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Psoriasis – Symptoms and causes – Mayo Clinic

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In psoriasis, the life cycle of your skin cells greatly accelerates, leading to a buildup of dead cells on the surface of the epidermis.

Psoriasis is a skin disease that causes red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp.

Psoriasis is a common, long-term (chronic) disease with no cure. It tends to go through cycles, flaring for a few weeks or months, then subsiding for a while or going into remission. Treatments are available to help you manage symptoms. And you can incorporate lifestyle habits and coping strategies to help you live better with psoriasis.

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Plaque psoriasis is the most common type of psoriasis. It usually causes dry, red skin lesions (plaques) covered with silvery scales.

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Guttate psoriasis, more common in children and adults younger than 30, appears as small, water-drop-shaped lesions on the trunk, arms, legs and scalp. The lesions are typically covered by a fine scale.

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Psoriasis causes red patches of skin covered with silvery scales and a thick crust on the scalp most often extending just past the hairline that may bleed when removed.

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Inverse psoriasis causes smooth patches of red, inflamed skin. It's more common in overweight people and is worsened by friction and sweating.

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Psoriasis can affect fingernails and toenails, causing pitting, abnormal nail growth and discoloration.

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Pustular psoriasis generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. It can occur in widespread patches or in smaller areas on your hands, feet or fingertips.

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The least common type of psoriasis, erythrodermic psoriasis can cover your entire body with a red, peeling rash that can itch or burn intensely.

Psoriasis signs and symptoms can vary from person to person. Common signs and symptoms include:

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas. The most commonly affected areas are the lower back, elbows, knees, legs, soles of the feet, scalp, face and palms.

Most types of psoriasis go through cycles, flaring for a few weeks or months, then subsiding for a time or even going into remission.

There are several types of psoriasis, including:

If you suspect that you may have psoriasis, see your doctor. Also, talk to your doctor if your psoriasis:

Viven Williams: Your fingernails are clues to your overall health. Many people develop lines or ridges from the cuticle to the tip.

Rachel Miest, M.D.: Those are actually completely fine and just a part of normal aging.

Viven Williams: But Dr. Rachel Miest says there are other nail changes you should not ignore that may indicate

Rachel Miest, M.D.: liver problems, kidney problems, nutritional deficiencies ...

Viven Williams: and other issues. Here are six examples: No. 1 is pitting. This could be a sign of psoriasis. Two is clubbing. Clubbing happens when your oxygen is low and could be a sign of lung issues. Three is spooning. It can happen if you have iron-deficient anemia or liver disease. Four is called "a Beau's line." It's a horizontal line that indicates a previous injury or infection. Five is nail separation. This may happen as a result of injury, infection or a medication. And six is yellowing of the nails, which may be the result of chronic bronchitis.

For the Mayo Clinic News Network, I'm Vivien Williams.

Psoriasis is thought to be an immune system problem that causes the skin to regenerate at faster than normal rates. In the most common type of psoriasis, known as plaque psoriasis, this rapid turnover of cells results in scales and red patches.

Just what causes the immune system to malfunction isn't entirely clear. Researchers believe both genetics and environmental factors play a role. The condition is not contagious.

Many people who are predisposed to psoriasis may be free of symptoms for years until the disease is triggered by some environmental factor. Common psoriasis triggers include:

Anyone can develop psoriasis. About a third of instances begin in the pediatric years. These factors can increase your risk:

If you have psoriasis, you're at greater risk of developing other conditions, including:

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Psoriasis - Symptoms and causes - Mayo Clinic

Psoriasis: Causes, Triggers, Treatment, and More

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.

Read the rest here:

Psoriasis: Causes, Triggers, Treatment, and More

Psoriasis | Symptoms, Causes, Types and Treatments – DrugWatch.com

Psoriasis is a common disease, and more than eight million Americans have it, according to the National Psoriasis Foundation.

Psoriasis comes and goes in spurts. When the disease is active, it is called a flare. Flares can last for weeks or months and then go into remission or subside. Manifestations of the disease range from a few spots of scaly skin that resemble dandruff to more severe flare-ups that cover bigger areas of the body.

Its not contagious, but its more than a cosmetic problem. About 60 percent of people with psoriasis said the disease interferes with their daily lives.

There is no cure for psoriasis, but people with psoriasis have treatment options aimed at controlling symptoms. Common treatments include light therapy (phototherapy), ointments, and medications.

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Psoriasis signs and symptoms vary from person to person. Depending on the type and severity of the disease, it may manifest differently.

People with psoriasis are also more likely to have co-occurring health conditions, including cardiovascular problems, obesity, high blood pressure and diabetes.

Common signs and symptoms include:

Psoriasis can be mild, moderate or severe depending on the percent of body surface area affected. The scale goes from less than three percent to over 10 percent.

For reference, a hand is about the same as one percent of skin surface, according to The National Psoriasis Foundation. How a persons quality of life is affected is also a factor in classifying disease severity.

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Scientists dont know exactly what causes psoriasis, but they know its an autoimmune disease. This means the bodys immune system overreacts, causing other health problems.

Immune cells called T cells become overactive and trigger immune responses such as swelling and abnormally quick skin cell growth, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

In people without psoriasis, skin cells usually take about a month to go through their life cycle. But in people with psoriasis, it only takes a few days. These extra skin cells grow deep in the skin and rise to the surface, causing red, scaly patches.

A few factors can cause flares.

Some things that trigger symptoms or flares include:

Research suggests that psoriasis is hereditary, meaning it runs in families. One in three people with psoriasis report having a family member with the disease.

A child with one parent with psoriasis has a 10 percent chance of also having it. If a child has two parents with psoriasis, the likelihood they will get the disease increases to 50 percent, according to the National Psoriasis Foundation.

Most of these types of disease are chronic, but not life threatening. The rarest type, called erythrodermic psoriasis, is a severe disease and is a medical emergency.

According to the National Psoriasis Foundation, there are five main types of psoriasis. Each type differs in severity and symptoms. Doctors will vary the treatment recommendations depending on the type.

Plaque psoriasis is the most common form. It appears as patches of red, raised skin covered with a silvery buildup of dead skin. These patches most commonly affect the scalp, elbows, knees and lower back.

Guttate psoriasis most often affects children or young adults. This type of psoriasis appears as small, red, scaly dots on the trunk, arms and legs. Strep throat infections are a typical trigger.

Inverse psoriasis affects the body in places with skin folds such as behind the knee, in the groin or under the arm. Unlike plaque psoriasis, it typically appears red, shiny and smooth. People who have this type of psoriasis usually have it on more than one part of the body at the same time.

Pustular psoriasis is a rarer type of psoriasis that manifests as red skin with pustules, or blisters, filled with non-infectious pus. It occurs most often on the hands or feet, though it can occur anywhere on the body. The liquid in the blisters is made of white blood cells, and despite how it looks it is not an infection nor is it contagious.

Erythrodermic psoriasis is a very severe, but rare form of the disease. Only about three percent of people with psoriasis have this type. It causes extreme, widespread redness over most of the body. Skin layers come off in sheets and cause severe itching and pain. It can also cause dehydration, body temperature changes, changes in heart rate and nail changes.

This is a medical emergency. Seek medical help right away if you think you have erythrodermic psoriasis because it can be life threatening.

Doctors diagnose psoriasis by examining the rash or lesions. He or she will look at the scales and plaques and where they appear on the body.

Sometimes, the doctor will take a skin sample and send it off to a lab, a procedure called a biopsy. This allows the doctor to rule out other skin disorders such as skin cancer.

