Dermalex Treatment For Psoriasis How it Affects the Skin - Dermalex
Dermalex treatment for psoriasis how it affects the skin. Dr Barbara Geusens of OmegaPharma discusses the effects of psoriasis of the skin. She explains ho...
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What are the Causes and Triggers of Psoriasis? - Dermalex
What are the causes and triggers of psoriasis? - Dr Barbara Geusens from Omega Pharma discusses the characteristics, main causes and triggers of psoriasis an...
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What are the Causes and Triggers of Psoriasis? - Dermalex - Video
DUBLIN--(BUSINESS WIRE)--
Research and Markets (http://www.researchandmarkets.com/research/c8phkl/global_psoriasis) has announced the addition of the "Global Psoriasis Pipeline Capsule - 2013" report to their offering.
Fore Pharma's latest report Global Psoriasis Pipeline Capsule - 2013' provides up-to-date information on key Research and Development (R&D) activities in the global psoriasis market. It covers active psoriasis pipeline molecules in clinical trials, preclinical research, and drug discovery.
This report helps executives track competitor pipeline molecules. The pipeline data presented in this report can be used for identifying partners, evaluating opportunities, formulating business development strategies, and executing in-licensing and out-licensing deals.
The scope of the report includes information on psoriasis pipeline molecules by clinical trial stages, company, mechanism of action, and country (The US, Germany, France, Italy, Spain, UK, Japan, and Rest of the World). Psoriasis pipeline molecules licensing activities are also covered in this report.
Key Features of the Report:
- Psoriasis Pipeline Overview
- Psoriasis Phase 3 Clinical Trial Pipeline
- Psoriasis Phase 2 Clinical Trial Pipeline
- Psoriasis Phase 1 Clinical Trial Pipeline
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Research and Markets: Global Psoriasis Pipeline Capsule - 2013 Report Available now for Review
Q: Your readers did it again! I've been drinking oolong tea for more than a month now, and the patches of psoriasis have disappeared, along with the flaking. I still have a couple of areas that need some ointment now and then, but overall I can wear shorts now without being embarrassed about my skin. (My skinny legs are another matter.) Thanks.
A: A study long ago in Japan found that oolong tea was effective in easing treatment-resistant eczema (Archives of Dermatology, January 2001), but we have found no studies of oolong tea for psoriasis.
Several visitors to our website have reported that drinking oolong tea eased their psoriasis. Others have noted that turmeric or cilantro also can be helpful.
Q: My husband has suffered with polyneuropathy for three years. After his doctors said there was no cure, we located a cure at our vitamin store and want to share it with others.
He takes 600 mg of alpha-lipoic acid (ALA) daily. We are elated with the results. We have a neighbor who also began taking it, and he, too, is much-improved.
A: A randomized, placebo-controlled study in Russia and Israel showed that 600 mg of ALA daily can greatly ease the symptoms of neuropathy (nerve pain) such as stabbing or burning pain, numbness and "pins and needles" (Diabetes Care, November 2006).
A recent article points out that ALA is one of the few treatments that has shown promise for diabetic polyneuropathy and calls for more research (Diabetes/ Metabolism Research and Reviews online, Feb. 5, 2013).
Another nonprescription approach to this problem is benfotiamine, a synthetic form of the B vitamin thiamine. We learned about it from Dr. Charles Beauchamp several years ago, and recently heard this from a reader: "I appreciate the suggestion of benfotiamine for my foot pain. Within a month it has totally cleared up, and I am ready to move to a maintenance regimen."
Q: My daughter had head lice several times when she was very young and her hair was long. The lice shampoos did not work at all.
Finally, we used mayonnaise in her hair. We applied it from the scalp to the ends and then wrapped her head with plastic wrap. We left it on for at least two hours while she watched her favorite DVD. When we washed her hair, you could see the lice rinsing out. We did this every three days for two weeks to make sure that they were all gone.
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By Dennis Thompson HealthDay Reporter
WEDNESDAY, May 29 (HealthDay News) -- People with psoriasis who lose weight could experience some relief from the symptoms of their chronic skin disease, according to a small new study.
A clinical trial based in Denmark found that obese patients with psoriasis who lost weight through a low-calorie diet experienced a significant improvement in their quality of life, compared to obese psoriasis patients who didn't lose weight.
