Psoriasis – Symptoms and causes – Mayo Clinic


Psoriasis signs and symptoms are different for everyone. Common signs and symptoms include:

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas.

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

There are several types of psoriasis. These include:

Guttate psoriasis. This type primarily affects young adults and children. It’s usually triggered by a bacterial infection such as strep throat. It’s marked by small, water-drop-shaped, scaling lesions on your trunk, arms, legs and scalp.

The lesions are covered by a fine scale and aren’t as thick as typical plaques are. You may have a single outbreak that goes away on its own, or you may have repeated episodes.

Pustular psoriasis. This uncommon form of psoriasis can occur in widespread patches (generalized pustular psoriasis) or in smaller areas on your hands, feet or fingertips.

It generally develops quickly, with pus-filled blisters appearing just hours after your skin becomes red and tender. The blisters may come and go frequently. Generalized pustular psoriasis can also cause fever, chills, severe itching and diarrhea.

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

Seek medical advice if your signs and symptoms worsen or don’t improve with treatment. You may need a different medication or a combination of treatments to manage the psoriasis.

The cause of psoriasis isn’t fully understood, but it’s thought to be related to an immune system problem with T cells and other white blood cells, called neutrophils, in your body.

T cells normally travel through the body to defend against foreign substances, such as viruses or bacteria.

But if you have psoriasis, the T cells attack healthy skin cells by mistake, as if to heal a wound or to fight an infection.

Overactive T cells also trigger increased production of healthy skin cells, more T cells and other white blood cells, especially neutrophils. These travel into the skin causing redness and sometimes pus in pustular lesions. Dilated blood vessels in psoriasis-affected areas create warmth and redness in the skin lesions.

The process becomes an ongoing cycle in which new skin cells move to the outermost layer of skin too quickly in days rather than weeks. Skin cells build up in thick, scaly patches on the skin’s surface, continuing until treatment stops the cycle.

Just what causes T cells to malfunction in people with psoriasis isn’t entirely clear. Researchers believe both genetics and environmental factors play a role.

Psoriasis typically starts or worsens because of a trigger that you may be able to identify and avoid. Factors that may trigger psoriasis include:

Anyone can develop psoriasis, but these factors can increase your risk of developing the disease:

If you have psoriasis, you’re at greater risk of developing certain diseases. These include:

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Psoriasis – Symptoms and causes – Mayo Clinic

Janssen’s Tremfya (guselkumab) Makes its Debut in the Psoriasis Market and Early Dermatologist Feedback Reveals … – PR Newswire (press release)

Possible barriers to rapid uptake will come in the form of differentiation from the existing biologics, namely Janssen’s own Stelara, as well as from the IL-17 inhibitors, Novartis’ Cosentyx and Lilly’s Taltz. In response to Tremfya’s launch, one respondent questioned, “What contribution does Tremfya provide in a sea of psoriasis options?” While close to half of the respondents feel that Tremfya is a significant advance over the TNF inhibitors and Celgene’s Otezla, only one in five believe it is a significant advance over the IL-17 inhibitors or Stelara.

Additionally, a number of respondents note a general lack of knowledge and voiced some confusion regarding Tremfya’s mechanism of action. Others appear to be under the impression that the biologic was an IL-17 inhibitor and several noted that Tremfya is associated with a suicide risk; implying a potential confusion between Tremfya and Siliq, Valeant’s recently approved IL-17 inhibitor that carries a black box warning for suicidal ideation. The lack of knowledge can partially be explained by low sales representative contact rates, with only one-third of the sampled dermatologists reporting contact to date. As Tremfya penetrates the market and representative contact rates increase it can be assumed that this confusion will dissipate.

The third quarter update of RealTime Dynamix: Psoriasis, which will field at the end of August, will include an in depth analysis and tracking of Tremfya’s launch and will also highlight benchmark launch comparisons to Taltz, Lily’s IL-17 inhibitor which was approved in 2016. At one month post-launch, 86% of dermatologists were aware of Taltz’s approval, one-third reported use of the IL-17 inhibitor, and two-thirds had been briefed by a sales representative all metrics Tremfya needs to match or exceed for successful entry into this increasingly competitive market.

RealTime Dynamix: Psoriasis is an independent report series published on a quarterly basis. The series tracks the evolution of the PsO market, provides a deep dive on launch effectiveness, and highlights opportunities for pipeline agents.

About Spherix Global Insights Spherix Global Insights is a business intelligence and market research company specializing in renal, autoimmune, neurologic and rare disease markets. We provide clients with strategic insights leveraged from our independent studies conducted with healthcare providers and other stakeholders.

All company, brand or product names in this document are trademarks of their respective holders.

For more information contact: Lynn Price, Immunology Franchise Head Email: info@spherixglobalinsights.com

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Janssen’s Tremfya (guselkumab) Makes its Debut in the Psoriasis Market and Early Dermatologist Feedback Reveals … – PR Newswire (press release)

Anchoring Improves Compliance of Injections for Psoriasis – Medical News Bulletin

Anchoring is defined as having the tendency to make subsequent judgements based on the first piece of information received. A group of researchers determined that anchoring improves patient adherence to injections for psoriasis.

