same dark line corresponding to phosphine, although at lower concentrations, about 10 parts per billion.

But other scientists like Dr. Snellen did not find the analysis by the scientists, and the suggestions of a biological source, nearly as convincing.

The ALMA data, which recorded the brightness of light from Venus over a range of wavelengths, contained many wiggles and the one corresponding to phosphine was not particularly larger than any of the others. Dr. Greaves and her colleagues used a technique called polynomial fitting to subtract out what they believed was noise and pull out the phosphine signal. The technique is common, but they also used a polynomial with an unusually large number of variables 12.

That, critics said, could generate a false signal seeing something when there was nothing there.

If your signal is not stronger than your noise, then you just cannot succeed, Dr. Snellen said.

Other scientists contend that even if there was a signal, it was much more likely to come from sulfur dioxide, which absorbs light at nearly the same wavelength.

Dr. Greaves argued that the critics did not understand the precautions taken to rule out fake lines. She said the specific shape of the absorption line was too narrow to match that of sulfur dioxide.

As the scientists debated back and forth, there was an unexpected surprise in October: the ALMA observatory had provided incorrectly calibrated data to Dr. Greaves, and it contained spurious noise. For weeks, the Venus researchers waited in limbo.

When the reprocessed ALMA data became available in November, the noisy wiggles around the phosphine absorption line were diminished, but there now also appeared to be less phosphine about 1 part per billion over all, with places that might be as high as 5 parts per billion.

The line weve got now is much nicer looking, Dr. Greaves said, even though it was not as pronounced. But it is what it is. We now have a better result.

Bryan Butler, an astronomer at the National Radio Astronomy Observatory in Socorro, N.M., said he and others had looked at the same ALMA data, both the original and reprocessed versions, and failed to see any sign of phosphine.

They claim they still see it, and we still claim that its not there, Dr. Butler said. From a purely data scientists viewpoint, nobody is backing them up because nobodys been able to reproduce their results.

A new paper by a team of astronomers, led by Victoria S. Meadows at the University of Washington, says that a more detailed model of Venuss atmosphere developed in the 1990s shows that phosphine in the cloud layer would not even create an absorption line detectable from Earth. The team found that the phosphine would have to be some 15 miles higher in order to absorb the light. The research will be published in The Astrophysical Journal Letters.

What were showing is that the gas above basically doesnt cool to the point that it can absorb until it gets to about 75 or 80 kilometers, Dr. Meadows said. Which is well above the cloud deck.

Other scientists delved into older observations of Venus to see whether there might be signs of phosphine hidden there.

In 1978, a NASA spacecraft, Pioneer Venus, dropped four probes in the planets atmosphere. One of them even continued sending back data from the surface for more than an hour after impact.

Going back through the Pioneer Venus data, Rakesh Mogul, a professor of chemistry at California State Polytechnic University-Pomona, spotted telltale signs for the element phosphorous in Venuss clouds. There is a chemical, most likely a gas, that contains phosphorus, Dr. Mogul said. The data does support the presence of phosphine. Its not the highest amounts, but its there.

However, scientists looking at data from Venus Express, a European Space Agency spacecraft that orbited Venus from 2006 to 2014, came up empty for phosphine.

So did astronomers including Dr. Greaves and Dr. Sousa-Silva who were trying to identify a different absorption line of phosphine in infrared observations from a NASA telescope in Hawaii.

Dr. Greaves said the Venus Express and the infrared observations in Hawaii did not peer as deeply into the Venus atmosphere, and thus it should not be a surprise that they did not detect phosphine.

The levels of phosphine, if it is there, could also be changing over time.

That would make it more difficult to come up with definitive answers, much like the enduring mystery of methane on Mars. More than a decade ago, telescopes on Earth and an orbiting European spacecraft reported the presence of methane in the Martian air. On Earth, most methane is produced by living organisms, but it can also be produced in hydrothermal systems without any biology involved.

But the methane readings were faint, and then subsequent observations failed to confirm it. Perhaps the readings were misinterpreted noise. When NASAs Curiosity rover arrived on Mars in 2012, it carried an instrument that could measure minute amounts of methane. The scientists looked and looked and measured none.

But then, Curiosity did detect a burst of methane that persisted for weeks before dissipating. Later, it detected an even stronger outburst, but then it was gone again.

Mars scientists remain at a loss as to the quick appearance and disappearance of the methane.

The Venus phosphine debate will remain a stalemate until there are further observations. But the coronavirus pandemic shut down ALMA as well as NASAs Stratospheric Observatory for Infrared Astronomy, or SOFIA, a telescope aboard a modified 747 that can study infrared light from high in Earths atmosphere (The plane resumes flying this month).

The balloon that would be part of Dr. Gilmores flagship Venus mission could resolve the uncertainties by directly collecting samples of air. It would be able to find not only the phosphine but also carbon-based molecules of any microbes.

We really need to be in the clouds, Dr. Gilmore, of Wesleyan University, said, because that is the habitat that is hypothesized to support life.

Planetary scientists are in the process of putting together their once-a-decade recommendations to NASA about their priorities. There are many intriguing places to study, and NASA usually undertakes only one costly flagship mission at a time. A flagship mission also takes longer to build and one for Venus would not be scheduled to launch until 2031 at the earliest.

NASA is also considering a couple of smaller Venus missions for its Discovery program, a competition in which scientists propose missions that fit under a $500 million cost cap.

One of them, DAVINCI+, would be a 21st century version of one of the Pioneer Venus probes. It would be able to look for phosphine, although just at one place and one-time.

The second proposal, VERITAS, would send an orbiter that would produce high-resolution images of the surface. Although it does not include a phosphine-detecting instrument, one could be added.

And at least one private company, Rocket Lab, wants to send a small probe to study Venus in the coming years.

Further observations are warranted, said Dr. Butler of the National Radio Astronomy Observatory. Theres nothing you can point to that says, Oh, yeah, we absolutely see phosphine on Venus. But, you know, its tantalizing.

But he also said, I would not bet my life savings that its not there.

Continue reading here:

Life on Venus? The Picture Gets Cloudier - The New York Times

How Andrei Linde Redefined the Universe – The Atlantic

Posted on by

Measurements of infinity are impossible, or at least impossible according to the usual notions of size. If you cut infinity in half, each half is still infinite. In an imaginary scenario known as Hilberts grand hotel, if a weary traveler arrives at a fully occupied hotel of infinite size, no problem. You simply move the guest in room 1 into room 2, the guest in room 2 into room 3, and so on ad infinitum. In the process, youve accommodated all the previous guests and freed up room 1 for the new arrival. Theres always room at the infinity hotel.

We can play games with infinity, but we cannot visualize it. By contrast, we can visualize flying horses. Weve seen horses, and weve seen birds, so we can mentally implant wings on a horse and send it aloft. Not so with infinity. Its unvisualizability is part of its mystique.

One of the first recorded conceptions of infinity seems to have occurred around 600 B.C., when the Greek philosopher Anaximander used the word apeiron, meaning unbounded, or limitless. For Anaximander, the Earth and the heavens and all material things were caused by the infinite, although infinity itself was not a material substance. About the same time, the Chinese employed the word wuji, meaning boundless, and wuqiong, meaning endless, and believed that the infinite was very close to nothingness. In Chinese thought, being and nonbeing, like yin and yang, are in harmony with each otherthus the kinship of infinity and nothingness. A few centuries later, Aristotle argued that infinity does not actually exist, though he conceded something he called potential infinity. The whole numbers are an example. For any number, you can always create a bigger number by adding 1 to it. This process can continue as long as your stamina holds out, but you can never get to infinity.

Read: We need a new word for infinite spaces

Indeed, one of the many intriguing properties of infinity is that you cant get there from here. Infinity is not simply more and more of the finite. It seems to be of a completely different nature, although pieces of it may appear finite, such as large numbers or large volumes of space. Infinity is a thing unto itself. Everything we see and experience has limits, boundaries, tangibilities. Not so with infinity. For similar reasons, St. Augustine, Baruch Spinoza, and other theological thinkers have associated infinity with God: the unlimited power of God, the unlimited knowledge of God, the unboundedness of God. God is everywhere, and in all things, inasmuch as He is boundless and infinite, said Thomas Aquinas. Beyond the religious sphere of the immaterial world, physicists believe that there might be infinite things in the material world as well. But this belief can never be proved. You cant get there from here. Most of us have our first glimmerings of infinity as children, when we look up at the night sky for the first time. Or when we go to sea, out of sight of land, and gaze upon the ocean extending on and on until it meets the horizon. But these are only glimmerings, like counting to a few thousand in Aristotles potential infinity. Were overwhelmed. But we havent even come close.

The rest is here:

How Andrei Linde Redefined the Universe - The Atlantic

207’s Best In Academic Achievement Named For February – Journal & Topics Newspapers Online

Posted on by

The Maine Township High School Dist. 207 Board of Education honored three students as 207s Best in the area of academic achievement during the Feb. 1 board of education meeting. The students recognized were Ozair Bashir from Maine West, Eric Biedke from Maine South and Ashutosh Kumar from Maine East.

OZAIR OZZIE BASHIR: Bashir takes a rigorous course of study at Maine West a theme during his four years at the school. His current course load includes AP Calculus, AP Chemistry, AP Spanish and AP U.S. Government and Politics.

He is a senior leader, a Link Crew leader, an officer in the Principals Leadership Team, a COACH tutor, and a member of the math, Spanish, science, English and national honor societies. He also is a volunteer at the Des Plaines Public Library.

He is thankful for all of the positive relationships he has built during his time at the school and is looking at psychiatry as a career because he realizes people dont always have the ready access to the help they need.

When Ozzie walks into a room he seems surrounded by an aura of positivity, a glowing sense of friendliness thats contagious, said his English teacher Charles Gray.

Ozzie is one of the most kind and humble students I have had the pleasure to work with, said science teacher Aggie Piechocinski.

ERIC BIEDKE: Biedke is one of the most impressive students at Maine South who is at the top of his class academically and has taken advantage of a wide-range of course offerings. He enjoys math, physics and band, among all of his classes. He is looking toward a career in astrophysics.

He has been a member of the band, where he plays trombone, as well as the Astronomy Club, Math Team, German Club, Science National Honor Society, stage band for V-show and jazz band. Last year, he made the District VII band. He also is a member of the peer tutoring network, which offers online support for our students in a virtual format. In addition, hes an active member of his church where he has traveled to South Carolina, Tennessee and upstate New York on mission trips.

He is my only student to ever take the senior level class Space Science as a sophomore just for fun, said Bob Tortorelli, Biedkes counselor. He is really a gifted problem solver who has a knack for thoroughly assessing a challenge before considering numerous avenues to the solution including the standard and the unconventional path.

Eric is very intellectually curious, said Multivariable Calculus and Differential Equations teacher Peter Nilsen. He always is interested in truly understanding the problem and not just getting the answer.