The patients in the weight-loss group reported less stinging and burning, were less likely to be embarrassed by unsightly lesions, and found that their condition affected their everyday life less often, said Dr. Peter Jensen, of the Copenhagen University Hospital Gentofte, and colleagues.
"Our results emphasize the importance of weight loss as part of a multimodal treatment approach to effectively treat both the skin condition and its [related medical] conditions in overweight patients with psoriasis," the researchers said in the study, which was published online May 29 in the journal JAMA Dermatology.
Psoriasis is a chronic inflammatory skin disease that develops when a person's immune system malfunctions and causes skin cells to grow too quickly. The new skin cells form in days rather than weeks and pile up on the skin's surface, causing scaly, painful lesions.
In the randomized clinical trial, 27 patients were assigned to an intervention group that followed a low-calorie diet and 26 patients were assigned to a control group that continued to eat ordinary healthy foods. Researchers tracked psoriasis symptoms and quality of life using two questionnaires.
The patients on a low-calorie diet ended up losing nearly 34 pounds in 16 weeks, and reported improvements in both their psoriasis symptoms and their overall quality of life.
Dermatologists said the study's results are not surprising, but do reinforce the need for overweight or obese people with psoriasis to try to lose weight.
"Obesity is a huge issue for patients with psoriasis," said Dr. Joel Gelfand, an associate professor of dermatology and medical director of the clinical studies unit at the Hospital of the University of Pennsylvania, in Philadelphia. "If you're obese with psoriasis, psoriasis is less likely to get clear."
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Public release date: 4-Jun-2013 [ | E-mail | Share ]
Contact: Noe Baker media@psoriasis.org 503-546-8416 National Psoriasis Foundation
PORTLAND, Ore. (June 4, 2013)Six of the top scientists studying psoriasisthe most common autoimmune disease in the country, affecting 7.5 million Americansand psoriatic arthritis, an inflammatory joint and tendon disease affecting up to 30 percent of people with psoriasis, received National Psoriasis Foundation (NPF) research grants totaling $450,000 for projects that aim to discover new treatments and a cure for these chronic diseases.
"National Psoriasis Foundation is dedicated to increasing the number of scientists, dollars and projects dedicated to psoriatic diseases," said Randy Beranek, National Psoriasis Foundation president and CEO. "We are the only organization funding these types of promising research projects, each of which will move us faster toward finding a cure, which is our highest priority."
Learn about the NPF research grant program: http://www.psoriasis.org/research.
Theoharis Theoharides, M.D., Ph.D., professor of pharmacology at Tufts University School of Medicine in Boston, received a two-year, $200,000 Translational Research Grant to take laboratory findings and translate them into real-world applications to manage health. Dr. Theoharides will explore how stress contributes to psoriasis and how molecules derived from chamomile might interrupt this psoriasis-stress connection.
Additionally, five researchers each received a one-year, $50,000 Discovery Grant for early-stage research to advance basic understanding of psoriasis and psoriatic arthritis.
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The National Psoriasis Foundation is the world's largest charitable funder of psoriasis and psoriatic arthritis research worldwide. Learn more about the Foundation research priorities at http://www.psoriasis.org/research.
About the National Psoriasis Foundation
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National Psoriasis Foundation awards $450,000 in research grants
DUBLIN--(BUSINESS WIRE)--
Research and Markets (http://www.researchandmarkets.com/research/55snsq/global_plaque) has announced the addition of the "Global Plaque Psoriasis Pipeline Capsule - 2013" report to their offering.
Fore Pharma's latest report Global Plaque Psoriasis Pipeline Capsule - 2013' provides up-to-date information on key Research and Development (R&D) activities in the global plaque psoriasis market. It covers active plaque psoriasis pipeline molecules in clinical trials, preclinical research, and drug discovery.
This report helps executives track competitor pipeline molecules. The pipeline data presented in this report can be used for identifying partners, evaluating opportunities, formulating business development strategies, and executing in-licensing and out-licensing deals.
The scope of the report includes information on plaque psoriasis pipeline molecules by clinical trial stages, company, mechanism of action, and country (The US, Germany, France, Italy, Spain, UK, Japan, and Rest of the World). Plaque psoriasis pipeline molecules licensing activities are also covered in this report.