Psoriasis is an autoimmune disease which is managed with several different medications. Among these medications, biological therapy has been proven to be effective; however, adherence can be difficult because of the fear associated with injections.

A research letter published in JAMAdescribes the results of a study conducted to determine if anchoring patients diagnosed with psoriasis before initiation of treatment would improve treatment compliance. Anchoring is defined as having the tendency to make subsequent judgements based on the first piece of information received. In this study, the researchers assessed if patients offered with monthly injections for psoriasis would adhere to the injection if they were initially presented with a once-daily injection. A total of 100 patients diagnosed with psoriasis, aged 18 years and older and not previously prescribed injectable medications were included in the study. Participants were randomized to two groups. One group was initially anchored by assessing their willingness to have once-daily injections for their treatment before determining their willingness to have monthly injections. The other group was only asked about their willingness to start a monthly injection.

The results of the study show that the group who received anchoring with a once-daily injection were more willing to start a monthly injection compared to the other. Anchoring has been studied in other areas such as psychology and behavioral economics, but its applications in the practice of medicine have yet to be proven. One of the issues encountered is the manipulation of the patient perception with regards to their decision making. The clinician is faced with the ethical dilemma of what to use as an acceptable anchor when offering procedures or treatments to patients.


Oussedik, E., et al. (2017). An anchoring based intervention to increase patient willingness to use injectable medication in psoriasis. JAMA Dermatology. doi:10.1001/jamadermatol.2017.1271

Written byKarla Sevilla

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Anchoring Improves Compliance of Injections for Psoriasis – Medical News Bulletin

Psoriasis severity linked to increased risk of uveitis – Medical News Bulletin

In a large study in Taiwan, investigators looked at the pattern of incidence of uveitis (eye inflammation) in people with psoriasis. They found that as the severity of psoriasis increased patients had an increasing risk of uveitis compared to people without psoriasis.

Psoriasis is a common chronic inflammatory condition of the skin. While its cause is still unclear, it is thought to be an autoimmune diseasewhere they bodys own defense system reacts abnormally to healthy cells. Although psoriasis mainly affects the skin and nails, in some cases sufferers may develop several other associated inflammatory conditions including arthritis. Psoriatic arthritis can lead to joint destruction and disability. (For more information on psoriasis click here)

Uveitis is an inflammation of part of the eye called the uveal tract this includes the iris, ciliary body and choroid tissue.Symptoms include a painful red eye, light sensitivity and blurred vision. One or both eyes may be affected. Uveitis can have several different causes, but it has alsobeen linked topsoriasis although the relationship is not well defined. In order examinethis further, researchers in Taiwan reviewed a large group of patients with psoriasis and looked at the pattern of incidence of uveitis in these patients compared to people without psoriasis. The findings were recently reported in JAMA Ophthalmology.

The National Health Insurance Research Database in Taiwan contains comprehensive health data on the Taiwanese population and is a useful resource for studying the pattern of diseases. The researchers reviewed all those in the database who had psoriasis between 2000-2011. They divided these patients into four subgroups according to the severity of their psoriasis and whether or not they had associated psoriatic arthritis. The four groups were: mild psoriasis without arthritis, severe psoriasis without arthritis, mild psoriasis with arthritis, severe psoriasis with arthritis. Over 147,000 psoriasis patients were included and compared with the same number of people without psoriasis (control group).The researchers looked at the occurrence of uveitis in all of these subjects and compared the relative risk between the psoriasis groups and controls.

Patients with severe psoriasis and arthritis had the greatest risk of developing uveitis, followed by those with severe psoriasis but no arthritis, and mild psoriasis with arthritis. There was no significant increase in the risk of uveitis in the mild psoriasis with no arthritis group compared to the control group.

The researchers concluded that the incidence of uveitis differs according to the severity of psoriasis. There greatest risk is in patients with severe psoriasis andarthritis. They suggest that doctors should be aware of these varying risk levels and should educate psoriasis patients about the signs and symptoms of uveitis so that they can seek medical attention if necessary.

Written By:Julie McShane, Medical Writer


Chi CC, Tung TH, Wang J, et al. Risk of uveitis among people with psoriasis. A Nationwide cohort study. JAMA Ophthalmology. Published online April 13, 2017.

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Psoriasis severity linked to increased risk of uveitis – Medical News Bulletin

Survey Reveals Psoriasis Patients’ Journeys Take Different Paths – Benzinga

PHILADELPHIA, PA–(Marketwired – August 09, 2017) – A new Health Union national survey of more than 1,000 individuals diagnosed with psoriasis reveals that each person’s symptoms and treatment journey is different and some patients’ paths are more circuitous than others.