ASHUTOSH ASH KUMAR: Kumar has been incredibly consistent in his academic performance at Maine East, having earned As in every class hes taken over the past three and half years. He has consistently taken a challenging course load. He is currently enrolled in AP English Literature and Composition, AP Calculus BC, AP Physics C, AP Psychology, Design & Materials and Sociology. He is a PE leader, active in the Gifted Lyceum program and earned distinction as a National Merit Commended Scholar. He is also a member of National Honor Society, Rotary Interact, the track and field team, and he is a COACH program tutor. In the broader community, Kumar is a volunteer at his local temple, and he is a paid accounting intern at Kumar and Associates, his familys accounting company.

Ash is an extremely bright and talented individual, said math teacher Cassie Cowperthwaite. In my math analysis class last year, he always was able to critically think through problems on his own.

He is extremely bright, articulate, and mature, said economics teacher Snjezana Salamon. He exudes calmness even under the most stressful conditions. I used to observe him during major unit tests and his concentration was impressive as nothing would ever throw him off. I would often joke with him that if he missed any questions on the test, I would have to check my key to make sure that my answers were correct.

Originally posted here:

207's Best In Academic Achievement Named For February - Journal & Topics Newspapers Online

St. Mary’s College Board of Trustees Approves Academic Program Changes for Fall 2021 – The Southern Maryland Chronicle

Posted on by

St. Marys College of Maryland, The National Public Honors College, has been engaged in efforts the last several years to ensure its viability and relevancy as the premier public liberal arts honors college.

The critical and analytical thinking skills and the ability to effectively express oneself the hallmarks of our teaching take on greater meaning in an era in which the world has expanded and become more integrated, diverse and competitive, said Tuajuanda C. Jordan, president of St. Marys College of Maryland. With that in mind, the Board of Trustees asked for a program prioritization review of current offerings with an eye towards ensuring that the College offeredrelevant programs that will attract and prepare students for the opportunities and challenges presented in the 21stcentury.This student-centric approachsecures the Colleges future.

The College has already completed several initiatives. Among them, the College has:

The program prioritization review, just completed, evolved over the past 18 months with task force work involving input from faculty, Trustees, Provost Michael Wick and President Jordan. Among the criteria, academic programs were measured for effectiveness, efficiency and equity.

The Board of Trustees asked that the emphasis throughout this review be on ensuring the St. Marys College of Maryland curriculum is relevant to the needs of global citizens, attracts and retains students, and prepares them for long-term success as engaged and productive citizens of the world, said Arthur Lex Birney Jr., chair of the Colleges Board of Trustees.

During its February 6, 2021 Board meeting, the Trustees carefully considered the recommendations designed to reflect how best to prepare students for satisfying careers with a rigorous liberal arts education that captures the relevant issues of today and the projected needs of tomorrows students.

It unanimously adopted the following program changes:

In addition:

These actions will impact 11 faculty positions, inclusive of retirements and contract expirations, and the College is closely working with faculty members affected.

Current St. Marys College of Maryland students in any of the majors or minors noted will not be affected and will be able to graduate in their chosen programs.

The following link provides the list of program changes as well as the majors and minors students can choose from who enroll in the College this fall.

I am confident that the outcomes from the program review, combined with gains in enrollment, student engagement, the LEAD initiative, among other areas, will ensure that our students will be in an even stronger position to compete in the ever-changing and competitive world in which we live, said President Jordan. St. Marys College will be the college of choice for tomorrows students.

Like Loading...

Related

Here is the original post:

St. Mary's College Board of Trustees Approves Academic Program Changes for Fall 2021 - The Southern Maryland Chronicle

Psoriasis – Diagnosis and treatment – Mayo Clinic

Posted on by

Diagnosis

Your doctor will ask questions about your health and examine your skin, scalp and nails. Your doctor might take a small sample of skin (biopsy) for examination under a microscope. This helps determine the type of psoriasis and rule out other disorders.

Psoriasis treatments aim to stop skin cells from growing so quickly and to remove scales. Options include creams and ointments (topical therapy), light therapy (phototherapy), and oral or injected medication.

Which treatments you use depends on how severe the psoriasis is and how responsive it has been to previous treatment. You might need to try different drugs or a combination of treatments before you find an approach that works for you. Usually, however, the disease returns.

Corticosteroids. These drugs are the most frequently prescribed medications for treating mild to moderate psoriasis. They are available as ointments, creams, lotions, gels, foams, sprays and shampoos. Mild corticosteroid ointments (hydrocortisone) are usually recommended for sensitive areas, such as your face or skin folds, and for treating widespread patches. Topical corticosteroids might be applied once a day during flares, and on alternate days or weekends only to maintain remission.

Your doctor may prescribe a stronger corticosteroid cream or ointment triamcinolone (Acetonide, Trianex), clobetasol (Temovate) for smaller, less-sensitive or tougher-to-treat areas.

Long-term use or overuse of strong corticosteroids can thin the skin. Over time, topical corticosteroids may stop working.

Retinoids. Tazarotene (Tazorac, Avage) is available as a gel and cream and applied once or twice daily. The most common side effects are skin irritation and increased sensitivity to light.

Tazarotene isn't recommended when you're pregnant or breast-feeding or if you intend to become pregnant.

Calcineurin inhibitors. Calcineurin inhibitors such as tacrolimus (Protopic) and pimecrolimus (Elidel) reduce inflammation and plaque buildup. They can be especially helpful in areas of thin skin, such as around the eyes, where steroid creams or retinoids are too irritating or may cause harmful effects.

Calcineurin inhibitors are not recommended when you're pregnant or breast-feeding or if you intend to become pregnant. This drug is also not intended for long-term use because of a potential increased risk of skin cancer and lymphoma.

Coal tar. Coal tar reduces scaling, itching and inflammation. It's available over-the-counter or by prescription in various forms, such as shampoo, cream and oil. These products can irritate the skin. They're also messy, stain clothing and bedding, and can have a strong odor.

Coal tar treatment isn't recommended for women who are pregnant or breast-feeding.

Light therapy is a first-line treatment for moderate to severe psoriasis, either alone or in combination with medications. It involves exposing the skin to controlled amounts of natural or artificial light. Repeated treatments are necessary. Talk with your doctor about whether home phototherapy is an option for you.

Psoralen plus ultraviolet A (PUVA). This treatment involves taking a light-sensitizing medication (psoralen) before exposure to UVA light. UVA light penetrates deeper into the skin than does UVB light, and psoralen makes the skin more responsive to UVA exposure.

This more aggressive treatment consistently improves skin and is often used for more-severe cases of psoriasis. Short-term side effects include nausea, headache, burning and itching. Long-term side effects include dry and wrinkled skin, freckles, increased sun sensitivity, and increased risk of skin cancer, including melanoma.

If you have moderate to severe psoriasis or other treatments haven't worked, your doctor may prescribe oral or injected (systemic) drugs. Because of the potential for severe side effects, some of these medications are used for only brief periods and might be alternated with other treatments.

Methotrexate. Usually administered weekly as a single oral dose, methotrexate (Trexall) decreases the production of skin cells and suppresses inflammation. It's less effective than adalimumab (Humira) and infliximab (Remicade). It might cause upset stomach, loss of appetite and fatigue. People taking methotrexate long term need ongoing testing to monitor their blood counts and liver function.

Men and women should stop taking methotrexate at least three months before attempting to conceive. This drug is not recommended when you're breast-feeding.

Cyclosporine. Taken orally for severe psoriasis, cyclosporine (Neoral) suppresses the immune system. It's similar to methotrexate in effectiveness but cannot be used continuously for more than a year. Like other immunosuppressant drugs, cyclosporine increases your risk of infection and other health problems, including cancer. People taking cyclosporine need ongoing monitoring of their blood pressure and kidney function.

These drugs are not recommended when you're pregnant, breast-feeding or if you intend to become pregnant.

Biologics. These drugs, usually administered by injection, alter the immune system in a way that disrupts the disease cycle and improves symptoms and signs of disease within weeks. Several of these drugs are approved for the treatment of moderate to severe psoriasis in people who haven't responded to first-line therapies. The therapeutic options are rapidly expanding. Examples include etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), ustekinumab (Stelara), secukinumab (Cosentyx) and ixekizumab (Taltz). These types of drugs are expensive and may or may not be covered by health insurance plans.

Biologics must be used with caution because they carry the risk of suppressing your immune system in ways that increase your risk of serious infections. In particular, people taking these treatments must be screened for tuberculosis.

Although doctors choose treatments based on the type and severity of psoriasis and the areas of skin affected, the traditional approach is to start with the mildest treatments topical creams and ultraviolet light therapy (phototherapy) in people with typical skin lesions (plaques) and then progress to stronger ones only if necessary. People with pustular or erythrodermic psoriasis or associated arthritis usually need systemic therapy from the beginning of treatment. The goal is to find the most effective way to slow cell turnover with the fewest possible side effects.

A number of alternative therapies claim to ease the symptoms of psoriasis, including special diets, creams, dietary supplements and herbs. None have definitively been proved effective. But some alternative therapies are deemed generally safe and might reduce itching and scaling in people with mild to moderate psoriasis. Other alternative therapies are useful in avoiding triggers, such as stress.

If you're considering dietary supplements or other alternative therapy to ease the symptoms of psoriasis, consult your doctor. He or she can help you weigh the pros and cons of specific alternative therapies.

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Try these self-care measures to better manage your psoriasis and feel your best:

Coping with psoriasis can be a challenge, especially if the affected skin covers a large area of your body or is visible to other people. The ongoing, persistent nature of the disease and the treatment challenges only add to the burden.

Here are some ways to help you cope and to feel more in control:

You'll likely first see your family doctor or a general practitioner. In some cases, you may be referred directly to a specialist in skin diseases (dermatologist).

Here's some information to help you prepare for your appointment and to know what to expect from your doctor.

Make a list of the following:

For psoriasis, some basic questions you might ask your doctor include:

Your doctor is likely to ask you several questions, such as:

Read more:

Psoriasis - Diagnosis and treatment - Mayo Clinic

Psoriasis: Causes, Triggers, Treatment, and More

Posted on by

What is psoriasis?

Psoriasis is a chronic autoimmune condition that causes the rapid buildup of skin cells. This buildup of cells causes scaling on the skins surface.

Inflammation and redness around the scales is fairly common. Typical psoriatic scales are whitish-silver and develop in thick, red patches. Sometimes, these patches will crack and bleed.

Psoriasis is the result of a sped-up skin production process. Typically, skin cells grow deep in the skin and slowly rise to the surface. Eventually, they fall off. The typical life cycle of a skin cell is one month.

In people with psoriasis, this production process may occur in just a few days. Because of this, skin cells dont have time to fall off. This rapid overproduction leads to the buildup of skin cells.