Key Topics Covered
1. Plaque Psoriasis - Disease Overview
2. Plaque Psoriasis Pipeline Overview
3. Plaque Psoriasis Pipeline by Geography
4. Plaque Psoriasis Phase 3 Clinical Trial Pipeline Insights
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Research and Markets: Global Plaque Psoriasis Pipeline Capsule - 2013
Anaheim, CA (PRWEB) June 04, 2013
TriDerma, a maker of specialized skin care, announced the launch of its new Psoriasis Control Shampoo, a medical strength shampoo that helps provide fast relief for the itchy and scaly scalp that are symptoms of psoriasis, dandruff and dermatitis.
Psoriasis can affect any skin surface and is marked by a build-up of skin cells called scales. Patches of skin affected by psoriasis become itchy, dry, red, and sometimes painful. It is estimated that half of the 7.5 million Americans with psoriasis are affected by scalp psoriasis. It can appear as one or multiple patches on the scalp, affect the entire scalp, and spread beyond the scalp to the forehead, back of the neck, or behind the ears. It can be difficult to treat psoriasis of the scalp because of the difficulty applying topical psoriasis treatments to the affected area.
TriDerma Psoriasis Control Shampoo contains 3% salicylic acid. Salicylic Acid, approved by the FDA as a treatment for psoriasis, gently exfoliates flakes and scales, and helps relieve itching, redness and irritation due to psoriasis and seborrheic dermatitis. Healing botanicals in the companys proprietary AP4 Genuine Virgin Aloe complex are naturally anti-inflammatory and moisturizing to help relieve and prevent flaking and scaling. Specialized itch-fighting ingredients help stop the urge to scratch. Nourishing botanicals, Pro Vitamin B5 and Vitamin E help promote healthy scalp and hair. TriDerma also added a botanical color protectant, so the shampoo is safe for color-treated hair.
TriDerma has over ten years of experience in the psoriasis segment with its Psoriasis Control Skin Healing Cream. Holly Ahearn, Director of Research and Development at TriDerma, says, Psoriasis Control Shampoo was created in response to customer demand for a shampoo that does not smell like medicine, targets psoriasis symptoms, and also makes hair look great. Psoriasis Control Shampoo is an exclusive salon formula. Ms. Ahearn says it is formulated like a luxurious salon treatment, leaving hair soft and manageable, looking beautiful and smelling fresh and clean.
TriDerma Psoriasis Control Shampoo can be ordered online at http://www.triderma.com.
About Triderma
Headquartered in Anaheim, California, TriDerma has provided fast healing without a prescription for 21 years. Founded upon the determination of one woman seeking a natural healing solution, TriDerma now manufactures over 50 products available online and in the First Aid, Skin Care and Baby section of drugstores and supercenters across the U.S. and the world. TriDerma formulas are purpose-driven to help heal specific skin conditions without the use of cortisone, steroids, parabens or other harmful ingredients. Proprietary formulations made in the USA ensure quality and efficacy are never compromised. TriDerma is a women-owned company. For more information and a store locator, go to http://www.Triderma.com. Follow us on Facebook at Facebook.com/TriDerma.
Contact: Angie Echele 636-633-6499
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Pictured: Woman scratching psoriatic lesions on her elbow/iStock, helivideo
Alumis on Saturday posted promising data from the Phase II STRIDE study demonstrating that its investigational TYK2 inhibitor ESK-001 can significantly reduce the severity of lesions in patients with moderate-to severe plaque psoriasis.
The results, presented during a late-breaking session at the annual meeting of the American Academy of Dermatology, showed that all dose levels and schedules of ESK-001 resulted in a significantly higher proportion of patients achieving a 75% improvement on the Psoriasis Area and Severity Score (PASI), which is a widely used tool to evaluate the severity of psoriasis.
At week 12, 64.1% of patients treated with a 40-mg, twice-daily regimen achieved the endpoint, also known as PASI-75. Meanwhile, 56.4% of those assigned to the 20-mg, twice-daily and 40-mg, once-daily schedules met the same outcome. These data were all significantly higher than in the placebo group, in which no participant achieved PASI-75.
Even the lowest dosing regimen of 10-mg, once-daily ESK-001 elicited a significantly higher rate of PASI-75 than placebo.