Psoriasis In America 2017 was conducted online between April 4, 2017 – May 26, 2017 and released through Health Union’s online community, PlaquePsoriasis.com. Survey respondents reported being frustrated with their psoriasis symptoms on a daily basis, with 70 percent reporting flaking skin, 62 percent itchy skin, and 44 percent cracked skin for all seven days during the past week.

Psoriasis is an autoimmune disease causing chronic inflammation of skin and other parts of the body. In the United States, there are an estimated 7.5 million adults with psoriasis. Plaque psoriasis is the most common type of psoriasis, representing about 80 percent of cases. Psoriasis symptoms have different levels of severity — from mild to severe — which are medically characterized by the percent of the body surface affected by skin lesions.

For many people, their psoriasis journey reveals signs of autoimmune disease that go beyond their skin. Among current symptoms reported by survey respondents, 58 percent are affected by pain and 66 percent are affected by fatigue. In addition, 45 percent report that their nails are currently affected, which is considered an early warning sign of psoriatic arthritis.

Because psoriasis is a chronic condition with no cure, many people can become discouraged with the available treatment options. Six out of 10 survey participants reported having never gone into remission from their psoriasis symptoms. Still, for some people, remission is possible. With treatment, many patients can have longer periods of remission and relief from skin symptoms.

Chris Petit, PlaquePsoriasis.com patient advocate agreed.

“Even when your skin is clear, the fear of it coming back is always there. You’re never 100-percent done with it until they find a cure,” he explained.

Almost half of survey respondents started on a prescription medication to treat their psoriasis within a month of diagnosis. Even with treatment, patients continue to deal with skin symptoms which may worsen before they get better. This stress and anxiety can cause further skin flares, adding to the frustration.

“Writing about my psoriasis journey on PlaquePsoriasis.com has been a great way to help others,” Petit added. “In the beginning it was rough. Over the years I’ve learned to embrace it. You can’t let the disease run your life — you have to take control. It doesn’t define who you are.”

In fact, 73 percent of survey respondents report turning to a psoriasis-specific website to learn more about managing their condition.

“The results of this survey highlight the complex journey facing people who live with psoriasis,” said Tim Armand, president and co-founder of Health Union. “People come to PlaquePsoriasis.com when they experience judgment and isolation and don’t know where else to turn. We are proud to be able to provide this much needed resource for support and information.”

A summary infographic of the survey results is also available. More details about the survey are available upon request.

About Health Union, LLC and PlaquePsoriasis.comHealth Union inspires people to live better with challenging health conditions — combining new, original content every day with digital, social and mobile technologies to cultivate active online health communities. Health Union platforms are unique ecosystems dedicated to illuminating the voices and experiences of people with type migraine, rheumatoid arthritis, type 2 diabetes, and more. Its services and offerings foster open and honest interactions about these health conditions between and among patients, caregivers, professionals, providers and industry partners to help all stakeholders make more informed decisions about healthcare. PlaquePsoriasis.com is Health Union’s online community dedicated to people living with psoriasis, where patients and supporters of people living with this condition can connect, share experiences, and learn about managing the condition.

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Survey Reveals Psoriasis Patients’ Journeys Take Different Paths – Benzinga

Dermatologists collaborate on data-driven pediatric psoriasis research – ModernMedicine

Emerging research from an international dataset of pediatric psoriasis patients is revealing much needed information about how children fare with commonly used systemic treatments, says dermatologist Amy S. Paller, M.D., M.S.

And she says the collaborative effort is powered by pediatric dermatologists not industry.

Dr. Paller, professor and chair of dermatology at Northwestern University Feinberg School of Medicine and pediatric dermatologist at Ann and Robert H. Lurie Childrens Hospital of Chicago, presented findings from the PeDRA-EPPWG Study of Systemic Therapy in Pediatric Psoriasis at the July World Congress of Pediatric Dermatology in Chicago. She not only talked about the soon-to-be-published studys findings, but also how a retrospective analysis could inform a prospective registry.

Dr. Paller and colleagues launched the Pediatric Dermatology Research Alliance, or PeDRA, in 2012, recognizing that pediatric dermatologists needed to work as a group to research dermatologic conditions in children because many of the conditions are rare and lack pediatric-specific data.

Thats exactly what has happened in this work with pediatric psoriasis, Dr. Paller says.

Colleagues in the European Pediatric Psoriasis Working Group, or EPPWG were willing to buy in. The groups shared goals to better understand dermatologists experiences with systemic drugs for pediatric psoriasis, and to get experience with a joint registry, which hopefully would pave the way for a prospective pediatric psoriasis registry, according to Dr. Paller.

Ten centers from PeDRA in North America and 10 centers in Europe came together to perform the study.

It was a tremendous learning experience about some of the challenges of retrospective data collection and the benefit to prospective research using common data collection, Dr. Paller says.

The researchers extracted 54 different items from charts of patients treated with systemic therapy or phototherapy, but only allowed patients to be included who had at least a minimum dataset that could provide important information on demographics, clinical characteristics and severity, systemic agents used, treatment duration and efficacy, side effects and reasons for discontinuation of medications.