Scales typically develop on joints, such elbows and knees. They may develop anywhere on the body, including the:

Less common types of psoriasis affect the nails, the mouth, and the area around genitals.

According to one study, around 7.4 million Americans have psoriasis. Its commonly associated with several other conditions, including:

There are five types of psoriasis:

Plaque psoriasis is the most common type of psoriasis.

The American Academy of Dermatology (AAD) estimates that about 80 percent of people with the condition have plaque psoriasis. It causes red, inflamed patches that cover areas of the skin. These patches are often covered with whitish-silver scales or plaques. These plaques are commonly found on the elbows, knees, and scalp.

Guttate psoriasis is common in childhood. This type of psoriasis causes small pink spots. The most common sites for guttate psoriasis include the torso, arms, and legs. These spots are rarely thick or raised like plaque psoriasis.

Pustular psoriasis is more common in adults. It causes white, pus-filled blisters and broad areas of red, inflamed skin. Pustular psoriasis is typically localized to smaller areas of the body, such as the hands or feet, but it can be widespread.

Inverse psoriasis causes bright areas of red, shiny, inflamed skin. Patches of inverse psoriasis develop under armpits or breasts, in the groin, or around skinfolds in the genitals.

Erythrodermic psoriasis is a severe and very rare type of psoriasis.

This form often covers large sections of the body at once. The skin almost appears sunburned. Scales that develop often slough off in large sections or sheets. Its not uncommon for a person with this type of psoriasis to run a fever or become very ill.

This type can be life-threatening, so individuals should see a doctor immediately.

Check out pictures of the different types of psoriasis.

Psoriasis symptoms differ from person to person and depend on the type of psoriasis. Areas of psoriasis can be as small as a few flakes on the scalp or elbow, or cover the majority of the body.

The most common symptoms of plaque psoriasis include:

Not every person will experience all of these symptoms. Some people will experience entirely different symptoms if they have a less common type of psoriasis.

Most people with psoriasis go through cycles of symptoms. The condition may cause severe symptoms for a few days or weeks, and then the symptoms may clear up and be almost unnoticeable. Then, in a few weeks or if made worse by a common psoriasis trigger, the condition may flare up again. Sometimes, symptoms of psoriasis disappear completely.

When you have no active signs of the condition, you may be in remission. That doesnt mean psoriasis wont come back, but for now youre symptom-free.

Doctors are unclear as to what causes psoriasis. However, thanks to decades of research, they have a general idea of two key factors: genetics and the immune system.

Psoriasis is an autoimmune condition. Autoimmune conditions are the result of the body attacking itself. In the case of psoriasis, white blood cells known as T cells mistakenly attack the skin cells.

In a typical body, white blood cells are deployed to attack and destroy invading bacteria and fight infections. This mistaken attack causes the skin cell production process to go into overdrive. The sped-up skin cell production causes new skin cells to develop too quickly. They are pushed to the skins surface, where they pile up.

This results in the plaques that are most commonly associated with psoriasis. The attacks on the skin cells also cause red, inflamed areas of skin to develop.

Some people inherit genes that make them more likely to develop psoriasis. If you have an immediate family member with the skin condition, your risk for developing psoriasis is higher. However, the percentage of people who have psoriasis and a genetic predisposition is small. Approximately 2 to 3 percent of people with the gene develop the condition, according to the National Psoriasis Foundation (NPF).

Read more about the causes of psoriasis.

Two tests or examinations may be necessary to diagnose psoriasis.

Most doctors are able to make a diagnosis with a simple physical exam. Symptoms of psoriasis are typically evident and easy to distinguish from other conditions that may cause similar symptoms.

During this exam, be sure to show your doctor all areas of concern. In addition, let your doctor know if any family members have the condition.

If the symptoms are unclear or if your doctor wants to confirm their suspected diagnosis, they may take a small sample of skin. This is known as a biopsy.

The skin will be sent to a lab, where itll be examined under a microscope. The examination can diagnose the type of psoriasis you have. It can also rule out other possible disorders or infections.

Most biopsies are done in your doctors office the day of your appointment. Your doctor will likely inject a local numbing medication to make the biopsy less painful. They will then send the biopsy to a lab for analysis.

When the results return, your doctor may request an appointment to discuss the findings and treatment options with you.

External triggers may start a new bout of psoriasis. These triggers arent the same for everyone. They may also change over time for you.

The most common triggers for psoriasis include:

Unusually high stress may trigger a flare-up. If you learn to reduce and manage your stress, you can reduce and possibly prevent flare-ups.

Heavy alcohol use can trigger psoriasis flare-ups. If you excessively use alcohol, psoriasis outbreaks may be more frequent. Reducing alcohol consumption is smart for more than just your skin too. Your doctor can help you form a plan to quit drinking if you need help.

An accident, cut, or scrape may trigger a flare-up. Shots, vaccines, and sunburns can also trigger a new outbreak.

Some medications are considered psoriasis triggers. These medications include:

Psoriasis is caused, at least in part, by the immune system mistakenly attacking healthy skin cells. If youre sick or battling an infection, your immune system will go into overdrive to fight the infection. This might start another psoriasis flare-up. Strep throat is a common trigger.

Here are 10 more psoriasis triggers you can avoid.

Psoriasis has no cure. Treatments aim to reduce inflammation and scales, slow the growth of skin cells, and remove plaques. Psoriasis treatments fall into three categories:

Creams and ointments applied directly to the skin can be helpful for reducing mild to moderate psoriasis.

Topical psoriasis treatments include:

People with moderate to severe psoriasis, and those who havent responded well to other treatment types, may need to use oral or injected medications. Many of these medications have severe side effects. Doctors usually prescribe them for short periods of time.

These medications include:

This psoriasis treatment uses ultraviolet (UV) or natural light. Sunlight kills the overactive white blood cells that are attacking healthy skin cells and causing the rapid cell growth. Both UVA and UVB light may be helpful in reducing symptoms of mild to moderate psoriasis.

Most people with moderate to severe psoriasis will benefit from a combination of treatments. This type of therapy uses more than one of the treatment types to reduce symptoms. Some people may use the same treatment their entire lives. Others may need to change treatments occasionally if their skin stops responding to what theyre using.

Learn more about your treatment options for psoriasis.

If you have moderate to severe psoriasis or if psoriasis stops responding to other treatments your doctor may consider an oral or injected medication.

The most common oral and injected medications used to treat psoriasis include:

This class of medications alters your immune system and prevents interactions between your immune system and inflammatory pathways. These medications are injected or given through intravenous (IV) infusion.

Retinoids reduce skin cell production. Once you stop using them, symptoms of psoriasis will likely return. Side effects include hair loss and lip inflammation.

People who are pregnant or may become pregnant within the next three years shouldnt take retinoids because of the risk of possible birth defects.

Cyclosporine (Sandimmune) prevents the immune systems response. This can ease symptoms of psoriasis. It also means you have a weakened immune system, so you may become sick more easily. Side effects include kidney problems and high blood pressure.

Like cyclosporine, methotrexate suppresses the immune system. It may cause fewer side effects when used in low doses. It can cause serious side effects in the long term. Serious side effects include liver damage and reduced production of red and white blood cells.

Learn more about the oral medications used to treat psoriasis.

Food cant cure or even treat psoriasis, but eating better might reduce your symptoms. These five lifestyle changes may help ease symptoms of psoriasis and reduce flare-ups:

If youre overweight, losing weight may reduce the conditions severity. Losing weight may also make treatments more effective. Its unclear how weight interacts with psoriasis, so even if your symptoms remain unchanged, losing weight is still good for your overall health.

Reduce your intake of saturated fats. These are found in animal products like meats and dairy. Increase your intake of lean proteins that contain omega-3 fatty acids, such as salmon, sardines, and shrimp. Plant sources of omega-3s include walnuts, flax seeds, and soybeans.

Psoriasis causes inflammation. Certain foods cause inflammation too. Avoiding those foods might improve symptoms. These foods include:

Alcohol consumption can increase your risks of a flare-up. Cut back or quit entirely. If you have a problem with your alcohol use, your doctor can help you form a treatment plan.

Some doctors prefer a vitamin-rich diet to vitamins in pill form. However, even the healthiest eater may need help getting adequate nutrients. Ask your doctor if you should be taking any vitamins as a supplement to your diet.

Learn more about your dietary options.

Life with psoriasis can be challenging, but with the right approach, you can reduce flare-ups and live a healthy, fulfilling life. These three areas will help you cope in the short- and long-term:

Losing weight and maintaining a healthy diet can go a long way toward helping ease and reduce symptoms of psoriasis. This includes eating a diet rich in omega-3 fatty acids, whole grains, and plants. You should also limit foods that may increase your inflammation. These foods include refined sugars, dairy products, and processed foods.

There is anecdotal evidence that eating nightshade fruits and vegetables can trigger psoriasis symptoms. Nightshade fruits and vegetables include tomatoes as well as white potatoes, eggplants, and pepper-derived foods like paprika and cayenne pepper (but not black pepper, which comes from a different plant altogether).

Stress is a well-established trigger for psoriasis. Learning to manage and cope with stress may help you reduce flare-ups and ease symptoms. Try the following to reduce your stress:

People with psoriasis are more likely to experience depression and self-esteem issues. You may feel less confident when new spots appear. Talking with family members about how psoriasis affects you may be difficult. The constant cycle of the condition may be frustrating too.

All of these emotional issues are valid. Its important you find a resource for handling them. This may include speaking with a professional mental health expert or joining a group for people with psoriasis.

Learn more about living with psoriasis.

Between 30 and 33 percent of people with psoriasis will receive a diagnosis of psoriatic arthritis, according to recent clinical guidelines from the AAD and the NPF.

This type of arthritis causes swelling, pain, and inflammation in affected joints. Its commonly mistaken for rheumatoid arthritis or gout. The presence of inflamed, red areas of skin with plaques usually distinguishes this type of arthritis from others.

Psoriatic arthritis is a chronic condition. Like psoriasis, the symptoms of psoriatic arthritis may come and go, alternating between flare-ups and remission. Psoriatic arthritis can also be continuous, with constant symptoms and issues.

This condition typically affects joints in the fingers or toes. It may also affect your lower back, wrists, knees, or ankles.

Most people who develop psoriatic arthritis have psoriasis. However, its possible to develop the joint condition without having a psoriasis diagnosis. Most people who receive an arthritis diagnosis without having psoriasis have a family member who does have the skin condition.

Treatments for psoriatic arthritis may successfully ease symptoms, relieve pain, and improve joint mobility. As with psoriasis, losing weight, maintaining a healthy diet, and avoiding triggers may also help reduce psoriatic arthritis flare-ups. An early diagnosis and treatment plan can reduce the likelihood of severe complications, including joint damage.

Learn more about psoriatic arthritis.

Around 7.4 million people in the United States have psoriasis.