Treatment for psoriasis includes topical therapy, phototherapy (light therapy) and medications. Sometimes, doctors may recommend a combination of treatments.

Topical therapies typically come in the form of creams, shampoos, lotions, gels or ointments applied directly to the skin.

Examples of topical therapy include:

Phototherapy is the go-to treatment for moderate to severe psoriasis. The doctor may recommend it alone or with medications. This type of therapy exposes the skin to controlled amounts of artificial or natural light to control psoriasis.

The light source may be natural sunlight, also called heliotherapy. Artificial light techniques include UVB broadband and narrowband therapy, Psoralen plus ultraviolet A and targeted laser therapy.

Side effects include skin dryness, itchy skin, skin burns, freckles, increased sun sensitivity and increased skin cancer risk. Moisturizing regularly may help with itchiness and dryness.

Medications for psoriasis include immunosuppressants and biologic agents that suppress the immune system to prevent psoriasis symptoms. These drugs reduce the bodys ability to fight off infections and may cause damage to organs such as the liver and kidneys.

Medications for psoriasis include:

Psoriasis and eczema both cause itchy, red skin and it can be difficult to tell these rashes apart. The biggest difference is that psoriasis is an autoimmune disorder, and eczema is not.

Psoriasis tends to have a milder itchiness, whereas eczema can be more intense. The places most commonly affected by psoriasis are the scalp, elbows, knees, buttocks and face. Eczema most often occurs on the inside of the elbows or the back of the knees.

The rash caused by eczema usually comes with fluid leaking through the skin, whereas psoriasis is a thicker plaque with dry scaling.

The best way to tell these two rashes apart is to see a dermatologist.

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Psoriasis | Symptoms, Causes, Types and Treatments - DrugWatch.com

Psoriasis: Types, Pictures, Causes, Symptoms, Treatments …

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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.

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

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Psoriasis: Types, Pictures, Causes, Symptoms, Treatments ...

Psoriasis: Treatments, medication, symptoms and more – TODAY – TODAY

What is psoriasis? Psoriasis is a skin condition where your body makes new skin cells quickly. In about 80 to 90% of people with psoriasis, these skin cells build up in thick, scaly patches called psoriasis plaques, according to the American Academy of Dermatology (AAD). The condition is not contagious.

More than 8 million people in the U.S. have psoriasis, and it usually starts in the teen years or early 20s, though it can strike at any age, reports the National Psoriasis Foundation (NPF). It can develop in people of any race, and is more common in people who have a family member with the condition.

Dr. Carolyn Jacob, medical director of Chicago Cosmetic Surgery and Dermatology and a member of the American Academy of Dermatology (AAD), was diagnosed with psoriasis 36 years ago. Its what got me into dermatology, she said.

Untreated, people with psoriasis can leave a trail of unsightly scales that make them want to stay home. Most people dont care for that, said Dr. Amy McMichael, chair of the dermatology department at Wake Forest Baptist Health in North Carolina and a member of the American Academy of Dermatology. Now we can get those patients to where they have a very manageable disease.

Most people with psoriasis develop itchy, scaly plaques that are usually white or silver. They often crop up on the knees, elbows, lower back or scalp. On the scalp, they can spread to psoriasis of the face.

Less-common types of psoriasis can cause tiny pink bumps, skin thats sore and red, pus-filled bumps on the hands and feet or other skin problems. You can have more than one type of psoriasis.

Its also possible to have psoriasis with arthritis, where the psoriasis affects the joints. According to the NPF, 30 percent of people with psoriasis will go on to develop psoriatic arthritis.

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What causes psoriasis? The immune system plays a role. With psoriasis, the white blood cells, or T-cells, in the bodys immune system attack the skin cells. The body responds by making more skin cells, which build up on top of the skin.

Theres also a genetic factor behind who gets psoriasis. But some people get psoriasis even though they dont have the genes that increase their risk, according to the AAD. And its possible that some people who do have the genes that increase their risk never develop psoriasis. Researchers think exposure to a trigger might kickstart psoriasis in people who are more likely to develop it.

There are certain triggers that can cause psoriasis for the first time. These triggers can also cause psoriasis flare-ups.

Triggers linked with psoriasis, according to the AAD:

Not every trigger causes flare-ups in every person with psoriasis, so its important to watch your symptoms and try to determine what could be causing them.

Your dermatologist will look over your skin, nails and scalp to check for signs of psoriasis, and ask about your symptoms, joint problems, family history and possible triggers.

Examining a skin sample under a microscope can help confirm a psoriasis diagnosis.

Psoriasis is almost always a lifelong condition. We dont have a cure, but we have many medications now that can make you feel like you dont have psoriasis, Jacob said. The medications have advanced so far since when I was diagnosed they used to call it the heartbreak of psoriasis.'

McMichael recalls an 18-year-old patient with severe psoriasis the plaques covered her body and she needed a wheelchair to get around. She had been through all the medications we had. Now you never see a patient like that, she said. Today, if one medication doesnt work there are a lot more to try. That has made the lives of psoriasis patients so much easier, she said.

According to the NPF, psoriasis treatment options include:

While todays treatments are highly effective, its often necessary to use a combination of different treatments to achieve clear or nearly clear skin and sometimes it can take months, or even years, to find a treatment regimen that works well for you, according to the NPF. But reducing your psoriasis is an important goal. Not only will it make your skin feel better, itll help improve your overall health, including any depression that may be related to your psoriasis; it can also reduce your risk of other conditions, such as diabetes and cardiovascular disease.

People with psoriasis and their providers can use the NPFs treatment targets for guidance on how soon results can be expected when trying out medication options. The NPF says that after 3 months on a medication, psoriasis should only appear on 1% or less of your body surface area, though 75% improvement is also acceptable. But if you havent reached 1% or less psoriasis on your body after 6 months on the treatment regimen (and if you havent had an acceptable response after 3 months), the NPF recommends discussing other treatment options with your doctor.

Additionally, if youve achieved success with a treatment regimen, but it stops working well, talk to your doctor about finding another treatment solution for your psoriasis.

Its one of my favorite skin conditions to treat because there are so many options to make it better, Jacob said. The new biologics work so well we can get peoples skin clear so they feel like they dont have psoriasis I forget I have it now.

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Psoriasis: Treatments, medication, symptoms and more - TODAY - TODAY

My Psoriasis Doesnt Get in the Way of My Body Confidence – Yahoo Lifestyle

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From Oprah Magazine

Millions of Americans have psoriasis, which can cause patches of red or scaly skin to appear around the body. And because these flare-ups can occur anywhereincluding the hands, legs, face, and neck, all of which can be difficult to covershame and embarrassment have traditionally been part and parcel of having the disease. But that's starting to change, partly thanks to efforts by women like Angelique Miles and Joni Kazantzis, who use blogs and social media platforms to advocate for psoriasis patients and work to destigmatize the condition. We recently caught up with both of them to discover how they changed their way of thinking about psoriasis and kicked self-consciousness to the curb. Their words will resonate with anyone struggling with their confidence, regardless of the skin they're in.

As a 13-year-old with psoriasis on her scalp and forehead, Angelique Miles did everything she could to hide it. At the time, there were no available medications to treat the disease. I had bangs and I remember a girl said to me once, You know you can still see it, Miles recalls. It was traumatizing.

That was the early 80s, and there wasnt that much doctors could do. Miles dermatologist at the time basically told her to try a tar shampoo on her scalp, and that was it. It wasnt until her twenties that Miles discovered NYUs medical center, where they had a specific division for psoriasis. She started going twice a week for UVB treatment and, through an ongoing process with her doctorand through lots of trial and errorMiles was able to find the right medications and biologics to keep flare-ups to a minimum and better control her psoriasis.