A review of thousands of patient records revealed 446 which met criteria for the minimal dataset; of those, 390 involved systemic therapy for pediatric psoriasis. In this joint PeDRA-EPPWG study, which was funded by the International Psoriasis Council, data was collected using the Research Electronic Data Capture, or REDCap, web-based data capture tool.

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Dermatologists collaborate on data-driven pediatric psoriasis research – ModernMedicine

NICE backs new treatment option for psoriasis – PharmaTimes

The National Institute for Health and Care Excellence has issued draft guidelines backing NHS use of Almiralls Skilarence to treat moderate to severe plaque psoriasis.

The Institute is recommending the drugs use only in adults who have severe disease and have not responded to, or cannot take, other systemic non-biological treatments.

According to NICE, clinical trial results showed that Skilarence (dimethyl fumarate) improves severe psoriasis more than placebo but, when compared indirectly, is less effective than systemic biological therapies and apremilast (Celgenes Otezla).

The incremental cost effectiveness ratio for the drug followed by best supportive care compared with best supportive care alone was 23,115 per QALY gained, thus falling within the threshold for what is considered a cost-effective use of NHS resources in this setting.

Another condition of the recommendation is that treatment with Skilarence (dimethyl fumarate) is stopped at 16 weeks if the psoriasis if the response has not been adequate, defined a 75 percent reduction in the PASI score from when treatment started or a 50 precent reduction in the PASI score and a 5-point reduction in the Dermatology Life Quality Index.

It is estimated that 951,000 people in England have psoriasis, of whom about 90 percent have plaque psoriasis.

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NICE backs new treatment option for psoriasis – PharmaTimes

Therapy for Psoriasis May Not be Triggering Inflammatory Bowel Disease – Medical News Bulletin

A currently approved antibody for the treatment of plaque psoriasis, ixekizumab, targets a cytokine that may also play a role in the pathogenesis of inflammatory bowel disease. This has led to concerns that ixekizumab increases the occurrence of inflammatory bowel disease in patients with psoriasis. A recent study published in the American Journal of Dermatology have now put those concerns to rest.

Plaque psoriasis is an inflammatory skin disorder, characterized by the appearance of raised red scales, which are often itchy and painful. Whats worse is that psoriasis has a significant genetic overlap with inflammatory bowel disease (IBD), and patients often develop IBD as a co-morbidity. Crohns disease and ulcerative colitis are the two most common manifestations of IBD, characterized by chronic and recurrent inflammation of the intestines.

Animal and human studies have suggested a potential role of the cytokine interleulin-17 (IL-17) in the pathogenesis of IBD, although the results have often been confounding. So far, clinical trials using antagonists of IL-17A have failed to show efficacy in treating Crohns disease, or worsened prognosis.

Ixekizumab, an antibody against IL-17A, is an effective monoclonal antibody approved for the treatment of plaque psoriasis. Considering the genetic overlap between psoriasis and IBD, and prior reports of adverse events in Crohns patients receiving IL-17A antagonists, Eli Lilly and Company, the pharmaceutical giant that helped developed ixekizumab, conducted a study to gain a better understanding of IBD incidence in psoriasis patients treated with ixekizumab.

The company set up an independent external committee to look at data from 4029 patients with moderate to severe psoriasis who have received ixekizumab. Participants were previously enrolled in one of 7 different randomized clinical trials for ixekizumab. Adjudication of IBD was performed according to an internationally recognized classification system, combining reviews of radiographic, endoscopic, pathological, clinical and laboratory features.

Published in the American Journal of Dermatology, the study found that rates of new IBD cases (comprising both Crohns disease and ulcerative colitis) were uncommon (

The authors, however, acknowledged one major limitation of the report: the post-hoc nature of the adjudication process, which may have limited the amount of data collection necessary for IBD confirmation. Also, no information on patient or family history of IBD was collected at the time of the trials. Furthermore, the study lacked information on the duration of earlier therapies that may have led to IBD symptoms i.e. before exposure to ixekizumab.

Albeit, the authors suggest that dermatologists monitor patients with concomitant psoriasis and IBD who are receiving IL-17 antibody therapy and advocate for providing full warnings and precautions when prescribing IL-17A antagonists.

Written By: Debapriya Dutta, PhD

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Therapy for Psoriasis May Not be Triggering Inflammatory Bowel Disease – Medical News Bulletin

Eczema and psoriasis treatment: THIS therapy could reduce the need for creams and tablets – Express.co.uk

Now, experts have said routine prescribing of UV light treatment for severe skin conditions could significantly reduce the use of steroid creams and tablets, according to new research from the University of Dundee.

Patients who experience the most severe forms of diseases such as psoriasis or eczema can find their lives affectged by their conditions.

Steroid creams are frequently prescribed but these can cause quite serious side effects and can prove inadequate to bring the disease under control.