Psoriasis may begin at any age, but most diagnoses occur in adulthood. The average age of onset is between 15 to 35 years old. According to the World Health Organization (WHO), some studies estimate that about 75 percent of psoriasis cases are diagnosed before age 46. A second peak period of diagnoses can occur in the late 50s and early 60s.

According to WHO, males and females are affected equally. White people are affected disproportionately. People of color make up a very small proportion of psoriasis diagnoses.

Having a family member with the condition increases your risk for developing psoriasis. However, many people with the condition have no family history at all. Some people with a family history wont develop psoriasis.

Around one-third of people with psoriasis will be diagnosed with psoriatic arthritis. In addition, people with psoriasis are more likely to develop conditions such as:

Though the data isnt complete, research suggests cases of psoriasis are becoming more common. Whether thats because people are developing the skin condition or doctors are just getting better at diagnosing is unclear.

Check out more statistics about psoriasis.

The rest is here:

Psoriasis: Causes, Triggers, Treatment, and More

Psoriasis Treatment, Symptoms, Causes, Types & Diet

Posted on by

Alwan, W., and F.O. Nestle. "Pathogenesis and Treatment of Psoriasis: Exploiting Pathophysiological Pathways for Precision Medicine." Clin Exp Rheumatol 33 (Suppl. 93): S2-S6.

Arndt, Kenneth A., eds., et al. "Topical Therapies for Psoriasis." Seminars in Cutaneous Medicine and Surgery 35.2S Mar. 2016: S35-S46.

Benhadou, Fairda, Dillon Mintoff, and Vronique del Marmol. "Psoriasis: Keratinocytes or Immune Cells -- Which Is the Trigger?" Dermatology Dec. 19, 2018.

Conrad, Curdin, Michel Gilliet. "Psoriasis: From Pathogenesis to Targeted Therapies." Clinical Reviews in Allergy & Immunology Jan. 18, 2015.

Dowlatshahi, E.A., E.A.M van der Voort, L.R. Arends, and T. Nijsten. "Markers of Systemic Inflammation in Psoriasis: A Systematic Review and Meta-Analysis." British Journal of Dermatology 169.2 Aug. 2013: 266-282.

Georgescu, Simona-Roxana, et al. "Advances in Understanding the Immunological Pathways in Psoriasis." International Journal of Molecular Sciences 20.739 Feb. 10, 2019: 2-17.

Greb, Jacqueline E., et al. "Psoriasis." Nature Reviews Disease Primers 2 (2016): 1-17.

Kaushik, Shivani B., and Mark G. Lebwohl. "Review of Safety and Efficacy of Approved Systemic Psoriasis Therapies." International Journal of Dermatology 2018.

National Psoriasis Foundation. "Systemic Treatments: Biologics and Oral Treatments." 1-25.

Ogawa, Eisaku, Yuki Sato, Akane Minagawa, and Ryuhei Okuyama. "Pathogenesis of Psoriasis and Development of Treatment." The Journal of Dermatology 2017: 1-9.

Stiff, Katherine M., Katelyn R. Glines, Caroline L. Porter, Abigail Cline & StevenR. Feldman. "Current pharmacological treatment guidelines for psoriasis and psoriaticarthritis." Expert Review of Clinical Pharmacology (2018).

Villaseor-Park, Jennifer, David Wheeler, and Lisa Grandinetti. "Psoriasis: Evolving Treatment for a Complex Disease." Cleveland Clinic Journal of Medicine 79.6 June 2012: 413-423.

Woo, Yu Ri, Dae Ho Cho, and Hyun Jeong Park. "Molecular Mechanisms and Management of a Cutaneous Inflammatory Disorder: Psoriasis." International Journal of Molecular Sciences 18 Dec. 11, 2017: 1-26.

Read more:

Psoriasis Treatment, Symptoms, Causes, Types & Diet

Psoriasis – Melbourne, FL Dermatologist

Posted on by

Psoriasis is a skin condition that creates red patches of skin with white, flaky scales. It most commonly occurs on the elbows, knees and trunk, but can appear anywhere on the body. The first episode usually strikes between the ages of 15 and 35. It is a chronic condition that will then cycle through flare-ups and remissions throughout the rest of the patient's life. Psoriasis affects as many as 7.5 million people in the United States. About 20,000 children under age 10 have been diagnosed with psoriasis.

In normal skin, skin cells live for about 28 days and then are shed from the outermost layer of the skin. With psoriasis, the immune system sends a faulty signal which speeds up the growth cycle of skin cells. Skin cells mature in a matter of 3 to 6 days. The pace is so rapid that the body is unable to shed the dead cells, and patches of raised red skin covered by scaly, white flakes form on the skin.

Psoriasis is a genetic disease (it runs in families), but is not contagious. There is no known cure or method of prevention. Treatment aims to minimize the symptoms and speed healing.

There are five distinct types of psoriasis:

People who have psoriasis are at greater risk for contracting other health problems, such as heart disease, inflammatory bowel disease and diabetes. It has also been linked to a higher incidence of cardiovascular disease, hypertension, cancer, depression, obesity and other immune-related conditions.

Psoriasis triggers are specific to each person. Some common triggers include stress, injury to the skin, medication allergies, diet and weather.

Psoriasis is classified as Mild to Moderate when it covers 3% to 10% of the body and Moderate to Severe when it covers more than 10% of the body. The severity of the disease impacts the choice of treatments.

Mild to moderate psoriasis can generally be treated at home using a combination of three key strategies: over-the-counter medications, prescription topical treatments and light therapy/phototherapy.

The U.S. Food and Drug Administration has approved of two active ingredients for the treatment of psoriasis: salicylic acid, which works by causing the outer layer to shed, and coal tar, which slows the rapid growth of cells. Other over-the-counter treatments include:

Prescription topicals focus on slowing down the growth of skin cells and reducing any inflammation. They include:

Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Three primary light sources are used:

Treatments for moderate to severe psoriasis include prescription medications, biologics and light therapy/phototherapy.

Oral medications. This includes acitretin, cyclosporine and methotrexate. Your doctor will recommend the best oral medication based on the location, type and severity of your condition.

Biologics. A new classification of injectable drugs, biologics are designed to suppress the immune system. These tend to be very expensive and have many side effects, so they are generally reserved for the most severe cases.

Light Therapy/Phototherapy. Controlled exposure of skin to ultraviolet light has been a successful treatment for some forms of psoriasis. Two primary light sources are used:

Go here to read the rest:

Psoriasis - Melbourne, FL Dermatologist

The Best Creams for Psoriasis – Over-the-Counter and …

Posted on by

Psoriasis is a common and commonly misunderstood disorder. Its not simply itchy, dry skin; according to the National Psoriasis Foundation (NPF), its caused by an immune-system dysfunction that brings on inflammation. Normally, a persons skin cells grow and shed in about a month, but for a person with psoriasis, that process is sped up, taking only about 3 or 4 days, and the result is a build-up of skin cells causing scales and plaque. About 8 million Americans deal with its discomfort every day, says the NPF.

Psoriasis is not curable, but thankfully its very treatable, says Mona Gohara, MD, associate clinical professor of dermatology at the Yale School of Medicine. Theres no need to endure the psychological or physical discomfort that may come along with this conditionseek treatment for it. There are a range of possible treatments, from topical creams and lotions to prescription oral medications. If you start at the bottom of therapeutic pyramid with creams, this may be enough to quell the irritation, says Dr. Gohara.

Some creams and lotions that can ease the dryness and itch are available over the counter; with others, youll need a prescription from a doctor. It takes a bit of trial and error to find what topical treatment may work best for you. Here, some guidance to the most common types of creams and lotions for psoriasis.

This is the active ingredient (approved by the FDA for treating psoriasis) in treatments that can help banish scales by softening them and making the outer layer of skin shed. You can find salicylic acid in many forms (not just lotions/creams/ointments, but also foams, soaps, gels, patches, and more). These treatments are designed to work in combo with others, because getting rid of the scales can help other treatments do their work more efficiently. If its a strong version, salicylic acid can irritate the skin and make hair more likely to break off, and that can lead to temporary hair loss, says the NPF.

The NPF says that these are the most frequently used treatments for psoriasis. Theyre designed to quell inflammation and pump the brakes on the growth of skin cells (this helps sidestep the buildup that produces scales). Steroid treatments come in different strengths; mild ones are available over the counter (OTC) and stronger types require a prescription. Generally, the stronger ones are needed for elbows, knees, and other hard to treat areas. These are powerful meds with potential side effects (thin skin, broken blood vessels, and more) and should be used carefully under a medical doctor's supervision. Also,the use of topical steroids on brown skin can create lightening, which may take time to repigment, says Dr. Gohara. Its always important to apply steroids directly on, not all around, lesions or areas of concern.

The NPF advises not to use a topical steroid for longer than three weeks without consulting a doctor, as well as to avoid stopping the use of one suddenly because that can cause a flare-up of your psoriasis. Another reason to use these under the care of a physician: Topical steroids can be absorbed via the skin and have an impact on internal organs when used for a long period of time or over a wide area of skin.

These prescription treatments also come in various forms not just creams, lotions and ointments, but also gels, foams, and more. In some medications, vitamin D is combined with a steroid. Like other treatments, meds with vitamin D slow down the pace of your skin cells' growth. (Depending on the specific medication, side effects can include skin irritation, stinging, burning, itching or excessive calcium in the urine.) One advantage of vitamin D creams is they dont run the risk of causing skin atrophy a very real side effect of chronic topical steroid use, says Dr. Gohara. But they can be more irritating. Generally, systemic side effects are rare, yet hypercalcemia is a theoretical risk, and your doctor may opt to have you get blood tests.

Vitamin A treatments

A topical retinoid, vitamin A is the active ingredient in prescription medication that comes in the form of a cream, gel, or foam. It also works by slowing the growth of skin cells. When using it, the plaques of psoriasis may turn bright red before clearing up. Side effects here also include skin irritation; the medication increases the risk of sunburn as well, so its critical to use sunscreen to protect your skin when using these meds.

Coal tar

This ingredient is found in different strengths in various treatment forms, including shampoo. It can be found in OTC products in its weaker strength and by prescription for stronger versions. Like other products, coal tar slows the growth of skin cells, but it can be stinky and irritating, and can stain your bedding and clothes (as well as blond hair).

Heres one of the challenging things about treating psoriasis: Your body can build up a tolerance to a certain medications, so something that seemed magical in its ability to bring you relief could suddenly stop working. On the other hand, a treatment that didnt work for you years ago could suddenly work wonders.

Thats why trial and error is a necessary part of psoriasis treatment. Finding the right treatment for psoriasis is much like finding the right partner. It may take some 'dating' until the right one finally comes along, says Dr. Gohara. Some may work for a bit, but then efficacy fizzles. Topical steroids are the most common culprit of this phenomenon, although it may happen with other topical or systemic medication as well.