Alumis CMO Jrn Drappa in a statement said that these data support the potential for a best-in-class profile for ESK-001 in psoriasis, pointing to patients who demonstrated a high degree of clinical improvement at week 12 that continued to increase over time.
The biotech is now preparing to take ESK-001 into Phase III trials, with an eye toward launching the drug as an oral therapy with a better efficacy profile than current treatments on the market, Alumis CEO Martin Babler said in a statement. The company will also advance the candidate in other immune-mediated indications.
ESK-001 is a highly selective allosteric inhibitor of the TYK2 protein. The oral drug candidate works by dampening signaling through the IL-12, IL-13 and interferon- receptors, tempering the bodys immune and inflammatory responses.
In STRIDE, this mechanism of action also helped ESK-001 meet key secondary endpoints. At the highest dosing schedule40-mg twice-daily38.5% of treated participants achieved PASI-90, while 15.4% reached PASI-100, indicating a 100% improvement in PASI scores.
In terms of safety, ESK-001 was overall well-tolerated, inducing no treatment-related serious adverse events. Study dropouts due to side effects were low and the study did not find signs of toxicities associated with JAK inhibition.
STRIDEs open-label extension phase, which followed patients up to 16 weeks, likewise showed that PASI endpoint responses increased even further and that ESK-001 continued to be well-tolerated.
Saturdays readout comes days after Alumis closed its $259 million Series C funding round to help bring ESK-001 into late-stage development. The candidate will help it compete with Bristol Myers Squibb, which owns the TYK2 inhibitor Sotyktu that won the FDAs approval in September 2022 for the treatment of moderate-to-sever plaque psoriasis.
Tristan Manalac is an independent science writer based in Metro Manila, Philippines. Reach out to him on LinkedIn or email him at tristan@tristanmanalac.com or tristan.manalac@biospace.com.
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Alumis TYK2 Blocker Clears Phase II in Plaque Psoriasis on Heels of Series C - BioSpace
This is a video synopsis/summary of a panel discussion involving Linda Stein Gold, MD; Mona Shahriari, MD, FAAD; and Seemal Desai, MD.
In this conversation, the participants discuss the complexities of treating patients with skin of color who have psoriasis, emphasizing the need for a holistic approach to care. They explore the cultural sensitivities surrounding skin conditions, acknowledging the stigma and isolation that patients may experience, particularly in cultures valuing fair skin.
The importance of recognizing and addressing cultural concerns during patient encounters is highlighted, with a focus on leaving biases behind and creating a judgment-free environment. The participants stress the significance of building trust and understanding individual patient needs and expectations.
Practical strategies for initiating conversations about cultural implications and treatment preferences are discussed, emphasizing the importance of active listening and collaboration in the decision-making process. Building a strong patient-provider relationship is seen as crucial for improving treatment adherence and overall patient outcomes.
Ultimately, the conversation underscores the importance of patient-centered care and the ongoing effort to break down barriers that may exist within the healthcare system, with the goal of providing personalized and effective treatment for all patients.
Video synopsis is AI-generated and reviewed by HCPLive editorial staff.
See more here:
Communicating With Patients With Psoriasis With Skin of Color - MD Magazine
Before reading, review part 1 here.
The panel delved into the specific needs of patients with melanin-rich skin and provided valuable insights into optimizing psoriasis care for this patient population. They noted that some patients have expressed distrust in the health care system or experience with clinical trials and may prefer topical treatments oversystemic agents.
When it comes to putting [patients with skin of color] on a systemic agent, a lot of them have distrust in the health care system or experience with clinical trials. They dont always want to go on a systemic [treatment], Shahriari said. Theyd rather go on a topical [treatment], and [with] our older-generation special topical corticosteroids, a big concern was hypopigmentation or other pigmentary alterations. In the scalp, the formulations we had werent ideal for tightlycoiled hairs.
The panel also discussed the potential risk of hypopigmentation and other pigmentary alterations with older topical corticosteroids and the need for newer formulations. We want to simplify the treatment regimen. We want to pay attention to skin of color and the hypopigmentation that can come from topical steroids, Stein Gold explained. We want to do a more holistic treatment for the patients [with] psoriasis where we can treat short term as well as a long term. It doesnt mean we wont use combination therapy with these new topicals, combination with topical steroids or systemic agents, but I think theyre [an] important addition to the treatment arm inthis area.