Here's how the former music publishing executive turned fitness influencer and health advocate rediscovered her confidence.

A therapist once told me that my skin is the largest organ and I have to learn to accept and love it, says Angelique. Thats not to say I could still do without my psoriasis, but I now wear dresses in the summer or go to the beach. Other people can tell if youre confident, and giving off that vibe makes them not notice your skin as much. Its liberating.

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It seems like everybody knows someone with it and celebrities are talking about it more and more, she says, so theres more awareness these days.

Fitness has always been a big part of my life and being in good shape really contributes to my confidence, says Angelique. I used to start every day at the gym, but recently I bought a Peloton bike and I also do some virtual training sessions and online workouts.

One morning, when Joni was 15, she woke up covered in spots. I had no symptoms before that, but my grandmother lived with us and she had psoriasis, so she knew what it was right away, she recalls. I was so young and insecure at the time, so it was a struggle back then.

Joni has continually worked with her doctor to find a medication that keeps her psoriasis mostly in check; she now injects a biologic every few weeks. She still has to work on managing triggers like stress that can cause it to reappear. The one silver lining to it all: Joni believes that being forced to grow up with psoriasis has made her stronger and more able to deal with it as an adult. Heres her approach.

I make sure that whatever I wear feels good, nothing too tight or made with a synthetic material that irritates my skin, says Joni.

In the summer, I live in maxi dresses, says Joni. They keep me cool and give me the opportunity to be covered, but I can also lift the dress up to expose my legs if I want, since the sun helps my psoriasis.

I work in advertising and stand in front of people a lot to make presentations, says Joni. I make sure I have a loose cardigan or something that covers up my skin so that it doesnt take peoples attention away from what Im saying.

Even though I feel confident most of the time, there are still moments when I see someone looking at my skin or moving away from me and it takes me back to how I felt as a teenager, says Joni. In that moment, I tell myself that my psoriasis is a part of who I am. It has been around for all the major events in my life: graduating from college, getting married, and having my two daughters. Its part of what makes me, me.

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My Psoriasis Doesnt Get in the Way of My Body Confidence - Yahoo Lifestyle

Psoriatic Arthritis Treatment Market Type, Share Size, Analysis Trends, Demand and Outlook 2028 – Cole of Duty

Global Psoriatic Arthritis Treatment Market: Overview

The demand within the global psoriatic arthritis treatment market has been rising on account of advancements in the field of healthcare and biosimilar analysis. The occurrence of psoriatic arthritis can place an extremely negative toll on the overall health of individuals. This is because psoriatic arthritis is more severe than any other form of arthritis. Under psoriatic arthritis, patients suffering from a skin condition called psoriases start to exhibit extreme symptoms of arthritis. This results in excessive pain, uneasiness, and discomfort for the sufferer, often necessitating emergency dosage of steroids. Hence, there is a dire need to ensure that psoriatic arthritis is controlled which in turn gives an impetus to the growth of the global market. The revenue scale of the global psoriatic arthritis treatment market shall improve alongside advancements in the field of geriatric care.

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There is no permanent treatment for psoriatic arthritis, and it can only be controlled with proper medication. The discomfort suffered by people affected with psoriatic arthritis is abysmal. Owing to the aforementioned factors, the global psoriatic arthritis treatment market is projected to attract the attention of the medical fraternity in the years to follow. The demand for psoriatic arthritis is projected to reach new heights in the years to follow.

The global psoriatic arthritis treatment market can be segmented on the basis of the following parameters: drug class, route of administration, and region. Based on drug class, the global psoriatic arthritis treatment market can be segmented into Disease-modifying Antirheumatic Drugs (DMARDs), Nonsteroidal Antiinflammatory Drugs (NSAIDs), and biologics. Based on route of administration, the global psoriatic arthritis treatment market can be segmented into orals, topical, and injectables.

Global Psoriatic Arthritis Treatment Market: Notable Developments

Several advancement in the competitive landscape have become a key characteristic of the global psoriatic arthritis treatment market in recent times.

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Global Psoriatic Arthritis Treatment Market: Growth Driver

The occurrence of psoriatic arthritis is preceded by the severity of psoriasis in individuals. Hence, the field of dermatology needs to be work in conjunction with other medical departments in order to treat and control psoriatic arthritis. Hence, the global psoriatic arthritis treatment market shall expand alongside advancements in the field of dermatology. Furthermore, the availability of over-the-counter drugs for treatment of psoriatic arthritis propelled demand within the global market.

The joints suffer severe pain during psoriatic arthritis treatment, and the patients need to be quick recourse treatments. In a lot of cases, psoriatic arthritis poses a risk of permanent damage of joints. For this reason, the demand for psoriatic arthritis treatment has been rising at a stellar pace.

Global Psoriatic Arthritis Treatment Market: Regional Outlook

On the basis of geography, the global psoriatic arthritis treatment market can be segmented into North America, Europe, Asia Pacific, the Middle East and Africa, and Asia Pacific. The psoriatic arthritis treatment market in North America is expanding alongside advancements in the field of regional healthcare.

The global psoriatic arthritis treatment market can be segmented as:

Route of Administration

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Psoriatic Arthritis Treatment Market Type, Share Size, Analysis Trends, Demand and Outlook 2028 - Cole of Duty

Doc Reacts to Wild Instagram ‘Health’ Posts – MedPage Today

Mikhail Varshavski, DO, (better known on social media as "Doctor Mike") is a board-certified family medicine physician at the Atlantic Health System's Overlook Medical Center in Summit, New Jersey. His YouTube channel educates over 3 million subscribers with two weekly shows covering everything from trending medical stories and health myths to reaction videos critiquing popular medical TV dramas. His goal is to expose medical misinformation and increase health literacy for a previously untapped audience of young adults.

Below is a partial transcript:

Varshavski: "Why You Should Eat Overripe Bananas. A yellow-skinned banana with dark spots on it, it is eight times more effective in enhancing the properties of white blood cells then green-skinned, than then..." Bro, am I reading something wrong? What is happening here?

Hey, guys. We've covered medical memes before, we've reacted to medical dramas, but it never hit me to talk about some of the crazy Instagram posts that have to do with health. I've seen a lot of those, you've sent me them, so I thought I'd react to some of them.

I feel like we're going to be in for a stressful video. Maybe a fun video, a fun, stressful video? I don't know. Let's find out.

Oh, my God. I'm just going to read this as is, because I feel like I'm in the "Twilight Zone." "A yellow-skinned banana with dark spots on it is eight times more effective in enhancing the properties of white blood cells than then green-skinned version. Eating one, two bananas a day increases immunity." That was just so stressful to read. I feel like whatever health benefit you get by eating a banana, it was fully negated by reading this meme/Instagram post.

Can people eat bananas and help support their immune system? Boosting and over-boosting your immune system is actually a really bad thing. Autoimmune conditions like psoriasis and Crohn's disease of the intestines that cause really bad problems for people is an over-boost in immune systems that starts attacking things that are not actually a threat to you.

"Did You Know? Once a week, for 20 minutes..." First of all, this is a very lavish bathtub, because there's clouds or marshmallows, plus sticks, and she doesn't quite fit in it. "Once a week for 20 minutes, sit in a hot tub that contains a handful of Epsom salts, ten drops of lavender essential oil, and a half-cup of baking soda. This combo draws out toxins, lowers stress, and balances your pH levels."

Frank Costanza: Serenity now!