According to the National Psoriasis Foundation, its key to moisturize daily it can lessen the itchy redness. They recommend that you use fragrance-free products and soaps that moisturize rather than dry you out, skip the way-hot shower (keep it lukewarm), and rub on moisturizer right after showering. The NPF recommends these OTC creams, based on information theyve heard from dermatologists while emphasizing that none of them are stand-ins for treatment from a healthcare provider. Still, theyre all deeply moisturizing and may improve some pesky symptoms such as flaking and itching:

Anti-Itch Concentrated Lotion with Calamine and Triple Oat Complex

This creamhas anti-inflammatory and antioxidant ingredients.

Moisturizing Cream for Psoriasis

CeraVe developed this with dermatologists to moisturize skin and rebuilt the skin barrier.

Hydra Therapy, Itch Defense Moisturizer

A shea butter lotion, it's designed to be used right after a shower.

Psoriasis Medicated Treatment Gel

$43.98

This gelhas salicylic acid to work on scales, itching, and dryness.

Skin Calming Intensive Itch Relief Lotion

With menthol and oatmeal, the lotion is especially good for nighttime itching, according to the manufacturer.

Ultimate Multi-Symptom Psoriasis Relief Cream

$28.82

A soothing cream with salicylic acid and a bunch of moisturizers.

Intense Skin Repair Body Lotion

Lubridermamazon.com

The manufacturer says this deeply moisturizing lotion lasts for 24 hours to help repair skin.

Medicated Moisturizing Psoriasis Cream

A salicylic acid cream that also contains aloe and shea butter.

This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. You may be able to find more information about this and similar content at piano.io

The rest is here:

The Best Creams for Psoriasis - Over-the-Counter and ...

Researchers Report 2 Cases of Erythrodermic Psoriasis Effectively Treated With Secukinumab – AJMC.com Managed Markets Network

Posted on by

Researchers in China documented 2 cases of refractory erythrodermic psoriasis (EP) effectively treated with secukinumab, a fully humanized immunoglobulin (IgG)1k monoclonal antibody that neutralizes interleukin (IL)-17A. After 4 weeks of a standard treatment regimen, patients demonstrated a 75% reduction in the Psoriasis Area and Severity Index score (PASI).

Although secukinumab has been shown to result in rapid and sustained improvements of plaque psoriasis symptoms, clinical data on the treatment of EP with the drug are scarce. The condition, which accounts for 1% to 2.25% of all psoriatic cases, impacts over 80% of the body surface area (BSA) and usually occurs in patients with poor control of existing psoriasis.

Both patients included in the case series (1 male, 1 female) presented with severe EP and were resistant to treatment with acitretin or methotrexate. The male patient also presented with cirrhosis while the female patient had iridocyclitis. Both individuals continued with secukinumab for at least 32 weeks and no adverse reactions were observed during follow-up.

The 50-year-old female patient originally presented with plaque psoriasis lesions at age 26. Her erythroderma was initially relieved under oral acitretin but soon gradually thickened and spread to the whole body, authors wrote. In July of 2019 she presented to a dermatology clinic with extensive erythroderma (100% BSA) and a PASI score of 40.

Following once weekly treatment of 300 mg of secukinumab subcutaneously between weeks 0 through 4, and 300 mg every 4 weeks, the patients PASI score and BSA decreased to 9.8% and 40.45%, respectively, at week 4. By week 12, she achieved a 90% reduction in PASI score with no adverse events, while at 32 weeks she remained free of relapse and adverse events.

Similarly, a 46-year-old man who was diagnosed with plaque psoriasis during adolescence achieved initial alleviation using oral acitretin treatment at age 38. In May 2019, the drug exhibited decreased efficacy and the patient was admitted in July 2019 with extensive erythroderma (PASI 28, BSA 80%). The patient also exhibited signs of early cirrhosis caused by the drug and other factors, though tests revealed normal liver and kidney function.

At weeks 0,1,2,3, and 4 the male patient injected 300 mg of secukinumab, followed by a 300 mg dose once every 4 weeks. At week 4, the patients PASI score and BSA decreased to 7.6 and 29.6%, respectively. Results were sustained without any side effects after 40 weeks.

National Psoriasis Foundation guidelines, updated in 2010, recommend cyclosporine or infliximab as first-line therapy for unstable cases of EP and acitretin or methotrexate for patients who present with less acute disease.

However, traditional treatments, including acitretin, cyclosporine, methotrexate, and supportive symptomatic treatment, often have limited efficacy and adverse effects, which do not meet the expectations of patients, authors wrote.

Because patients in China typically use traditional Chinese medicine for initial treatment, individuals have often already developed moderate or severe psoriasis by the time they seek professional help.

As noted with other biologic drugs, the metabolism of secukinumab is not affected by renal function, and hemodialysis does not seem to affect its plasma concentration, researchers said.

Future clinical trials with large samples ought to be carried out to support findings while personalized plans based on patient characteristics to ensure retention rates and reduce adverse reactions are warranted.

Secukinumab may be a viable, rapid treatment option for patients with EP who experience failure of multiple therapies, authors concluded.

Reference

Liu L, Jin X, Sun C, and Xia J. two cases of refractory erythrodermic psoriasis effectively treated with secukinumab and a review of the literature. Dermatol Ther. Published online February 2, 2021. doi:10.1111/dth.14825

Go here to see the original:

Researchers Report 2 Cases of Erythrodermic Psoriasis Effectively Treated With Secukinumab - AJMC.com Managed Markets Network

Rare, Severe Type of Psoriasis Merits Biologic Consideration, Researchers Say – AJMC.com Managed Markets Network

Posted on by

GPP is a chronic-relapsing and potentially life-threatening disorder and is considered a phenotype of pustular psoriasis. It presents with multiple coalescing sterile pustules on erythematous skin; patients may also have fever, malaise, high white blood cell counts, and elevated C-reactive protein (CRP). It can also appear as arthritis, acute respiratory distress syndrome, cholestasis, and neutrophilic cholangitis. Because it is so rare, data from larger, high-quality clinical studies are not available, the authors wrote.

Researchers analyzed medical records from January 2005 to May 2019 containing information about 201 treatment series from 86 patients with GPP. Those who had exclusive treatment with systemic glucocorticoids or phototherapy were excluded, as were patients with 1 prior course of treatment with anakinra but who then switched to secukinumab; or with brodalumab who then switched to ustekinumab.

Overall, 65.1% of the patients were female, with an average age of 51.2 years when GPP began; they had a mean disease duration of 8.7 years. Laboratory results from their first visit to a medical center showed elevated CRP in just over 75% of the patients; 62.4% had leukocytosis; 38.1% had an electrolyte imbalance; other patients had hypocalcemia, hypo- or hyperkalemia, or hyponatremia.

Additional characteristics stemming from flare-related complications that indicated the severity of the disease included:

Additionally, nearly 13% of the patients needed admission to an intensive care unit or other intensive care due to a GPP flare; 74.1% of patients had evidence of disease at the time of their last visit.

Patients had received an average 2.3 systemic therapies for GPP. Psoriatic vulgaris was diagnosed in 50.0% and psoriatic arthritis in 17.4% of the patients.

Overall, an excellent response was reached in 41.3% of all treatment courses, and a partial response was seen in 31.4%. Nonresponse occurred in 27.3% of treatment courses.

Biological treatment was significantly more effective than nonbiological therapies, with biologics seeing an excellent response in 47.4% of treatment series compared with 35.9% of nonbiologics (P = .02). Overall, the median drug survival was 14 months (36 months for biologics vs 6 months for nonbiologics; P <.001).

Inhibitors of interleukins 17A and 23 showed particularly strong efficacy and drug survival, the researchers said, and should be considered earlier in the course of the disease. They noted that in Japan, guidelines on GPP recommend biologics and antitumor necrosis factor agents for GPP; in Germany, corticosteroids and acitretin are the only licensed drugs for GPP.

The crude probability of drug survival was highest for secukinumab (HR of drug discontinuation compared with acitretin, 0.22), followed by ixekizumab and ustekinumab (HR, 0.38 each).

This study is one of the larger case series adding to the growing evidence on treatment of GPP and, to our knowledge, is the first in-depth analysis of drug survival in GPP in a real-life setting, the researchers wrote.

Reference

Kromer C, Loewe E, Schaarschmidt ML, et al. Drug survival in the treatment of generalized pustular psoriasis: a retrospective multicenter study. Dermatol Ther. Published online January 26, 2021. doi:10.1111/dth.14814

Continued here:

Rare, Severe Type of Psoriasis Merits Biologic Consideration, Researchers Say - AJMC.com Managed Markets Network

Psoriatic Arthritis and Raynaud’s Syndrome: The Link – Healthline

Posted on by

Raynauds syndrome, also known as Raynauds phenomenon, is a condition that affects body extremities such as the fingers.

In response to a trigger like cold air or emotional stress, blood vessels become narrow and normal circulation is cut off. This can make your fingers very pale or blue, tingly, or numb. Raynauds can also sometimes affect other areas like your toes, nose, and ears.

Raynauds syndrome has been associated with certain autoimmune diseases.

Psoriatic arthritis (PsA) is a chronic, inflammatory autoimmune condition. It affects the joints and surrounding areas where the bone connects to ligaments and tendons. It can occur at any age but often develops between ages 30 and 50.

If you have PsA, you may be wondering if you should be looking out for signs of Raynauds syndrome. Read on for more information about the two conditions.

While PsA is a type of autoimmune disease, research supporting a direct correlation between PsA and Raynauds is limited. Theres not much evidence to show that the two conditions are related.

However, its possible to have both conditions.

If you experience symptoms of cold intolerance and color changes of your fingers or toes, a rheumatologist can perform tests to determine whether or not those symptoms are consistent with Raynauds.

This diagnostic process may include:

Certain factors can increase your chance of developing Raynauds phenomenon. They include:

Raynauds syndrome has been linked to another inflammatory type of arthritis called rheumatoid arthritis. Still, Raynauds is less common in rheumatoid arthritis compared with other types of rheumatic diseases, such as lupus.

Raynauds phenomenon is a type of vasculitis. The sudden narrowing of the arteries in your fingers or other extremities is called vasospasm, and it happens in response to triggers like cold and anxiety.

Over time, people who have been living with rheumatoid arthritis may develop vasculitis. Where rheumatoid arthritis affects the joints, vasculitis causes inflammation in the blood vessels. This affects blood flow to certain areas of your body.

Vasculitis can cause artery walls to become inflamed, which narrows the passage through which your blood travels.

PsA treatment depends on the frequency and severity of symptoms you experience. Mild, intermittent PsA symptoms can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, taken as needed.

More severe cases of PsA are treated with stronger medications like disease-modifying anti-rheumatic drugs (DMARDs) and biologics, or even surgery.

Treatment for Raynauds is different from PsA treatment and depends on the type. There are two types of Raynauds: primary and secondary.