The panelists highlighted the significance of tailored treatment approaches for patients with melanin-rich skin, with Kircik noting, When you look at the statistics, theres so much discordance between the perception of the disease by the provider vs the patient and it doesnt match. This insight underscores the need for health care providers to understand and address the unique experiences and perceptions of psoriasis in patients with melanin-rich skin.
Stein Gold, Shahriari, and Cameron explored emerging oral treatments for the management of plaque psoriasis, emphasizing the novelty of TYK2 inhibition. They discussed the unique POETYK PSO-LTE (NCT04036435) trial design, stressing the importance of the inclusion of an active control arm. Shahriari explained the significance of trials for deucravacitinib (Sotyktu; Bristol Myers Squibb), stating, We had our POETYK PSO trials, which were the pivotal trials for deucravacitinib. And apremilast, our other oral agent on the market, was theactive comparator.
The POETYK PSO-LTE clinical trial assessed the 3-year results of deucravacitinib treatment in adult patients with moderate to severe plaque psoriasis. The trial included 1519 patients who received at least1 dose of deucravacitinib acrossmultiple phases.1
Shahriari provided an overview of the evolution of treatments for plaque psoriasis, stating, After the 2000s, we decided to become more targeted and specific in our treatments for plaque psoriasis, and thats when the era of the biologics started. The panel shared insights into the pivotal role of biologic agents in the shift toward more targeted and specific treatments forplaque psoriasis.
Han discussed diversity within the IL-17 family of biologic agents, stating, Whats interesting to me is that in the IL-17 family, we have so much diversity now: IL-17A inhibitors and IL-17 receptor blockers, a dual IL-17A and IL-17F. This emphasizes the diversity and ongoing development within the IL-17 family of biologic agents, reflecting the evolving landscape ofbiologic treatments.
The panel also discussed the considerations for choosing between biologic and small-molecule treatments and treatment duration. Han also mentioned, I think it makes sense. One of the things that Leon [Kircik] said, to your point of why not just put them on a biologic, with a small-molecule [treatment], you dont have to worry about the half-life, about how long they keep it on board, about developingantidrug antibodies.
Kircik emphasized the importance of topical treatments in combination with systemic therapies and said, I always say that topical treatment is the foundation of dermatologic treatment. No matter what, we have biologics, we have oral treatments, we still use topical treatment for those patients. And we use combination treatment, right? Regardless of what we are doing...oral, systemic, light treatments, I always add topicals. I use biologics in combination with topicals; systemics-topicals; and lighttreatment- topicals.
Reference
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Not available March 19? Dont worry. Register now and well send you the replay link to watch at your convenience.
Learn about psoriasis and other health conditions, or comorbidities, often linked to it in this webinar hosted by WebMD. Nehal N. Mehta, M.D., will explain how these conditions are related to inflammation, which can affect different parts of your body. Hell discuss how treating your psoriasis, and following specific prevention steps, can help protect you from developing other health issues when you live with psoriasis.
In this WebMD webinar, you will learn about:
Have a question for the expert? There will be an opportunity to post questions for the presenter during the live webinar.
Click here to view the full list of on-demand and upcoming WebMD webinars.
Nehal Mehta, M.D., a renowned expert and researcher on psoriasis and related conditions, is a clinical professor of medicine at George Washington University and adjunct professor at the University of Pennsylvania. He was founding chief of Inflammation and Cardiometabolic Diseases at the National Institutes of Health (NIH) and served as principal Investigator of the largest cohort study examining psoriasis impacts on cardiometabolic diseases from 2012 to 2022. Hes a board member of the American Society of Preventive Cardiology and an elected member of the American Society of Clinical Investigation. Hes the inaugural recipient of the Lasker Clinical Scholar Award. He received lifetime achievement awards for his work in the psoriasis community from two international foundations in 2021 and 2023.
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Health Conditions Linked to Psoriasis: Heart Disease & More - ADDitude magazine
I'm going to walk the team through the head-to-head clinical trial data, but also the real-world data because the reality is a drug may perform beautifully in a controlled clinical trial setting, but the real world is messy, so that drug may not perform in the same way. I'm going to guide the attendees on which drugs offer the best durability of response over time. Spoiler alert: the IL-23's have really held up not only from an efficacy standpoint, but also from a safety standpoint over time, said Mona Shahriari, MD, FAAD, in an interview with Dermatology Times at the 2024 American Academy of Dermatology (AAD) Annual Meeting in San Diego, California.