In such instances patients may be referred to a dermatologist for more intensive treatment, which may take the forms of pills, injections or filtered UV light, known as phototherapy.

Experts from Dundee Universitys School of Medicine, examined the outcomes of 1800 patients with severe psoriasis who received UV treatment over a six-year period.


They found that three-quarters of patients experienced significant improvements in their condition and that the need for steroid creams was reduced by 25 per cent.

Phototherapy involves safe, controlled delivery of narrow wavebands of ultraviolet radiation in specially constructed cabins.

It has been known to help skin disease sufferers for decades but this study is the first to demonstrate that its use can reduce the need for steroids in the treatment of psoriasis in routine practice and not just in a short-term clinical study.

Importantly, the findings also suggest that many patients can delay or avoid altogether the need for oral or injection treatments which can cause side effects such as gastric upset, liver dysfunction and infections.

Physicians have been using phototherapy or even direct sunlight to treat skin conditions for 50 years, said Dr Foerster.

We know that it helps patients with psoriasis and eczema but until now we did not know that it actually causes a reduction in the use of steroid creams and can reduce the need for patients to have their conditions controlled by tablets or injections.


Getty Images/Cultura RF

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Resist the itch – Eczema is almost always itchy no matter where it occurs on the body and although it may be tempting to scratch affected areas of the skin, this should be avoided as much as possible

Phototherapy could reduce the need for eczema and psoriasis creams

These can work very well but can also have a downside.

The form of treatment we are talking about is targeted, non-dangerous exposure to filtered light to treat skin conditions that are so severe that they cant be contained with creams.

We were able to exploit a uniquely complete set of anonymised prescribing records that exists in Tayside and found that there was a very significant reduction in the amount of steroid cream prescribed to people who underwent phototherapy for up to 12 months after their treatment.

Access to phototherapy across the UK largely depends on a patients location.

Sadly phototherapy is not equally available around the UK, said Dr Foerster.


Tablet treatments can be effective and safe with proper monitoring but it would be fantastic if everyone had the opportunity to try something that circumvents the need for any laboratory monitoring in the first place.

There are other risks resulting from a lack of access to phototherapy.

Sufferers of psoriasis or eczema may take matters into their own hands and seek out a sun-filled holiday or use sun beds.

I have seen this on several occasions and it brings with it the many well-known dangers arising from skin exposure.

The research is published in the journal PLOS ONE.


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Eczema and psoriasis treatment: THIS therapy could reduce the need for creams and tablets – Express.co.uk

Psoriasis Treatment in Skin of Color – MedPage Today

When it comes to treating psoriasis in non-white patients, there is a paucity of data on differences in epidemiology, clinical presentation, and approaches to treatment.

“Although psoriasis appears to have a lower prevalence in non-white racial ethnic groups, including African Americans, it is by no means an uncommon or rare disease,” said Andrew Alexis, MD, chair of the department of dermatology and director of the Skin of Color Center at Mount Sinai St. Luke’s and Mount Sinai West in New York City, speaking about the topic at the Skin of Color Seminar Series (SOCSS) in New York City.

In fact, a recent study found a 1.9% prevalence rate of psoriasis in African Americans. “This is much more common than previously reported,” Alexis said.

The clinical presentation of psoriasis in darker-skinned individuals can vary, based primarily on the visual appearance. For example, because of the background melanin pigmentation, “the erythema may look more violaceous, hyperpigmented, or dark brown or gray. Therefore, one has to train the eye to detect psoriasis-related erythema in darker skin types,” he explained.

Diagnostic Pearls

Clues of psoriasis include the quality of the scale, the anatomic distribution, and associated features.

There are scenarios, though, where a biopsy is needed to confirm the diagnosis of psoriasis. “I find this is more frequent in darker skin types,” Alexis said.

For instance, patients with skin type VI may present with violaceous, gray, or hyperchromic scaly plaques without appreciable erythema. “In these patients, it may be difficult to distinguish the psoriasis from lichen planus, cutaneous T-cell lymphoma, or sarcoidosis in some cases.”

Therapeutic Insights

For treatment, a few studies have looked at potential racial ethnic differences in safety and efficacy.

“One such study found comparable safety measures and efficacy outcome measures for the injectable TNF [tumor necrosis factor] antagonist etanercept [Enbrel, Amgen],” Alexis said.

However, in the above study, published in 2011 in the Journal of Drugs in Dermatology, racial/ethnic differences in quality-of-life impact were observed. As measured by the Dermatology Quality of Life Index (DLQI), “baseline quality of life was actually worse in African American and Hispanic/Latino patients compared to Caucasians,” he said.

More recently, Alexis was co-author of a poster at this year’s SOCSS that evaluated the safety and efficacy of the recently approved biologic agent brodalumab (Siliq, Valeant), for which there was no significant racial or ethnic differences in safety or efficacy.