Varshavski: The essential oil community's trying to get me frustrated. It does not balance your pH levels. Can you imagine if an oil...? Your pH level is so tightly controlled. Between 7.35 and 7.45 is its little range that it lives in. Then if it comes out of that even slightly, like if it goes to 6.9, you die. Can you imagine in order to live you needed to take a bath that looks like this? That's a problem, folks.

You are not a dish. If I was trying to balance the pH levels of my chicken in a pot, maybe I would want to throw some lemon followed by baking soda on it. But you, my friend, are not a piece of chicken in a pot.

"Cashew. Good source or protein." Is it a good source, or is it a protein? We'll never know. "Improve vitality, assit metabolism function..." Because you know, our metabolism function likes to stand, and we like for it to sit. "Prevent migraine headache, lower risk of diabetes, prevent gallstones, fight heart disease."

The next time my patient has a migraine headache or is about to get one, I'm going to say, "Hey, why don't you chill out and get a cashew?"

Can you say it's a good source? I don't know. What is considered a good source of protein? It is a source of protein.

Does it improve vitality? What, like livelihood, like how happy you are? Does it assit? Does it assist your metabolic function? I mean anything that you eat assists metabolic function, because your metabolism's going to start working.

Does it prevent a migraine headache? That's ridiculous. Throw it out there. You know, though, I will say something about cherries. Cherries have natural aspirin in them, very small amounts, but some.

"Coconut. Regulates thyroid function, improves brain function, maintain body mass, stimulate immunity, keeps heart healthy, improves digestion, full of energy, glowing skin."

I don't know if they're saying positive things about coconuts or this is what's going to happen to you if you eat a coconut. Is the coconut full of energy? Does the coconut have glowing skin? Is the coconut rich in fiber? I'm kind of getting mad here.

"Maintain body mass." That's what food does, folks. Have you ever eaten anything before? I can put that on every label. I'm pretty sure you can put that on a pillow. I'm pretty sure if I put this on this bear pillow it will maintain body mass. It probably won't. But anything that's edible, anything that has a calorie, helps maintain body mass, so that one is ridiculous...

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Doc Reacts to Wild Instagram 'Health' Posts - MedPage Today

Superior Skin Clearance Observed With Risankizumab in Head-to-Head Psoriasis Study – Monthly Prescribing Reference

New data from a head-to-head study comparing risankizumab-rzaa to secukinumab in patients with moderate to severe plaque psoriasis were recently presented online at the American Academy of Dermatology virtual annual meeting.

In this 52-week, phase 3b, open-label, active-comparator study, patients were randomized to receive risankizumab 150mg subcutaneously (n=164) at baseline, week 4, then every 12 weeks thereafter, or secukinumab 300mg subcutaneously at baseline, weeks 1, 2, 3, and 4, then every 4 weeks thereafter. The co-primary end points were the proportion of patients with a 90% reduction in the Psoriasis Area and Severity Index score (PASI 90 response) at week 16 (noninferiority) and at week 52 (superiority) from baseline.

Results showed that the study met both primary end points of noninferiority and superiority. A greater proportion of patients treated with risankizumab achieved a PASI 90 response at week 16 (74% vs 66%) and at week 52 (87% vs 57%; P <.001) compared with secukinumab.

Risankizumab also met key secondary end points including a superior rate of complete skin clearance (PASI 100 response) at week 52 compared with secukinumab (66% vs 40%; P <.001). Moreover, 88% of patients treated with risankizumab achieved a static Physician Global Assessment (sPGA) score of clear (0) or almost clear (1) at week 52 compared with 58% of patients treated with secukinumab (P <.001).

Risankizumab and secukinumab demonstrated comparable rates of adverse reactions. The most common were nasopharyngitis, upper respiratory tract infection, headache, arthralgia and diarrhea.

Risankizumab, an interleukin-23 antagonist, is marketed under the trade name Skyrizi and is indicated for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy.

Secukinumab, an interleukin-17A antagonist, is marketed under the trade name Cosentyx and is indicated for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. It is also approved for the treatment of active psoriatic arthritis or ankylosing spondylitis in adults.

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Superior Skin Clearance Observed With Risankizumab in Head-to-Head Psoriasis Study - Monthly Prescribing Reference

The Bidirectional Association Between Psoriasis & OSA – Physician’s Weekly

With psoriasis and obstructive sleep apnea (OSA) sharing various comorbidities and having a common pathogenesis of inflammatory and immune imbalance, many studies have examined the association between the two conditions. However, the results of these studies have differed. In order to evaluate the evidence on the bidirectional association of psoriasis and OSA, Ching-Chi Chi, MD, MMS, DPhil, Tzong-Yun Ger, MD, and Yun Fu, MD, conducted a systematic review and meta-analysis of case-control, cross-sectional, and cohort studies in the MEDLINE and Embase databases.

Exploring the Data

The researchers used the Newcastle-Ottawa Scale to evaluate the risk of bias of included studies and performed random-effects model meta-analysis to calculate pooled odds ratio (ORs) with 95% confidence intervals (CIs) for case-control and cross-sectional studies as well as pooled incidence rate ratio (IRR) with 95% CIs for cohort studies in association between psoriasis and OSA. Four case-control or cross-sectional studies and three cohort studies with a total of 5.8 million subjects were included.

Increased risk of OSA among patients with psoriasis was found in one cohort study, one cross-sectional study, and two case-control studies. Meta-analysis of the latter three showed a significant association of psoriasis with OSA among nearly 300,000 study subjects, with a pooled OR of 2.60, indicated that patients with psoriasis are 2.6-fold more likely to develop OSA when compared with patients without psoriasis, adds Dr. Ger (Figure 1). Although these three studies had considerable statistical heterogeneity, all had consistently positive results. In the cohort study, patients with mild psoriasis had a consistently increased risk of OSA (adjusted IRR, 1.36), as did those with severe psoriasis (adjusted IRR, 1.53) and psoriatic arthritis (adjusted IRR, 1.98).

Conversely, a consistent increase in psoriasis among patients with OSA was found across three cohort studies and one case-control study. A meta-analysis of the cohort studies showed a significant association of OSA with psoriasis (polled IRR, 2.52) across more than 5.5 million study subjects, with no statistical heterogeneity within the studies (Figure 2). After excluding one study with a high risk of bias in the representativeness of the exposed cohortall were nursesthe association of OSA with psoriasis remained positive (pooled IRR, 2.47). A significantly increased odds for psoriasis in relation to OSA was seen in the one case-control study (adjusted OR, 13.31).

Looking Ahead

Drs. Ger and Chi note the need for future research investigating the relationship between OSA and psoriasis in patients with varying races/ethnicities and from various regions, as well as the need for studies to confirm the mechanism(s) behind the relationship between the two conditions.

In the meantime, Dr. Ger suggests that all patients with psoriasis be made aware of their increased risk for OSA as a comorbidity that should not be overlooked. This patient population should be asked about sleep quality, and those with snoring at night, daytime sleepiness, and insomnia should be considered for polysomnography, consultation with a pulmonologists, or both. On the other hand, physicians should inquire about skin problems with their patients with OSA. Those suspected of having psoriasis should be referred to a dermatologist for further evaluation and treatment.

Bidirectional Association Between Psoriasis and Obstructive Sleep Apnea: A Systematic Review and Meta-Analysishttps://www.nature.com/articles/s41598-020-62834-x

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The Bidirectional Association Between Psoriasis & OSA - Physician's Weekly

Psoriasis Treatment Market Presents an Overall Analysis, Trends and Forecast to 2025 – 3rd Watch News

Global Psoriasis Treatment Industry Market, 2020-2025 Research Report provides crucial statistics on the market status of the Global Psoriasis Treatment Industry manufacturers and is a respected source of guidance and direction for companies and individuals interested in the industry.