Known as Raynauds disease, the primary form of Raynauds occurs without any associated medical conditions. Blood work is often normal with no indicators that anything is out of the ordinary.

Primary Raynauds can usually be managed with self-care measures. These include:

In some cases, Raynauds is the first sign that another underlying condition is present. Known as Raynauds syndrome or phenomenon, the secondary form of Raynauds is thought to occur as the result of an autoimmune-related condition, such as:

Secondary Raynauds is often more severe and can require more intervention to manage. It can cause pain and even result in complications like skin ulcers and gangrene. Its less common than primary Raynauds and usually occurs in people over 30 years of age.

Secondary Raynauds can benefit from lifestyle changes as well. However, its often most improved when the underlying condition is treated.

Other treatments specifically for Raynauds aim to prevent tissue damage like ulcers. These include:

PsA is an inflammatory, autoimmune type of arthritis that can accompany psoriasis. Raynauds phenomenon is a type of vasculitis, or narrowing of the blood vessels.

Both conditions are a result of an overactive immune system, which triggers inflammation in the body.

Research supporting a direct link between PsA and Raynauds is limited, but its possible to have both conditions. If you experience Raynauds symptoms, talk to your rheumatologist.

View post:

Psoriatic Arthritis and Raynaud's Syndrome: The Link - Healthline

Almirall announces a new publication in the British Journal of Dermatology of ILUMETRI (tildrakizumab) as the first anti-IL23p19 treatment for which…

Posted on by

- The British Journal of Dermatology has publishedevidence of sustained efficacy in tildrakizumab responders and a favourable long-term safety profile with total tildrakizumab exposure of over 5400 patient-years through 5 years (256 weeks)[1]

- The full complete pooled dataset demonstrates long-term psoriasis control with tildrakizumab with a consistent long-term safety profile through 5 years (256 weeks)[1]

- This is the first and longest complete pooled dataset published in a medical journal on an anti-IL23p19 inhibitor

BARELONA, Spain, Feb. 9, 2021 /PRNewswire/ -- Almirall, S.A. (BME: ALM), a global biopharmaceutical company focused on skin health, announced today that the British Journal of Dermatology (BJD) has published a full 5-year pooled data analysis from two phase III clinical studies, reSURFACE 1 and reSURFACE 2 of Ilumetri (tildrakizumab), an IL-23p19 inhibitor for the treatment of moderate-to-severe plaque psoriasis, and can be found in the BJD online library. These data provide evidence of sustained efficacy in tildrakizumab responders and in patients switched from etanercept to tildrakizumab at week 28, and a favourable long-term safety profile with total tildrakizumab exposure of over 5400 patient-years. During this period, PASI and PGA response rates were maintained in a large proportion of patients[1]. This is the first and longest complete dataset published in a medical journal on an anti-IL23p19 inhibitor.

Long-term efficacy and safety: up to 5-year results from reSURFACE 1 and reSURFACE 2[1]

Results of the 5-year pooled data from reSURFACE 1 and reSURFACE 2demonstrated long-term control of psoriasis, with a large proportion of patients who responded at week 28 maintaining efficacy by both relative and absolute PASI. Absolute PASI <3 at week 244 for tildrakizumab 100mg and 200mg were 78.8% and 82.6% respectively. PGA 0/1 at week 244 for tildrakizumab 100mg and 200mg were 68.5% and 74.2%, respectively (multiple imputation for missing data). Results show a favourable long-term safety profile with a total tildrakizumab exposure of over 5400 patient-years. Both 100mg and 200mg doses weregenerally well tolerated with low rates of serious adverse events and adverse events of special interest through 5 years.

"In our study, patients who responded to tildrakizumab maintained a clinically significant response over 5 years. Control of psoriasis was sustained with a reassuring safety profile. This tildrakizumab study confirms the role that the IL23p19 class can play in achieving long term control for our psoriasis patients," stated Prof Diamant Thai, Director of the Comprehensive Centre for Inflammation Medicine at Lbeck University in Germany, the first author of the study.

Safety was further explored in different analyses examining incidence rates of severe infections, malignancies, and major adverse cardiovascular events, as well as overall safety in patients over 65 years of age. No new reported signals were found in any of the sub-groups.

About tildrakizumab[2]

Tildrakizumab is a humanized monoclonal antibody that targets the p19 subunit of interleukin-23 (IL-23) and inhibits the release of proinflammatory cytokines and chemokines with limited impact on the rest of the immune system. Indicated for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy. Tildrakizumab demonstrated superiority vs placebo and etanercept in the phase 3 reSURFACE programme. Significantly more tildrakizumab patients achieved PASI 75 at Week 12 vs. placebo in both studies [re-SURFACE-1/2: 64%/61% (100 mg), 62%/66% (200 mg) vs 6%/6% (PBO), p<0.0001] and vs. etanercept [reSURFACE-2: 61% (100 mg, p=0.001), 66% (200 mg, p<0.0001) vs 48%]. Significantly more tildrakizumab patients achieved a PGA score of 'clear' or 'minimal', with 2-grade reduction from baseline at Week 12 in both studies vs. placebo [re-SURFACE-1/2: 58%/55% (100 mg), 59%/59% (200 mg) vs 7%/4% (PBO), p<0.0001], TIL 200 mg (59%, p=0.0031) and TIL 100 mg (55%, p=0.0663) vs. ETA (48%). The incidence of severe infections, malignancies, and major adverse cardiovascular events seen in the clinical trials were low and similar across treatment groups, with the most common AE being nasopharyngitis. Tildrakizumab was administered as 100 or 200 mg injection(s) at week 0 and 4 in the induction phase and then every 12 weeks thereafter for maintenance. DLQI 0/1 at week 12 was achieved by 42% of patients (n=309); by week 28 it was achieved by 52% of the patients (n=299) with patients reporting that psoriasis no longer affected their lives. By week 52, 64% of the responders at week 28 achieved DLQI 0/1 (n=113).

Almirall in-licensed Tildrakizumab from Sun Pharmaceutical Industries Ltd. (Sun Pharma) in July 2016. The agreement is for development and commercialization of tildrakizumab in Europe. So far, tildrakizumab has been launched in Germany, United Kingdom, Switzerland, Austria, Denmark, Spain, Italy and France.

References

1. Thai D, Piaserico S, Warren RB, et al. Five-year efficacy and safety of tildrakizumab in patients with moderate to severe psoriasis who respond at week 28: pooled analyses of two randomised phase 3 clinical trials (reSURFACE 1 and reSURFACE 2). Br J Dermatol. 2021 Feb 5. doi: 10.1111/bjd.19866.

2. IlumetriI (tildrakizumab) Summary of Product Characteristics.

Logo - https://mma.prnewswire.com/media/1217694/Almirall_Logo.jpg

https://www.almirall.com/

SOURCE Almirall, S.A.

See original here:

Almirall announces a new publication in the British Journal of Dermatology of ILUMETRI (tildrakizumab) as the first anti-IL23p19 treatment for which...

Common types of arthritis: Location, causes, treatment, and more – Medical News Today

Posted on by

Arthritis is a painful rheumatic condition that causes joint inflammation. There are many different types of arthritis that can affect the joints and other areas of the body and cause similar symptoms, such as pain, swelling, and stiffness.

There are more than 100 different types of arthritis. Some common types of arthritis include osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis (PsA).

Below, we explore these conditions, as well as other diseases that can present with arthritis. We also discuss potential treatment and when to seek medical guidance.

According to the Centers for Disease Control and Prevention (CDC), OA affects over 32.5 million adults in the United States.

Symptoms of OA include:

People often experience OA symptoms in the hips, hands, and knees.

The following increase the likelihood of developing OA:

Learn more about OA here.

RA is an autoimmune condition that causes painful swelling and inflammation in the joints. It typically affects the hands, wrists, and feet.

RA does not only affect joints. It can also cause problems in other organs of the body, including the heart, lungs, and eyes.

While some people experience a sustained progression of the disease, the intensity of symptoms usually comes and goes. Symptoms may include:

Another characteristic of RA is symmetrical involvement. This means pain and signs of inflammation occur on both sides of the body and in the same joints.

RA can cause lasting tissue damage, which can lead to:

Some people who have RA may also need assistance walking.

Some RA risk factors include:

Learn more about RA here.

PsA is an autoimmune condition.

Symptoms of PsA include:

PsA joint involvement is asymmetric, affecting different joints on either side of the body.

This type of arthritis can develop in people with a skin condition called psoriasis, which causes scaly, flushed, or silvery patches of skin. These patches can look different depending on a persons skin color.

Learn more about psoriasis on black skin here.

Researchers still do not fully understand what causes this form of arthritis. However, having a family history of PsA may increase a persons risk of developing this condition.

Learn more about PsA here.

Gout is a type of arthritis that causes painful swelling, often in a single joint at a time.

Symptoms of gout can flare up and go away quickly. They include:

Swelling is common in the big toe. Often, it also affects the knee or ankle joint.

A person may be at higher risk of developing gout if they:

Health conditions that may lead to gout include:

Gout may also occur due to metabolic syndrome, which is not a condition in itself. It refers to a number of characteristics, diseases, or habits that can make a person more likely to experience other health conditions, such as heart disease, stroke, or diabetes.

Learn more about gout here.

This chronic illness is an autoimmune condition that commonly affects females aged 1544 years.

Lupus is not a type of arthritis in itself. However, arthritis is one of the most common symptoms of this condition.

One symptom of lupus is the characteristic butterfly rash that can develop on the face. Other rashes can also develop on the arms, hands, and face. Rashes can worsen after sun exposure.

While symptoms may differ from person to person, they generally include:

Learn more about lupus here.

Juvenile arthritis, also known as childhood arthritis, affects children or even infants.

Symptoms of juvenile arthritis include:

There is no known cause of childhood arthritis. It appears to affect children regardless of race, age, or background.

Learn more about juvenile arthritis here.

Reaching a definitive diagnosis may take time, because many types of arthritis are similar or resemble other conditions.

Typically, a doctor will first check a persons medical and family history. They will also ask about symptoms and perform a physical exam. They may run tests such as:

Arthritis management depends on the type of arthritis. There are different forms of treatment available.

Medical treatment for arthritis may involve:

Surgery may not be necessary for everyone with arthritis. However, it can benefit certain complications of arthritis that result in malalignment of joints and functional limitations due to damaged joints. It can also help with intractable pain, which is when a person experiences pain that is difficult to treat or manage.

Common surgeries for arthritis include:

Physical therapy can be a great option for people with arthritis. It can help ease pain or increase activity.

Behavioral changes that can help with arthritis may include:

Some people find certain home remedies helpful in relieving pain and swelling from certain types of arthritis. These may include:

If a person has experienced joint symptoms that last more than 3 days, they should seek treatment from a healthcare professional.