“Studies like this are important to understand whether there are any potential differences in safety and efficacy, particularly with biologics that are so specific in their target. Fortunately, we have not seen any significant differences with the studies that have been conducted thus far.”

Treatment Nuances

An example of nuanced treatment is when psoriasis affects the scalp of women of African ancestry, he explained.

“One has to take into account the differences in hair-care practices in this cohort and differences in hair structure that can affect the optimal topical therapies.”

Therefore, before prescribing, the patient’s hair-washing frequency needs to be determined, as well as what is involved in her hairstyle and the preferred vehicle or formulation, whether it is a water-based solution, a lotion, an oil-based product, or a foam.

“You need to have some discussion about these issues to integrate the treatment recommendation into the patient’s existing or preferred hair-care practices,” Alexis said.

For example, if a woman straightens her hair using heat, “any exposure to water will revert the hair from straight to curly again. Hence, recommending daily washing with a medicated shampoo would not be compatible with that person’s usual hair-care practices and could potentially lead to hair breakage and dryness.”

Alexis said that he recommends instead once-weekly washing with a medicated shampoo: “To compromise for that less frequent shampooing, there are topical products that the patient can leave on the scalp that are effective for psoriasis.”

One such daily product is a two-compound scalp formulation containing calcipotriene and betamethasone diproprionate (Taclonex, Leo Pharma).

“This topical suspension also has castor oil in its vehicle, which is very well suited for this hair type and is widely accepted by patients in this population,” Alexis noted. “It was also specifically used in studies in black and Latino patients with scalp psoriasis.”

In addition to the scaling, redness, and thickness of psoriasis plaque that is found in all patient populations, individuals with darker skin types face the added burden of pigmentary alteration: “Once the psoriasis resolves, it tends to leave post-inflammatory hyperpigmentation or post-inflammatory hypopigmentation. This lasts for many months after the psoriasis is cleared, thus delaying the total clearance of the skin during treatment by 3 to 6 months, depending on the overall severity.”

Quality of Life

Such a bleak outlook “very likely contributes to the more adverse quality-of-life impact that has been observed in this population,” Alexis said.

“Thankfully, we now have a much larger range of treatment options for all of our psoriasis patients. But one should avoid undertreatment of psoriasis in darker skin types, given the risk of pigmentary sequelae that can last many weeks after a psoriasis plaque heals.”

Patients also need to be informed of a realistic timeline for pigmentation to resolve, Alexis added. “There are instances where we may need to use a skin-lightening agent like hydroquinone to treat the residential hyperpigmentation that is left behind after a psoriasis plaque resolves.”

Early and effective treatment, including use of systemic and biologic agents to adequately control the inflammatory disease, “will not only help address the scaling and the elevation and redness of the plaques, but also will likely reduce the severity and extent of pigmentary abnormalities that these patients face.”

A larger healthcare landscape issue, however, is that non-white racial ethnic minorities in the United States are less likely to visit a specialist for skin conditions, including psoriasis, according to some studies, Alexis noted.

“These heath disparities that do exist contribute to delays in diagnosis of psoriasis.”

This article originally appeared on our partner’s website Dermatology Times, which is a part of UBM Medica. (Free registration is required.)

Andrew Alexis, MD, has served as an investigator for Dermira and Novartis.


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Psoriasis Treatment in Skin of Color – MedPage Today

10 Best Weed Strains For Psoriasis – Green Rush Daily

What are the best weed strains for psoriasis? Recent studies suggest that cannabis can be effective in treating various skin disorders such as eczema and psoriasis. This is partially due to the anti-inflammatory nature of marijuana. Another study shows that cannabis is an effective treatment because the cannabinoids interact with the endocannabinoid system in a way that regulates the immune system. This helps prevent flare-ups.

Now that this information is available, we have to ask: how can we use cannabis to treat psoriasis?

Psoriasis is an autoimmune disorder that is characterized by a high cell turnover rate, which leads to a build-up of dry, flaky, and scaly skin. The dry skin is usually in patches along the persons body, and are often itchy and painful. About thirty percent of people with psoriasis also develop psoriatic arthritis, which is characterized by the painful swelling and stiffening of joints.

Due to the highly visible nature of the disease, psoriasis causesanxiety and depression in the people who suffer from it.

Psoriasis is incurable. However, it is treatable. Usually, doctors recommend managing mild to moderate psoriasis with topical treatments, like prescription corticosteroids and vitamin D analogs. For more severe cases, topical treatments are combined with light therapy and/or medication.

When it comes to treating psoriasis with cannabis, topical treatment is quite effective. CBD topicals, such as salves or creams, can directly and gently target the affected areas without irritating the skin further.

While ingesting cannabis to treat psoriasis, its critical to remember one thing: do not smoke it. While cannabis smoke isnt nearly as harmful as other kinds of smoke, like cigarettes, it can still be detrimental when treating psoriasis. So, when considering the following strains, make sure to use a vaporizer or cook some edibles.