Shahriari, an assistant clinical professor of dermatology at the Yale School of Medicine and the associate director of clinical trials at CCD Research in Connecticut, presented pearls from her AAD session, Comparative Efficacy and Relative Ranking of Psoriasis Biologics Using Real-world and Clinical Trial Data. Shahriari reviewed the efficacy of various biologics and systemics for psoriasis in both clinical trials and real-world examples. Shahriari also reviewed the efficacy of biosimilars and their success.
At AAD, Shahriari also participated in a panel during Bristol Myers Squibbs Women Connection Forum. Shahriari spoke alongside Latanya Benjamin, MD, FAAD, FAAP; Alexandra Golant, MD, FAAD; and Jenny Murase, MD, FAAD, to share their personal and professional journeys, as well as advice for women in dermatology.
If there's something that you want, it's okay to ask. I think a lot of times as women, we assume that certain opportunities are given to us based on our credentials, people look at our CV, people look at everything that we've done. But that's not always the case. Sometimes people don't even know that you're interested in activity. I learned that if there was something I was interested in, if I just asked and said, Hey, I just want to throw my name in the hat for XYZ opportunity that's coming up, they've actually looked at me more carefully, and I've been able to partake in that opportunity, said Shahriari when sharing her advice for women wanting to advance in dermatology.
Transcript
Mona Shahriari, MD, FAAD: Hi, my name is Mona Shahriari. I'm an assistant clinical professor of dermatology at Yale University and the associate director of clinical trials at CCD research.
Dermatology Times: What pearls are you sharing during your session, "Comparative efficacy and relative ranking of psoriasis biologics using real-world and clinical data?"
Shahriari: At this year's American Academy of Dermatology meeting, I'm going to be doing a talk that looks at the comparative effectiveness of different biologics and systemics for plaque psoriasis, not only in clinical trial data, but also in real-world data, because we have a busy toolbox of medications. And sometimes, it's tough to know which drug do I reach for first, and if that fails, which drug do I reach for a second? I'm going to really walk the team through the head-to-head clinical trial data, but also the real-world data, because the reality is a drug may perform beautifully in a controlled clinical trial setting, but the real world is messy, so that drug may not perform in the same way. I'm going to guide the attendees on which drugs offer the best durability of response over time. Spoiler alert the IL-23's have really held up not only from an efficacy standpoint, but from a safety standpoint over time. And interestingly, some of our biosimilars have proven to be just as good as our originator drugs. So,we'll walk through the nitty gritty of those details.
Dermatology Times: What other topics or sessions are you looking forward to at AAD?
Shahriari: Well, I have to say the late breaker session is always my absolute favorite. I make sure not to miss that because being on the cutting edge of clinical trials and dermatology research, I want to make sure I'm offering my patients the most innovative treatment for their skin disease. So that is a session I do not miss because I want to make sure I know what the rest of 2024 is going to look like. But also, the JAK Inhibitors: A New Frontier, that was a new session that hit the space last year, heavily attended, and JAK inhibitors are revolutionizing how we treat so many different diseases within dermatology. I really want to see what else is out there on the horizon, and how we can bring this amazing therapy to our patients.
Dermatology Times: What is the significance of the Bristol Myers Squibb Women's Forum Panel that you participated in?
Shahriari: Well, I really think this is a landmark connection form that they put together, because the reality is as women not only in dermatology, but also as career women out there, there are definitely some disparities that go on, whether it's related to pay, whether it's related to promotion, or really just getting your name out there and exposure. And really, the purpose of this woman's connection forum is to not only help us gain connections with other women leaders within the field, and have those friendships develop and networking opportunities develop, but also to hear about the struggles of other women. Sometimes when you normalize it, and you have somebody who you look up to tell you, "You know what, I went through the same challenges. And this is how I overcame them." It can really help you feel closer to those individuals. But also, you realize everybody's human, everyone's going to face challenges, and what can you do to overcome those challenges and not let them get you down?
Dermatology Times: What advice do you have for other women in dermatology?