Similarly, if a person has joint symptoms at different times within a month, they should also contact a doctor.

Medications and other treatments can help a person manage chronic symptoms, such as pain and swelling.

Pain will come and go with many types of arthritis. However, even if the pain resolves, a person should still seek treatment.

It is important to treat arthritis early. If left untreated, some types of arthritis may worsen over time and cause permanent disability.

Arthritis is a painful condition that causes joint inflammation.

Different types of arthritis can cause similar symptoms. It is vital to get the correct diagnosis, as it can help determine most effective treatment options.

The right treatment may also prevent future complications and help a person live a more active life.

See original here:

Common types of arthritis: Location, causes, treatment, and more - Medical News Today

Highmark expands access to Freespira’s DTx, Almirall and Happify developing digital mental health program for European psoriasis patients and more…

Posted on by

Highmark, a Blue Cross Blue Shield-affiliated health insurer, will expand access to Freespira's digital therapeutic for PTSD, panic disorder, panic attacks and other panic symptoms.

In addition to bringing the treatment to members living in Pennsylvania, Delaware and West Virginia, the agreement will also provide remote coaching on how to use Freespirato those not already receiving support from a behavioral health professional, according to the announcement.

"We are pleased with the clinical and financial outcomes achieved for our health plan members through the use of Freespira," Demetrios C. Marousis, director of behavioral health at Highmark, said in a statement.

"This breakthrough, drug-free treatment has reduced the impact of symptoms associated with panic attacks, resulting in reduced use of medications and other healthcare costs for symptom management. Freespira adds value to our members' plans and helps us to create a remarkable health care experience, freeing people to be their best."

Barcelona-based biopharma company Almirall and New York-based Happify Health will be working together to develop an international version of Claro, a digital treatment that addresses the mental health of psoriasis patients. This product would be designed for psoriasis patients living in Spain, Italy, France and the U.K., and would be deployed later this year through the Almirall patient support program.

"Since mental health events act as stressors that can trigger psoriasis flare ups, Happify is excited to work with a European leader like Almirall in this condition to address the mental and physical health symptoms of these patients," Chris Wasden, head of digital therapeutics at Happify Health, said in a statement.

"Our digital therapeutic solution acts as a complement to Almirall's commitment to psoriasis patients to empower people with psoriasis to live full lives through meaningful behavior change. Together, we can help psoriasis patients, one patient at a time, and at scale."

Kaiser Permanente has signed a multi-year collaboration with Accenture and Microsoft to bring more of its digital ecosystem to the cloud. The healthcare provider said that the partnership will enable new capabilities for Kaiser Permanente members and clinicians alike for more personalized and accessible care.

This collaboration will help Kaiser Permanente better serve our members by providing our care teams with increased access to cloud-based services, which will enable them to deliver personalized digital experiences and make more data-informed decisions, Diane Comer, SVP and interim CIO for Kaiser Permanente, said in a statement.

Boehringer Ingelheim's representatives will be using air quality data from BreezoMeter when speaking with clinicians about their patients' respiratory health, the pharma company announced last week. By tapping both real-time and historical data, Boehringer would be able to help predict when and whether environmental stressors could exacerbate symptoms of asthma, COPD and other conditions, and thereby raise awareness among providers.

"We complement our commitment to developing innovative therapies by developing innovative digital solutions with the goal of supporting healthcare providers in managing chronic conditions, Jim Boushie, executive director of business transformation at Boehringer Ingelheim, said in a statement.

To improve respiratory health and treatment plans, we utilize BreezoMeters data to help expose the effects of high pollution and pollen. Their air quality analytics empower our teams and will continue to inform how we collaborate with physicians to improve patient outcomes.

Otsuka Pharmaceutical's Development & Commercialization arm has partnered with Spencer Health Solutions, the maker of an at-home medication adherence platform, to further evaluate and deploy direct-to-patient services through the device. In particular, the pharma company said it will be considering the device's medication adherence and patient engagement capabilities in upcoming traditional and decentralized clinical trials.

Our commitment to the democratization of clinical trials, patient engagement and leveraging technology to improve diversity and inclusion in clinical research helps drive our success at Otsuka, Dr. Christoph Koenen, EVP and chief medical officer at Otsuka Pharmaceutical Development & Commercialization, said in a statement.

The spencersmart hub will be an asset in our efforts to improve treatment plans for people living with challenging health conditions.

Originally posted here:

Highmark expands access to Freespira's DTx, Almirall and Happify developing digital mental health program for European psoriasis patients and more...

Tips to prevent cold weather skin issues | News, Sports, Jobs – The Express – Lock Haven Express

Posted on by

Dr. Mikita

Our skin is one of our hardest working organs. It not only protects all the other organs in our bodies, and can repair itself, but it also regulates body temperature and detects and fights off infection. Healthy skin is an essential part of your overall health and wellness, yet most of us take our skin for granted, especially in the winter.

Winters

Effects

on Skin

Frequent hand washing and sanitizer use may already be taking a toll on your hands as the pandemic continues, but as temperatures and humidity levels continue to drop, other body parts can also get itchy, cracked, and irritated.

The harsh weather can strip the skins natural protective barrier, creating gaps in the outer most layer, allowing water to escape promoting dehydration and irritants to get in. The dry environment may be responsible for that uncontrollable itch, as the inflammatory response kicks in and releases histamines. It can exacerbate inflammatory skin diseases such as rosacea, eczema, ichthyosis, and psoriasis, which suffer an impaired barrier function.

Tips to Avoid a Painful

Season

If you are not prepared, the changes to your skin can make for a long winter. Knowing how your skin typically reacts to cold weather can help you create a routine ahead of time and keep your skin from reacting negatively to fall and winter.

Know Your Skin: As winter approaches, try to remember how your skin changed during past winters. Maybe your skin stayed the same as it did in the summer. This could be because of the routine you have in place. If your skin changed and became dryer than usual, this may mean you need to better prepare your skin for winter.

If you know your skin is prone to drying out from cold weather, a way to prepare your skin before and during the winter is to stick to short and warm showers. Long, hot showers can feel great after a cold day, but can strip your skin of important oils, leaving it dry.

Its All About Moisture: Find a good moisturizer and use it before the cold weather hits and throughout the cold weather season. A moisturizer does exactly what its name implies: moisturizes. Moisturizing your skin in preparation for the cold weather and during the winter can help your skin from becoming dried out. An oil-free moisturizer that contains glycerin is best to help keep skin hydrated.

Some Conditions Require Special Treatment: If you have eczema or psoriasis, you will have to do more than simply slather on extra lotion and drink more water.

In the case of eczema, your body overreacts to an external trigger, such as dust mites or perfumes in cosmetics and soaps. Eczema develops as itchy, red skin, often in areas where skin touches skin, such as in the bends of the arms or knees. If you have eczema, its important to use fragrance-free, hypoallergenic soap and moisturizers, as fragrances can cause allergies and further trigger itchiness and inflammation. One over-the-counter cream that may help provide relief from symptoms. You should also use scent-free hypoallergenic laundry detergent for the same reason. Certain fabrics, such as those made with wool, may be irritating to delicate skin as well.

In the case of psoriasis, a hyperactive immune response causes new skin cells to proliferate more quickly than old ones can be shed. The result is that cells pile up on top of each other, causing red patches with silvery scales. Psoriasis almost always requires prescription treatment because of the underlying autoimmune disease, but the best option varies depending on how much of the skin is impacted. Lack of sun exposure during winter months can also have an effect on psoriasis so your provider may consider phototherapy, a treatment that essentially involves using a light box to expose skin to controlled amounts of UV light in order to dampen inflammation.

Preparation Can Go a Long Way

Dry skin can make for an uncomfortable winter which is why preparation is key as we continue through the cold winter months. If youre having trouble managing your skin care, talk to a dermatologist. Your dermatologist can help you develop a routine and care plan to meet your skins unique needs. If youre experiencing severely dry or chapped skin, or if youve recently developed a rash thats not improving, talk to your doctor as these could be signs of a dermatologic condition or symptoms of more serious illness or allergic reaction.

Dr. Sabrina Mikita is a dermatologist with UPMC seeing patients at SH Dermatology located at 1205 Grampian Blvd., Suite 1A, Williamsport. For more information or to schedule an appointment, call 570-326-8060.

Today's breaking news and more in your inbox

Read more:

Tips to prevent cold weather skin issues | News, Sports, Jobs - The Express - Lock Haven Express

If Youre Going to Follow Any Pandemic-Era Skin Care Advice, Derms Say to Make It This – Well+Good

Posted on by

Having lived through a global pandemic for going on a year now, weve learned a lot, like that face masks are important, toilet paper is a hot commodity, and the world of exotic animals is far wilder than we could have possibly imagined. And while all (*gestures wildly*) of that was going on, we still managed to learn a lot about skin care while social distancing at home as well.

As many of us used the time at home to recalibrate our beauty routines, we relied on some of our favorite dermatologists to help us do it properly. Over the course of the pandemic, Well+Good has published hundreds of stories about skin care, ranging from how to deal with maskne (a word none of us had ever even heard before 2020) to how to treat psoriasis with a $10, over-the-counter lotion. To find out which tips have made the biggest difference in our skin during this unusual year, keep on scrolling.

Cleansing oil is known to be one of the gentlest, most effective types of face wash that works for all skin types, but in order to reap its full benefits, youve got to use it properly. According to derms, you should start by applying it to dry skin, which will better help it pick up the makeup, dirt, and oil from your pores, massage it in circular motions, then rinse it off entirely with warm water (never cold, because it will solidify the oil) to ensure it gets off all the gunk.

Adult acne is very much a thing, which means that when youre trying to treat it, you also may be trying to treat fine lines and wrinkles. The fix, according to board-certified dermatologist Joshua Zeichner, MD, is to use a simple two-ingredient combo. You need to make sure that the acne products are in line with other aesthetic needs of the patients, he says. Thats where topical retinoids are really helpful, and ingredients like salicylic acid, because they both give exfoliating benefits, and skin brightening and evening benefits, and retinoids can also help to stimulate collagen production.

There are plenty of effective hydrating ingredients out there (in the video above, board-certified dermatologist Mona Gohara, MD, names five of them), but the one that unquestionably deserves a spot in any no-frills routine is glycerin. Humectants attract water to the skin, explains Dr. Gohara, adding that glycerin and other fan-fave hydrator hyaluronic acid both fall into this category. And glycerin is not only so great at drawing water into the skin, but its also super gentle, which is why youll see it in a ton of products. I personally think that glycerin is the one ingredient thats good for everyone. Its no bells and whistles, we know it works, and everybody should have it.

There are certain serumslike the Skinceuticals legendary vitamin C serumthat are worth spending big bucks on. But others? Not so much. According to Dr. Gohara, its A-okay to skimp on other spots in your routine. When it comes to splurging, think about antioxidants, retinol, and any specific skin concern that you may have, she says. But I definitely think a gentle cleanser, a sunscreen, or even a moisturizer are places where you can save. This way, you can save up for one whizzbang treatment that really works.