This is an indica-dominant strain with a fruity and floral scent. While its not the best for treating inflammation it is a great stress reliever. It can also be effective at easing depression and physical pain.

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10 Best Weed Strains For Psoriasis – Green Rush Daily

How psoriasis arises – ModernMedicine

Dr. KruegerDermatologists’ appreciation of the central role that the interleukin (IL)-23/Th17 pathway plays in psoriasis has developed gradually, through research and serendipity, according to James Krueger, M.D., Ph.D., who spoke on the topic at the MauiDerm 2017 meeting.

“When I started researching psoriasis in the early 1990s, there was considerable debate about pathogenesis. But the dominant hypothesis was that keratinocytes were growing autonomously by overproduction of growth factors (transforming growth factor alpha) that would interact with overactive EGF receptors, producing a proliferative reaction.” In this hypothesis, “A few immune cells came along for the ride,” Dr. Krueger explained. He is D. Martin Carter Professor in Clinical Investigation at Rockefeller University.

Based on biopsies, “It’s clear that psoriasis represents a big change in biology from background skin. There’s a tremendous epidermal thickening reaction, on a bed of mononuclear inflammatory cells in the infiltrate.” Immunohistochemical (Ki67) staining of hyperkeratotic skin invariably shows that virtually every basal cell is in cycle, versus very few basal cells in background skin. This growth activation is also associated with incomplete differentiation this is a wound-healing program called regenerative maturation.”

The second invariable feature in psoriasis is a large infiltrate of T cells mostly CD4+ in the dermis, and CD8+ in the epidermis, Dr. Krueger says. Consistent overexpression of T cells led immunologists to theorize that psoriasis must involve an inductive reaction provoked by T cells with abundant high-affinity IL-2 receptors, he says.

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How psoriasis arises – ModernMedicine

Sulzberger lecturer provides in-depth look at psoriasis comorbidities – ModernMedicine

At AAD 2017, Joel M. Gelfand, MD, MSCE, was honored as the recipient of the Marion B. Sulzberger, MD, Memorial Award and Lectureship. In his talk titled Getting to the heart (and other comorbidities) of psoriasis, Dr. Gelfand discussed the findings from research investigating associations between psoriasis and comorbidities and their relevance for providing comprehensive medical care for patients with psoriasis.

Concluding his talk, Dr. Gelfand expanded on a quote from Dr. Francis Peabodys essay, The Care of the Patient, written 90 years ago.

Dr. Peabody stated, the secret of the care of the patient is in caring for the patient. For the patient with psoriasis, that means we need to look beyond the skin, said Dr. Gelfand, Professor of Dermatology and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Establishing evidential support

Focusing primarily on associations between psoriasis and cardiovascular disease, Dr. Gelfand highlighted results from population-based epidemiological studies, including those from his own clinical research laboratory analyzing data in a prospectively maintained medical record database in the United Kingdom.

Our studies showed an independent, dose-response relationship between psoriasis severity and risks of major adverse cardiovascular events, ie., myocardial infarction, stroke, and cardiovascular disease-related mortality. Subsequently, numerous papers have been published investigating the association between psoriasis and cardiovascular risk, and results from nine meta-analyses covering more than 500,000 patients with psoriasis and more than 29 million controls largely confirm our initial findings, he said.

Findings from laboratory investigations provide insights into the potential biological mechanisms underlying the association between psoriasis and cardiovascular disease and provide proof of principle that inflammation restricted to the skin can lead to systemic vascular complications, Dr. Gelfand said.

In addition, clinical studies using [18F]-fluorodeoxyglucose positron emission tomography/computed tomography imaging show that as psoriasis severity increases so does aortic and subcutaneous fat inflammation.

A finding that subcutaneous fat under psoriatic plaques expresses miRNAs that modulate lipid metabolism suggests there is communication between the skin and the fat and that it plays a role in mediating some of the connections we are seeing between psoriasis and cardiometabolic disease, Dr. Gelfand said.

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Sulzberger lecturer provides in-depth look at psoriasis comorbidities – ModernMedicine

NICE issues draft guidance on Almirall’s Skilarence for psoriasis – The Pharma Letter (registration)

The National Institute for Health and Care Excellence (NICE), the cost-effectiveness watchdog for England

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NICE issues draft guidance on Almirall’s Skilarence for psoriasis – The Pharma Letter (registration)

Researchers reprogram immune cells to treat psoriasis and more – SlashGear

A new study details the successful reprogramming of certain immune cells that could lead to treatments for autoimmune diseases like psoriasis. The work was performed by researchers with the Gladstone Institutes, and it is made possible by a small-molecule drug that essentially converts immune cells from the type that attack the body to the type that keep things in check. It could also prove effect for treating cancers.

Immune cells are known as T cells, and they come in two varieties: regulatory, which keeps the immune system from running rogue and attacking a healthy body, and effector, which trigger the immune system into action. Autoimmune disorders are the result of a dysfunction with these cells, often resulting in the body attacking some healthy part of itself, such as causing inflamed, scaly skin in the case of psoriasis.