This Psoriasis Treatment Industry market research study is a collection of insights that translate into a gist of this industry. It is explained in terms of a plethora of factors, some of which include the present scenario of this marketplace in tandem with the industry scenario over the forecast timeframe.

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The report is also inclusive of some of the major development trends that characterize the Psoriasis Treatment Industry market. A comprehensive document in itself, the Psoriasis Treatment Industry market research study also contains numerous other pointers such as the current industry policies in conjunction with the topographical industry layout characteristics. Also, the Psoriasis Treatment Industry market study is comprised of parameters such as the impact of the current market scenario on investors.

The pros and cons of the enterprise products, a detailed scientific analysis pertaining to the raw material as well as industry downstream buyers, in conjunction with a gist of the enterprise competition trends are some of the other aspects included in this report.

How has the competitive landscape of this industry been categorized?

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Other pivotal aspects encompassed in the Psoriasis Treatment Industry market study:

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Psoriasis Treatment Market Presents an Overall Analysis, Trends and Forecast to 2025 - 3rd Watch News

UCB flashes the data behind its positive psoriasis readouts. Can it compete in a crowded field? – Endpoints News

Eight months after UCB announced that a little-watched drug candidate outperformed J&Js blockbuster Stelara, the Belgian pharma is out with full data that one investigator calls remarkable.

In the Phase III trial, 58.6% of patients who took UCBs IL-17 blocker bimekizumab were completely cleared of skin lesions after 16 weeks, compared to 20.9% of patients on Stelara. The UCB drug also outperformed Stelara at how many patients were clear after one year and at lesser benchmarks for plaque clearance, with more than 8 out of 10 patients showing 90% improvement, compared to roughly half on Stelara.

In a second study, first announced positive in November, bimekizumab was compared to placebo. In that one, 68% of patients on the treatment arm saw their skin completely clear and over 90% saw a 90% improvement. For placebo that number was 1.2%.

It really showed some quite impressive, remarkable I dont know how you want to say it, but extremely high level of responses, Kenneth Gordon, lead investigator on the placebo-controlled study, told Endpoints News.

Gordon singled out a couple distinct characteristics about the responses that stood out. Those included how sweepingly the drug alleviated symptoms, how quick it did so, and how long it lasted.

If you compare it to other clinical trials programs, both the speed and magnitude of the responses were around the highest weve seen, Gordon said.

Researchers often caution against comparing different clinical trials, such comparisons will be crucial for a drug like bimekizumab. The plaque psoriasis is a highly competitive market, suffuse with approved biologics from some of the worlds biggest drugmakers. Stelara is just one of several options patients can currently choose from.

The new data were released in abstracts for the annual American Academy of Dermatology meeting. On Friday afternoon, AbbVie also released abstracts from its open-label Phase III trial testing Skyrizi, an IL-23 inhibitor approved last year for psoriasis, against Novartis Cosentyx.

While trouncing Cosentyx, Skyrizi showed a virtually identical ability as UCBs drug to clear plaque psoriasis after one year: 66%. In addition, Eli Lillys IL-17 inhibitor beat J&J Tremfya last year in a head to head trial on psoriasis. UCB also beat AbbVies Humira last year, although results have yet to be announced.

From a medical perspective, though, Gordon suggested that asking which one is best might not be the best approach. Instead, prescribing decisions may come down to matching individual patients to the best drug.

Bimekizumab blocks multiple cytokines involved in plaque psoriasis, IL-17a and IL-17f. Because IL-17f exists in greater quantities in plaques, but IL-17a is more active, it had been an open question whether it was best to blockade both or if you could just target one and have the same effect.

Though cautioning no trial has been completed, Gordon said the latest data seem to resolve that debate. He argued the new insight, along with some of the other new molecules, represented a capstone on the progress the field has made since the chemotherapy drug methotrexate was first given to modest effect in the 1950s.

This might be culminating biologic molecule for psoriasis we have in the near future, he said. Now the question is how can we best apply each of our medications.

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UCB flashes the data behind its positive psoriasis readouts. Can it compete in a crowded field? - Endpoints News

Global Psoriasis Drugs Industry Market Overview, Cost Structure Analysis, Growth Opportunities and Forecast to 2027 – 3rd Watch News

With having published myriads of reports, Psoriasis Drugs Market Research imparts its stalwartness to clients existing all over the globe. Our dedicated team of experts delivers reports with accurate data extracted from trusted sources. We ride the wave of digitalization facilitate clients with the changing trends in various industries, regions and consumers. As customer satisfaction is our top priority, our analysts are available to provide custom-made business solutions to the clients.

In this new business intelligence report, Psoriasis Drugs Market Research serves a bunch of market forecast, structure, potential, and socioeconomic impacts associated with the global Psoriasis Drugs market. With Porters Five Forces and DROT analyses, the research study incorporates a comprehensive evaluation of the positive and negative factors, as well as the opportunities regarding the Psoriasis Drugs market.

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The Psoriasis Drugs market report has been fragmented into important regions that showcase worthwhile growth to the vendors. Each geographic segment has been measured based on supply-demand status, distribution, and pricing. Further, the study brings information about the local distributors with which the market players could create collaborations in a bid to sustain production footprint.

The following manufacturers are covered:

Takeda PharmaceuticalJanssen BiotechMerckUCBBiogenAbbvieCelgene CorporationEli Lilly & CompanyAmgenAbbVieJohnson & JohnsonAstraZenecaNovartis AGStiefel LaboratoriesPfizer

Segment by Regions

North America

Europe

China

Japan

Southeast Asia

India

Market Segmentation based on Type:

Tumor Necrosis Factor InhibitorInterleukin InhibitorsOthers

Market Segmentation based on Application:

Plaque PsoriasisGuttate PsoriasisInverse PsoriasisPustular PsoriasisErythrodermic Psoriasis

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Segmentation of the Psoriasis Drugs market to target the growth outlook and trends affecting these segments.

Make An Enquiry About This Report @What does the Psoriasis Drugs market report contain?

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Global Psoriasis Drugs Industry Market Overview, Cost Structure Analysis, Growth Opportunities and Forecast to 2027 - 3rd Watch News

U.S. Dermatology Partners Georgetown, formerly Georgetown Dermatology & Skin Cancer Center, is pleased to announce the addition of David Ettinger,…

Dermatology PA, David Ettinger joins U.S. Dermatology Partners Georgetown

GEORGETOWN, Texas (PRWEB) June 22, 2020

U.S. Dermatology Partners Georgetown is excited to welcome David Ettinger, PA-C. Born and raised in the state of Washington, David relocated after high school and has lived in California, Arizona, and South America. He attended Northern Arizona University to obtain his Bachelor of Science before earning his Master of Physician Assistant Studies at the University of Washington School of Medicine in Seattle.

Since graduating, David Ettinger has worked in dermatology and craniofacial reconstructive plastic surgery with a focus in pediatrics. He loves dermatology and helping others feel more comfortable in their skin and providing relief to those struggling with various skin conditions.

He has participated in clinical research trials for psoriasis and "Spray-on Skin" to determine their efficacy and safety in the pediatric population. "It has been wonderful to be part of the process to find new ways to treat and provide relief to those suffering", says David, a member of the Society of Dermatology Physician Assistants (SDPA).

As a physician assistant with several years of dermatology experience, David will treat patients with medical dermatology concerns such as acne treatment, psoriasis, rosacea, and eczema. He welcomes both adult and pediatric patients at our Georgetown, Texas dermatology clinic.