Toner is one of the skin-care worlds most confusing routine steps, and derms have differing opinions on whether you really need it or not. The trick to getting the most out of it? Only apply it to certain spots. If you feel like you need it, just use it on areas where you may need a little extra love on your skin, says Dr. Gohara. If you have dry patches, look for a hydrating toner with hyaluronic acid, like Vichy Puret Thermale ($18) and if youre oily in certain spots, use an exfoliating AHA-packed option, like Glossier Solution ($24)

Last year gave us a swift introduction to the trials and tribulations of maskne, but (thankfully) also taught us how to treat it. Wearing masks is essential, but so is taking care of your skin, because thats the barrier between us and whats happening in the outside world, says Dr. Gohara. So to whatever extent you can, keep it gentle and basic. She suggests using a hydrating cleanser, likeLa Roche-Posay Toleriane Hydrating Gentle Face Cleanser ($15) to keep your skin extra clean, then applying an emollient moisturizer like Vaseline($2) orCerave Healing Ointment ($10) to the bridge of your nose, around your ears, jawline, cheekbones, and anywhere else where the mask might be rubbing.

Dont pick your skin is the skin-care advice dermatologists dish out on the reg and that most of us constantly ignore. If you are going to go all-in on your blackheads (which, same), Dr. Gohara says theres only one right way to go about it. One of the most important ways to get rid of blackheads is to extract them out, says Dr. Gohara. Im not giving you the carte blanche to go at them with your nails, but I definitely think there are ways we need to extract blackheads. Shes a fan of using at-home comedone extractors, like this one, which are a whole lot safer for your skin than your own fingers.

Considering this year forced us to spend time away from our dermatologists offices, we had to find at-home solutions for the treatments we often rely on them on. And in the case of Botox, we turned to collagen-stimulating peptides to help keep our skin plump. Peptides are small amino acids, which are the building blocks of collagen, explains Dr. Gohara. Kind of like a grape is to wine, peptides are to collagen. They wake up the collagen, shake it up a little bit, so it knows it has to produce itself more. The result? Smoother, juicier skinno needles required.

2020 was the year that I learned that those little pimple-looking spots on my butt werent actually pimples at all. One of the most common things that my patients come in forwhich can be very distressingare pimple-like lesions on the butt. Or, buttne, says Dr Gohara. But in reality, it aint buttne at all. While the blemishes on your behind maylook like red, angry, inflamed zits, theyre actually something different entirely. These arent true pimplestheyre inflamed hair follicles, explains Dr. Gohara. To deal with them, she suggests using a 1.5 or two percent benzoyl peroxide wash in the shower, like Panoxyl Acne Foaming Wash ($9). If that doesnt work, it may be time to take a trip to the dermatologist for a more intense prescription treatment.

Treating psoriasis can be frustrating, but it doesnt have to be expensive. According to Dr. Gohara, the best OTC treatment will only run your $10. Her go-to?Eucerin Advanced Repair Lotion($10). It has a smidge of exfoliators in it, so its a nice compromise between total exfoliation and just moisturizing, she says. Its made with lactic acid, which will help to gently slough away flakes, andceramides, which work to strengthen your skin barrier. I think that would be a very nice choice for somebody who has psoriasis on their skin, says Dr. Gohara.

Want even more beauty intel from our editors? Join Well+GoodsFine Print Facebookgroup (and follow us onInstagram) for must-know tips and tricks.

Read more here:

If Youre Going to Follow Any Pandemic-Era Skin Care Advice, Derms Say to Make It This - Well+Good

UPMC doctor: tips to prevent cold weather skin issues – NorthcentralPa.com

Posted on by

Our skin is one of our hardest working organs. It not only protects all the other organs in our bodies, and can repair itself, but it also regulates body temperature and detects and fights off infection. Healthy skin is an essential part of your overall health and wellness, yet most of us take our skin for granted, especially in the winter.

Winters Effects on Skin

Frequent hand washing and sanitizer use may already be taking a toll on your hands as the pandemic continues, but as temperatures and humidity levels continue to drop, other body parts can also get itchy, cracked, and irritated.

The harsh weather can strip the skins natural protective barrier, creating gaps in the outer most layer, allowing water to escape promoting dehydration and irritants to get in. The dry environment may be responsible for that uncontrollable itch, as the inflammatory response kicks in and releases histamines. It can exacerbate inflammatory skin diseases such as rosacea, eczema, ichthyosis, and psoriasis, which suffer an impaired barrier function.

Tips to Avoid a Painful Season

If you are not prepared, the changes to your skin can make for a long winter. Knowing how your skin typically reacts to cold weather can help you create a routine ahead of time and keep your skin from reacting negatively to fall and winter.

Know Your Skin: As winter approaches, try to remember how your skin changed during past winters. Maybe your skin stayed the same as it did in the summer. This could be because of the routine you have in place. If your skin changed and became dryer than usual, this may mean you need to better prepare your skin for winter.

If you know your skin is prone to drying out from cold weather, a way to prepare your skin before and during the winter is to stick to short and warm showers. Long, hot showers can feel great after a cold day, but can strip your skin of important oils, leaving it dry.

Its All About Moisture: Find a good moisturizer and use it before the cold weather hits and throughout the cold weather season. A moisturizer does exactly what its name implies: moisturizes. Moisturizing your skin in preparation for the cold weather and during the winter can help your skin from becoming dried out. An oil-free moisturizer that contains glycerin is best to help keep skin hydrated.

Some Conditions Require Special Treatment: If you have eczema or psoriasis, you will have to do more than simply slather on extra lotion and drink more water.

Preparation Can Go a Long Way

Dry skin can make for an uncomfortable winter which is why preparation is key as we continue through the cold winter months. If youre having trouble managing your skin care, talk to a dermatologist. Your dermatologist can help you develop a routine and care plan to meet your skins unique needs. If youre experiencing severely dry or chapped skin, or if youve recently developed a rash thats not improving, talk to your doctor as these could be signs of a dermatologic condition or symptoms of more serious illness or allergic reaction.

Dr. Sabrina Mikita is a dermatologist with UPMC seeing patients at SH Dermatology located at 1205 Grampian Blvd., Suite 1A, Williamsport. For more information or to schedule an appointment, call (570) 326-8060

Excerpt from:

UPMC doctor: tips to prevent cold weather skin issues - NorthcentralPa.com

Scientists to explore whether anti-inflammatory drugs control blood sugar Washington University School of Medicine in St. Louis – Washington…

Posted on by

Visit the News Hub

New grant to fund research into drugs that showed promise in small study of people with Crohns disease

Meals prepared for scientific studies of metabolism and nutrition stand ready for distribution at Washington University School of Medicine in St. Louis. Researchers at the School of Medicine are studying whether drugs to treat inflammatory conditions such as Crohn's disease also could help control blood sugar levels.

Inflammation and metabolic disorders are deeply intertwined. For example, people with inflammatory conditions such as Crohns disease and psoriasis are at risk of developing metabolic disorders such as insulin resistance and diabetes. However troubling that connection might seem, it also might point to some promising news.

Researchers at Washington University School of Medicine in St. Louis have received a Catalyst grant from the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) to investigate whether immunosuppressive drugs prescribed for inflammatory bowel disease (which includes Crohns disease and ulcerative colitis) or psoriasis also can control blood sugar levels. If they do, such drugs could provide a way to improve control of blood sugar in people with inflammatory diseases, thereby reducing the risk of serious complications such as diabetes. Catalyst grants are meant to support scientists of exceptional creativity who propose pioneering and possibly transformative approaches important to the mission of the NIDDK.

The idea for the study emerged from an unexpected observation. Gwendalyn Randolph, PhD, the Emil R. Unanue Distinguished Professor of Immunology and a professor of medicine, was investigating how people with Crohns disease handle fat in their diet by feeding participants a carefully designed milkshake and monitoring the levels of different kinds of fat in their blood over time. As part of the study, the researchers also collected data on blood sugar levels. The primary result of that study was negative: People with Crohns and healthy participants processed fat much the same. But an odd pattern in the data caught Randolphs eye: The five Crohns patients who happened to be taking the anti-inflammatory drug ustekinumab maintained normal blood sugar levels after a meal, unlike other participants with Crohns disease who were taking other medications. Their glucose levels strayed higher and normalized more slowly than healthy controls.

It was really just a side observation; the study was not designed to address the question of blood glucose levels, said Randolph, the principal investigator on the $500,000 NIH grant. But this new grant will help us check it out and see if it has merit. Its an exciting hypothesis because people with inflammatory bowel disease (IBD) are at higher risk of developing metabolic disorders including type 2 diabetes, and there are not great medications to treat glucose problems linked to inflammatory disease.

As a drug that might control blood sugar, ustekinumab may be a dark horse. Scientists have speculated for years that suppressing pro-inflammatory molecules known as cytokines might help control blood sugar in people with chronic inflammation. But there are dozens of cytokines, and none of them have panned out in clinical trials. The two cytokines suppressed by ustekinumab IL-12 and IL-23 have never been high enough on the list of likely targets to warrant a study.

The serendipitous observation suggests that IL-12 and IL-23 may have previously unrecognized effects that could shine light on the complicated relationship between metabolism and inflammation.

We caught a glimpse of something, in the previous study, related to how metabolism is modified in the setting of inflammation, said co-investigator Parakkal Deepak, MBBS, an assistant professor of medicine in the Division of Gastroenterology. As a member of the medical faculty of the Inflammatory Bowel Disease Center, Deepak sees patients with IBD on the Washington University Medical Campus. With further investigation into this area, we one day may be able to select therapy for people with inflammatory diseases based on the underlying metabolic profile and the effect of specific treatments on that metabolic profile.

The researchers plan to study patients who have inflammatory diseases and already are taking drugs that target IL-12 or IL-23. With the help of the Center for Human Nutrition, the researchers will monitor levels of blood sugar and other biomolecules while participants are fasting and after meals. Bettina Mittendorfer, PhD, a professor of medicine in the Division of Geriatrics and Nutrition Sciences and an expert on glucose metabolism, is helping to design the study in people.

The researchers also are planning mouse studies to see if neutralizing IL-12, IL-23 or both improves glucose and insulin tolerance.

The implications are much larger than diabetes alone, said co-investigator Matthew Ciorba, MD, an associate professor of medicine in the Division of Gastroenterology and director of the IBD Center. There are several other important complications of IBD linked to glucose metabolism, notably nonalcoholic fatty liver disease. Understanding if current therapies can modify glucose and other metabolic complications has the potential to impact millions of patients across the world.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

See the article here:

Scientists to explore whether anti-inflammatory drugs control blood sugar Washington University School of Medicine in St. Louis - Washington...