Immune system dysfunction can go the other way, as well, resulting from a suppression of it that causes different sorts of diseases or cancers. Because these T cells are so greatly involved in the function of the immune system and its balance, it makes sense that tweaking the presence of these cells in the body could address diseases, and thats exactly what researchers have done for the first time ever.

Using the aforementioned drug, the potentially damaging effector cells can be reprogrammed into regulatory T cells, which would then bring the immune system under control and stop it from attacking a healthy body. It is thought that producing more regulatory T cells in the body could also keep the immune system from rejecting transplanted cells in the case of stem cell therapies.

As far as cancer is concerned, the drug could also be used to boost regulatory T cells so that the immune system can better find and attack cancer cells, the aim being to treat or prevent cancers. Future plans for this research werent stated, however, it is a milestone discovery that could lead to treatments for many diseases.

SOURCE: Nature, EurekAlert


Researchers reprogram immune cells to treat psoriasis and more – SlashGear

24 People in Phase 1 Trial Focusing on Psoriasis Have Received KY1005, Which Is Also an MS Therapy – Multiple Sclerosis News Today

Twenty-four people have now received the multiple sclerosis and psoriasis therapy KY1005 in a Phase 1 clinical trial, according to its developer,Kymab.

The Cambridge, England, company createshuman antibody drugs for autoimmune diseases. The trial will focus on KY1005 as a psoriasis therapy, although its mechanism of action should work in MS as well, Kymab said.

KY1005 is the first of a series of products we are developing focused on autoimmune diseases, immune-oncology, hematology and infectious disease, Dr. David Chiswell, Kymabs CEO, said in a press release.

Our vision is to build Kymab into a major global biopharmaceutical company, he said. This, the first of what will be a steady stream of clinical trials, is an important step towards realizing our vision. Indeed, the potential of KY1005 is such that, on its own, it could treat a number of immune and inflammatory disorders. We are confident that this will be the first of several trials on this antibody alone.

KY1005 prevents a protein known as the OX40-Ligand from activating the protein it binds to, OX40. When activated, OX40 triggers the proliferation of memory and effector T lymphocytes, cells that regulate immune system responses.

OX40 plays a crucial role in the development of MS, studies in mice have shown.KY1005 blocks OX40L, allowing OX40 to rebalance the immune system and prevent autoimmune responses.

I am delighted that we have reached another important milestone for Kymab, said Professor Allan Bradley, a Kymab co-founder. Since the companys founding only seven years ago, we have generated a number of best-in-class drug candidates using our exquisite antibody platform, he said. Kymabs platform contains the entire repertoire of human antibodies, making it the most comprehensive antibody development platform available.

To now have our first antibody firmly on its clinical [trial] development pathway, with a rich pipeline of future products following, is a significant milestone and a testament to the unique qualities of the antibody drugs produced by ourproprietary antibody platform as well as the performance of the Kymab team in progressing them rapidly through development, he said.

The Phase 1 trial (NCT03161288) will evaluate the effects of single and multiple ascending doses of KY1005 versus a placebo in healthy volunteers and people with a mild-to-moderate psoriasis, an autoimmune diseasecharacterized by patches of abnormal skin.

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24 People in Phase 1 Trial Focusing on Psoriasis Have Received KY1005, Which Is Also an MS Therapy – Multiple Sclerosis News Today

Your child has psoriasis, now how do you treat it? – Miami Herald

Your child has psoriasis, now how do you treat it?
Miami Herald
If you've answered yes, your child might have psoriasis. Psoriasis is a chronic inflammatory skin disease that affects less than 1 percent of children. The risk is higher in individuals with a family history of psoriasis. Psoriasis lesions are well

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Your child has psoriasis, now how do you treat it? – Miami Herald

How to Deal With Psoriasis – Beliefnet


Psoriasis is an immune-mediated disease that causes raised, red scaly patches to appear on the skin. According to the American Academy of Dermatology, an estimated, 7.5 million people in the United States have psoriasis. “Psoriasis occurs in all age groups but is primarily seen in adults. Up to 40 percent of people with psoriasis experience joint inflammation that produces symptoms of arthritis.” Psoriasis affects the elbows, knees or scalp, though it can appear in any location and it can burn and sting. Scientists do not know what causes psoriasis. But it’s believed that that the immune system and perhaps genetics play a role in triggering the condition. The skin cells in people with psoriasis grow at an abnormally fast rate and this can cause lesions. AAD also shared that men and women develop psoriasis at equal rates. “Psoriasis also occurs in all racial groups, but at varying rates. About 1.9 percent of African-Americans have psoriasis, compared to 3.6 percent of Caucasians.” Psoriasis may be associated heart disease and depression. Here are 6 ways to deal with psoriasis.

Psoriasis is a battle for many people, but it can be managed with natural remedies and medications where you can feel more comfortable and more confident in your own skin.

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How to Deal With Psoriasis – Beliefnet