David Ettinger feels lucky to be raising 3 energetic, loving children alongside his wife. They enjoy spending time on the lake, exercising, and watching their children participate in their weekend sporting events.

U.S. Dermatology Partners Georgetown has been serving the dermatology needs of Georgetown and the Central Texas community since 2003. Founded by Dr. Kevin Miller, the Georgetown dermatology group includes Board-Certified Dermatologists, Dr. Monica Madray, Dr. Elizabeth Morris, Dr. Weilan Johnson, Fellowship-Trained Mohs Surgeon, Dr. Nicholas Snavely, Certified Physician Assistant David Ettinger, PA-C, and Licensed Aesthetician Corey Stoever, LA.

The state-of-the-art dermatology office was expanded in 2011 to meet the growing patient demand. U.S. Dermatology Partners Georgetown offers a full suite of clinical and surgical services, including Mohs surgery for the treatment of skin cancer. The providers treat conditions like acne, psoriasis and eczema to relieve or improve symptoms that limit your comfort, health and enjoyment. We provide specialized, highly effective treatments for a variety of skin cancers to restore and extend the quality of your life. The providers, who are parents of young children, feel comfortable treating patients of all ages, from the very young to the retirees of the Sun City community.

For more information or to schedule a new appointment, please contact the office at (512) 819-9910.

About U.S. Dermatology Partners

As one of the largest physician-owned dermatology practices in the country, U.S. Dermatology Partners' patients not only have access to general medical, surgical, and cosmetic skin treatments through its coordinated care network, but also benefit from the practice's strong dermatology subspecialty thought leaders and medical advisory board. To be the best partners to its patients, U.S. Dermatology Partners is fervently focused on providing the highest level of patient-first care, and its team, therefore, includes recognized national leaders in areas such as clinical research, psoriasis, and Mohs Surgery. To learn more, visit usdermatologypartners.com.

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U.S. Dermatology Partners Georgetown, formerly Georgetown Dermatology & Skin Cancer Center, is pleased to announce the addition of David Ettinger,...

Melanoma Risk and Biologic Therapy: Is There a Link? – Cancer Therapy Advisor

Immune-mediated inflammatory conditions such as inflammatory bowel disease (Crohn disease [CD], ulcerative colitis [UC]), psoriasis, and rheumatoid arthritis (RA) are frequently treated with antitumor necrosis factor-alpha (TNF-) agents. TNF- inhibitors (TNFIs) have shown significant clinical safety and efficacy profiles in these inflammatory conditions; however, the potential risks of long-term use are a consistent concern of both physicians and patients.

As the TNF- pathway plays a critical role in tumor surveillance, there is concern that inhibition of this pathway could predispose patients to certain malignancies.1 One such cancer that is of great concern with respect to the TNF- pathway is melanoma.1 As the use of TNFIs and other biologics have grown increasingly popular, there has been noteworthy research interest in the actual risk of melanoma in these patients.

When evaluating a study estimating the risk of melanoma in patients receiving TNFIs, it is critical to determine if the comparison group is either the general population or patients with inflammatory conditions treated with other systemic therapy. There is a meager number of studies specifically evaluating the latter, especially studies with IBD and psoriasis. Interestingly, Esse and colleagues recently published a systematic review and meta-analysis in JAMA Dermatology specifically evaluating the risk of melanoma in patients with IBD, RA, and psoriasis who were treated with biologic therapy compared to those who had received only other conventional systemic therapy.2

The authors identified 7 studies, all of which were published between 2007 and 2019, and were cohort studies that were conducted in several countries (United States, Denmark, Sweden, and Australia). These studies included a total of 34,029 patients who received biologic therapy compared with 135,370 biologic-naive patients who had received conventional systemic therapy. Mean patient-follow duration ranged from 1 year to 5.48 years. Most studies included TNFIs, however, there were some patients receiving abatacept and rituximab were also included in the meta-analysis.

There were no significant differences found in the pooled relative risk (pRR) estimates for patients treated with biologic therapy compared with those who were treated with conventional therapy in IBD (pRR, 1.20; 95% CI, 0.60-2.40) and RA (pRR, 1.20; 95% CI, 0.83-1.74).

All of the included studies were considered high-quality studies, according to the review authors, and there was no evidence of publication bias or significant heterogeneity in the studies across the patient groups. When specifically looking at each biologic agent individually (TNFIs, abatacept, rituximab), there remained no statistically significant difference in melanoma risk when compared with patients receiving conventional therapy. If individual RA studies were excluded, sensitivity analyses showed that the pRR continued to not be statistically significant from patients receiving conventional therapy.

A key distinguishing factor of this study was inclusion of patients with inflammatory conditions whom were biologic naive and their comparison with those receiving standard therapies. This study is interesting to juxtapose with several prior studies evaluating similar melanoma outcomes. Singh and colleagues published a similar systemic review and meta-analysis in Clinical Gastroenterology and Hepatology in 2014 that specifically evaluated the risk of melanoma in patients with IBD.3 This review evaluated 12 studies that included 172,837 patients with IBD and found a pooled crude incidence rate (IR) of melanoma in patients with IBD of 27.5 cases per 100,000 person-years (95% CI, 19.9-37). Overall, IBD was associated with a 37% increased risk of melanoma. This relative risk was higher in those patients with CD (RR, 1.80; 95% CI, 1.17-2.75) compared with those with UC (RR, 1.23; 95% CI, 1.01-1.50). This increased risk of melanoma was found to be independent of biologic therapy.

Another systematic review published by Peleva and colleagues in the British Journal of Dermatology in 2018 evaluated 8 prospective cohort studies evaluating the risk of all cancers in patients with psoriasis who were treated with biologic therapies.4 The authors found an increase in nonmelanoma skin cancer (NMSC) particularly squamous cell carcinoma but there was no evidence of increased risk of melanoma. This review was limited by the inclusion of only 1 study evaluating melanoma risk in patients treated with ustekinumab.

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Melanoma Risk and Biologic Therapy: Is There a Link? - Cancer Therapy Advisor

Skin Picking: How to Manage and Treat the Stress Disorder – Coveteur

How to address excoriation disorder during extreme stress.

I thought the office was empty, but it wasnt. I turned a corner and found a lone coworker with an embarrassed look on his face. He, too, thought he was alone, so hed picked at a pimple on his face, which was now bleeding. I felt his pain, since at the time I was suffering from the worst bout of adult acne Id ever had. My one reprieve was going to the office each day, where I had no choice but to keep my hands off my face.

After countless workers began working from home this spring, my friends have gradually revealed that theyre all struggling with the same issuethey cant stop picking at their faces. And who can really blame them? Tensions are high, to say the least, and recent events are triggering more cortisol (your fight-or-flight hormone) to flood our systems and incite stress responses, like excoriation disorder.

Also known as chronic skin picking or dermatillomania, excoriation disorder is related to obsessive-compulsive disorder and involves repeatedly picking at the skin, which can cause painful lesions as well as a disruption to daily life. Not all forms of skin picking fall into this more serious categoryin fact, most dontbut expert insight into both the causes and healing process can help anyone compulsively picking at their skin, hair, nails, or scabs begin to move forward on the path to recovery.

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Stress, stress, and more stress. Dr. Nancy Irwin, a licensed clinical psychologist, confirmed that the immense amount of stress and anxiety many people are experiencing right now are playing a two-pronged rolethey can both cause acne to develop and drive the desire to pick. Dr. Irwin noted that stress is behind about 72 percent of all illnesses and conditions, skin related or not. As the skin is our largest organ, it can hold clues as to what the person is feeling about the self and/or life at the current time, Dr. Irwin explains. The negative effects of stress on skin can manifest in conditions like acne, dandruff, itchy skin, and even hair loss. Stress can also cause flare-ups of skin issues such as psoriasis and rosacea to occur.

She notes that skin picking can become a compulsion if you do not identify the root of the problem, as well as make lifestyle changes that help you better manage your stress levels. Having a positive support system and making time for fun and self-care are a good place to start. These can involve exercising and eating healthy, enjoying leisure activities, or practicing your faith or meditation. We all have varying degrees of stress and challenges, so Dr. Irwin encourages patients to have a go-to list of how you can self-soothe and process those stressors when they present themselves. Work on building up trust in yourself that you have everything you need to weather the current challenges.

We know that picking at acne lesions, dry skin, or any part of our bodies can damage the skin, resulting in hyperpigmentation, multiple forms of scarring, disfigurement from lesions, and open wounds that might lead to further infection. Stopping the impulse to do so is easier said than done, however. Everything has a positive intent, and picking is a relief of anxiety, Dr. Irwin clarifies. But that doesn't mean its a healthy coping mechanism, [Patients that pick] are avoiding the issue [causing their stress] and compounding the belief that there is no other way to manage the pain or issue at hand.

One tactic for managing the urge to pick that Dr. Irwin recommends is asking yourself empowering questions likeIf I were able to handle this stress in my life while respecting my body, how would I do so? Who do I know that can help me? Another is seeking the counsel of those who have overcome picking-related struggles, such as in a support group. You are not alone. There are millions of others who have suffered this and overcome it. They can be excellent resources for you. If you are looking for professional help, Dr. Irwin suggests working with a therapist who concentrates in this area.

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Skin-picking disorder impacts as many as one in twenty people, with women being more commonly affected than men. After you identify the source of your stress and anxiety and seek treatment, the next step is healing the preexisting damage. Dr. Annie Chiu, board-certified cosmetic and general dermatologist, concedes that right now is an especially hard time to stop picking at your skin. She explains that stress weakens our skin barrier, which is why most skin conditions (like acne and psoriasis) tend to flare up during those moments. More lesions means you have more opportunities to pick. When you have good skin, its just not as tempting, she notes.

Weve all tried to pop the occasional pimple that we should have left alone, and watched it heal slower as a result, but serious cases of excoriation disorder can lead to more serious damage, like tissue injury, scarring, and discoloration. To heal the physical effects of picking or more extreme cases of excoriation disorder, Dr. Chiu recommends using a gentle facial cleanser followed by a soothing balm or serum to maintain skin hydration. She suggests reaching for any occlusive protectant (aka slippery balm-type products) like Aquaphor to help skin cells heal faster and create a protectant barrier. Look for ingredients such as ceramides, niacinamide, or hyaluronic acid, all of which can help build skin-health barriers. She also recommends incorporating overnight moisturizing masks and sheet masks into your skin-care routinebut be sure not to go overboard on new products, as tempting as it can be to try everything under the sun.

To address the breakouts themselves, Dr. Chiu is a fan of acne patches to cover the zit, such as COSRX Acne Pimple Master Patch, which physically blocks you from picking and contains acne-fighting ingredients like tea tree oil and salicylic acid. Says Dr. Chiu, If were actively conscious were taking care of our skin, we are not going to be as prone to want to ruin that. For those looking to heal deeper scarring, there are also in-office solutions such as cortisone injections and laser treatments. Your dermatologist will be able to recommend the best course of action depending on your current skin condition.

Below, five of our favorite products to help heal breakouts, soothe the skin, and repair damage from previous picking.

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Skin Picking: How to Manage and Treat the Stress Disorder - Coveteur

Are Patients With Psoriasis at Increased Risk for Serious Infection, Hospitalization? – Dermatology Advisor

Psoriasis is associated with increased risk for serious infection, according to the results of cohort study data published in the British Journal of Dermatology. During 5 years of follow-up, patients with psoriasis were more often hospitalized for infections than individuals without psoriasis.

Investigators conducted a cohort study of adults (18 years) with and without psoriasis using the United Kingdom Clinical Practice Research Datalink (CPRD). CPRD data were linked to hospital and mortality records in the United Kingdom for the years 2003 to 2016. Patients with psoriasis were matched with up to 6 control patients by age, sex, and place of clinical care. History of hospitalization was ascertained from the Hospital Episode Statistics database; death was ascertained from Office of National Statistics mortality records. Stratified Cox proportional hazard models were used to examine the relationship between psoriasis, hospitalization, and mortality. Models were adjusted for age, economic deprivation, body mass index, alcohol intake, smoking status, and comorbid conditions.

The study cohort comprised 69,312 patients with psoriasis and 338,598 comparators. Patients and comparators were followed for a median (interquartile range) of 4.9 (5.9) and 5.1 (6.3) years, respectively. The incidence rate of serious infection was 20.5 per 1000 person-years (95% confidence interval [CI], 20.0-21.0) in patients with psoriasis and 16.1 per 1000 person-years (95% CI, 15.9-16.3) in comparators. The fully adjusted hazard ratio (HR) for hospitalizations due to infection was 1.36 (95% CI, 1.31-1.40) in patients with psoriasis vs comparators. When analyses were stratified by infection type, patients with psoriasis had the highest HR for skin and soft-tissue infections (HR, 1.56; 95% CI, 1.43-1.70). Risk for respiratory infections was also increased (HR, 1.35; 95% CI, 1.27-1.44). Death due to any infection was also more common in patients vs control patients (HR, 1.33; 95% CI, 1.08-1.63).

Although the absolute risk for serious infection in patients with psoriasis was small, the likelihood of hospitalization and death were nonetheless increased compared with control patients. Future research is necessary to explore the mechanism by which psoriasis increases risk for certain infections, particularly soft-tissue and respiratory infections. As study limitations, investigators noted the risk for residual confounding and detection bias implicit in using hospital records. Increased psoriasis severity did not appear to influence risk for infection, suggesting that disease severity may have not been properly captured. Despite those findings, these results provide evidence for an increased risk for serious infection and hospitalization in patients with psoriasis.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry.

Please see the original reference for a full list of authors disclosures.

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Reference

Yiu ZZN, Parisi R, Lunt M, et al . Risk of hospitalisation and death due to infection in people with psoriasis: a population-based cohort study using the Clinical Practice Research Datalink [published online March 28, 2020]. Br J Dermatol. doi: 10.1111/bjd.19052

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Are Patients With Psoriasis at Increased Risk for Serious Infection, Hospitalization? - Dermatology Advisor

Significant Improvements Observed With Apremilast in Mild to Moderate Plaque Psoriasis – Monthly Prescribing Reference

Amgen announced positive topline results from the phase 3 study of apremilast (Otezla), a phosphodiesterase 4 (PDE4) inhibitor, for the treatment of adults with mild to moderate plaque psoriasis.

The multicenter, placebo-controlled, double-blind ADVANCE study evaluated the efficacy and safety of apremilast in 595 adult patients with mild to moderate plaque psoriasis. Patients were randomized to receive either apremilast 30mg orally twice daily or placebo for the first 16 weeks followed by all patients receiving apremilast in an open-label extension phase through week 32. The primary end point was the proportion of patients with static Physicians Global Assessment (sPGA) response of clear (0) or almost clear (1) with at least a 2-point reduction from baseline at week 16.

Results showed that apremilast met the primary end point achieving a statistically significant improvement in sPGA response at week 16 compared with placebo. In addition, the study met key secondary end points including at least 75% improvement from baseline in the percent of affected body surface area (BSA); change in BSA total score from baseline; and change in Psoriasis Area and Severity Index (PASI) total score from baseline.

The safety profile of apremilast was consistent with that seen in previous trials. The most commonly reported adverse events (5%) in either treatment group were diarrhea, headache, nausea, nasopharyngitis and upper respiratory tract infection.

Detailed results will be submitted for presentation at an upcoming medical meeting.

Many patients with mild to moderate plaque psoriasis who use topical therapies still have challenges managing their psoriasis, said David M. Reese, MD, executive vice president of Research and Development at Amgen. We look forward to discussions with the FDA about the potential to bring Otezla, which has already been prescribed to hundreds of thousands of patients with moderate to severe psoriasis, to more patients who may need additional therapeutic options.

Otezla is currently approved for the treatment of patients with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy, active psoriatic arthritis, and for oral ulcers associated with Behets disease. It is available in 10mg, 20mg, and 30mg tablets.

For more information visit amgen.com.

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Significant Improvements Observed With Apremilast in Mild to Moderate Plaque Psoriasis - Monthly Prescribing Reference

COVID-19 Outbreak Briefly Derails Phototherapy Treatment Market; Sales to Pick up Pace Once the Pandemic Begins to Recede – Cole of Duty

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The team of analysts at MRRSE, track the major developments within the Phototherapy Treatment sphere in various geographies. The market share, size, and value of each region are discussed in the report along with explanatory graphs, tables, and figures.

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This chapter of the report discusses the ongoing developments of leading companies operating in the Phototherapy Treatment market. The product portfolio, pricing strategy, the regional and global presence of each company is thoroughly discussed in the report.

Product Adoption Analysis

The report offers valuable insights related to the adoption pattern, supply-demand ratio, and pricing structure of each product.

Family physicians are playing a crucial role in diagnosing psoriasis in Canada

In Canada, the majority of the psoriasis patients are mainly diagnosed by family physicians rather than by dermatologists. The reason behind this is the lack of dermatologists and related services in Canada. For instance, according to a report published by the Economist Intelligence Unit, Canada had less than 2 dermatologists per 100,000 individuals in 2015, which is very less when compared with European countries. It has also been observed that family physicians typically prefer topical therapies than biologics/phototherapy to treat psoriasis conditions, while dermatologists prefer phototherapy more than the other available therapies/medications. This recent trend is boosting the phototherapy segment. While in the U.S. the growing population of adult women suffering from acne and psoriasis is an important factor driving revenue growth of the phototherapy segment. The population of adult women is rising with higher rates in North America than in European countries such as Germany, Italy, France and Spain. The growth in women adult acne conditions in North America is mainly due to increase in male hormonal (androgens) levels in females.

Complementary therapies to treat psoriasis conditions and combination therapies are recent trends in Western Europe, which are creating a positive impact on the phototherapy segment in the regional market

Complementary therapies such as balneotherapy along with UV radiation is quite popular in Western European countries. Balneotherapy is the oldest treatment method available to treat the psoriasis condition. In this treatment, the patient undergoes a bath in high mineralized brine, which causes a mechanical removal of skin scales and increases the sensitivity of skin to UV radiation. Combination therapies are set to witness high potential in austerity driven markets in Europe as noted by many clinic managers. Faltering out-of-pocket expenses for a service that is considered as a desire or luxury coupled with a tricky pricing of combination treatments involving a device and a drug are factors successfully helping in generating revenue in the market. This trend is very prominent in countries such as the U.K. and Spain.

Approved by the FDA to treat acne and psoriasis, blue light therapy dominates the North America and Europe phototherapy treatment market

By phototherapy type, blue light therapy dominated the North America and Europe phototherapy treatment market for psoriasis and acne, and is expected to be the most lucrative segment over the forecast period, with a market attractiveness index of 3.3. By the end of 2027, the blue light phototherapy segment is projected to reach more than US$ 1,000 Mn, expanding at a CAGR of 6.7% over the forecast period. Revenue from the Narrowband UVB phototherapy segment in the North America and Europe phototherapy treatment market for psoriasis and acne is expected to grow 1.9x by 2027 end as compared to that in 2017. The Red Light Phototherapy and Intense Pulsed Light (IPL) Phototherapy segments represent the lowest market attractiveness index of 0.3 each.

Availability of various treatments for acne and psoriasis and declining reimbursement rates are expected to hamper the growth of the phototherapy segment

Various treatments are currently available in the market to treat acne and psoriasis conditions. For instance, to treat acne conditions various drugs are available in the market such as topical/oral antibiotics and retinoid and chemical peels, among others. Due to a lot of available treatment options, physicians prescribe different treatments according to the patients skin nature and availability of drugs. Owing to the many treatment options, very few physicians prescribe phototherapy to patients. Furthermore, availability of non-office based treatments to treat acne and psoriasis conditions has a negative impact on the growth of the phototherapy segment. Furthermore, the decline of reimbursement pay and lack of adequate phototherapy units in the market are projected to hamper revenue growth of the phototherapy segment over the forecast period.

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COVID-19 Outbreak Briefly Derails Phototherapy Treatment Market; Sales to Pick up Pace Once the Pandemic Begins to Recede - Cole of Duty

Biologic, Immunosuppressive Therapies Not Tied to Severe Outcomes From COVID-19 Infection – Dermatology Advisor

There is no indication that certain patients with psoriasis or patients who have received a renal transplant are at increased risk for hospitalization or death from coronavirus disease 2019 (COVID-19), finds study data published in the Journal of the American Academy of Dermatology. This is despite a patient population who were immunocompromised as a result of medication and of older age and likely possessing metabolic and cardiovascular comorbidities.

From February 20 to April 10, 2020, researchers conducted a retrospective, observational study with the aim of determining if patients of Verona, Italy, with chronic plaque psoriasis receiving biologic or other immunosuppressive therapies as well as those who has received renal transplantation had a greater risk for hospitalization or death from COVID-19 than the general population of the city.

The investigators extracted data from hospital electronic medical records of patients with psoriasis receiving biologic or other immunosuppressive therapies and patients who had received renal transplantation. The data were then compared with the records from the general population of Verona (n=257,353) provided by the national public database.

At study conclusion, 1.2% (n=3199) of the population of Verona were COVID-19 positive; this percentage included patients who survived COVID-19 and those who did not require hospitalization. Results demonstrated that none of the 980 patients with chronic plaque psoriasis receiving biologic agents were hospitalized and none died. The researchers noted that of the 243 patients who had received renal transplantation, 1 patient was admitted to hospital for fever and pneumonia but fully recovered. Patients with psoriasis receiving biologic therapy and those who had received a renal transplant demonstrated a higher prevalence of obesity, hypertension, diabetes, and history of cardiovascular disease, the study data revealed. These patients also tended to be older and were predominantly men, compared with the general population.

The absence of molecular or serological testing for COVID-19 in the study population, the considerable difference in patient sample size and that of the general population cohort, and the small number of hospitalizations and deaths in the patient group were cited by the researchers as limitations of the study. However, because the authors had access to the complete medical record for all members of the patient group, a notable strength of the study was that if there had been a case of hospitalization or death from COVID-19, it would have been detected.

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Reference

Gisondi P, Zaza G, Del Giglio M, Rossi M, Iacono V, Girolomoni G . Risk of hospitalization and death from COVID-19 infection in patients with chronic plaque psoriasis receiving a biological treatment and renal transplanted recipients in maintenance immunosuppressive treatment [published online April 21, 2020]. J Am Acad Dermatol. doi:10.1016/j.jaad.2020.04.085

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Biologic, Immunosuppressive Therapies Not Tied to Severe Outcomes From COVID-19 Infection - Dermatology Advisor


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