Shahriari: I really think the 2 main pieces of advice I have is to find a good mentorship network. And I'm calling it a network and not a mentor because in different stages of your life and different aspects of your career, you're going to need different people. And that mentor might be a female, that mentor might be a male. You want to find different individuals to include in that network of yours so you'll have individuals to go through. But also, one other piece of advice I have is if there's something that you want, it's okay to ask. I think a lot of times as women, we assume that certain opportunities are given to us based on our credentials, people look at our CV, people look at everything that we've done. But that's not always the case. Sometimes people don't even know that you're interested in an activity. And I really learned that if there was something I was interested in, if I just asked and said, "Hey, I just want to throw my name in the hat for XYZ opportunity that's coming up, "they've actually looked at me more carefully, and I've been able to partake in that opportunity. So that was one of the simplest pieces of advice I got once upon a time. And it's really done well for me.
Dermatology Times: What positive changes have you seen in dermatology?
Shahriari: I think one thing I've noticed is historically, as a specialty, we used to prescribe a lot of topical agents for our patients. But we've had an explosion of oral and injectable medications for the treatment of various diseases. And I've been really pleased to find a lot of my colleagues jumping on the bandwagon to offer patients some of these newer therapies because sometimes as dermatologists we do want to see more safety data, we do want to see more efficacy data. But I think the value of these newer generation medications, not only from an efficacy standpoint, but also from a safety standpoint is becoming more evident. So, to see my colleagues jump on the bandwagon and offer these to the patients is really going to make a difference for our patients for years and years to come.
One other piece that I've seen is there's been a lot of emphasis on diversity within clinical trials and really allowing for our patients with skin of color to be at the forefront of many activities that we do within dermatology. Because the reality is that historically a lot of our patients with skin of color, they were not in our clinical trials. And when these individuals went to dermatology offices, they were either not getting appropriate treatment, or they were being undertreated. misdiagnosed. And many of my contemporaries and colleagues just didn't feel comfortable caring for these individuals, but as the population of the United States diversifies, and those people who are a minority today become more of the majority, I love that within dermatology, we are prioritizing the needs of these individuals so that we can take care of all of our patients across all skin tones moving forward.
[Transcript lightly edited for space and clarity.]
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Sharing Innovations in Psoriasis Biologics and Uplifting Women in Dermatology - Dermatology Times
As the understanding of psoriasis continues to evolve, the imperative of personalized care has gained prominence, reshaping the traditional paradigms of treatment. In the recentDermatology Timescustom video series Advancements in Psoriasis Care: Navigating Emerging Therapies and Guidelines, experts in the management of skin conditions discussed the latest developments in plaque psoriasis management. The panel discussion included Linda Stein Gold, MD, of Henry Ford Health in Detroit, Michigan; Mona Shahriari, MD, of Yale University School of Medicine in New Haven, Connecticut; Michael Cameron, MD, of Cameron Dermatology in New York, New York; Leon Kircik, MD, of Derm Research, PLLC, in Louisville, Kentucky; and George Han, MD, of Hofstra University in Hempstead, New York. The conversation shed light on the evolving paradigms, evidence-based approaches, and need for individualized care in managing thiscondition (Table).
Stein Gold emphasized the challenges posed by complex treatment regimens and said, The use of complex regimens with multiple topical agents can lead to lower adherence and less effective treatment. This sentiment underscores the critical need to streamline treatment approaches to enhance patient adherence and optimize treatment outcomes.
The panelists also highlighted the impact of treatment complexity on patient adherence, with Cameron noting, The more complex the regimen is, the lower the adherence, which means were less effectively [managing] the disease. This insight underscores the direct correlation between treatment complexity and patient adherence, emphasizing the need for streamlined andpatient-friendly regimens.
Furthermore, Shahriari said, Its really a matter of simplifying the treatment regimen. This sentiment underscores the need to reevaluate treatment approaches and streamline regimens to enhance patient adherence andtreatment efficacy.
In the realm of psoriasis management, the emergence of steroid phobia and evolving patient preferences has sparked critical discussions among health care professionals. Kircik highlighted the growing trend of steroid phobia among patients, stating, There is now this trend that nobody wants to be on steroids. This observation underscores the shifting attitudes toward steroid-based treatments and the impact on patient-provider discussions regarding treatment options.
The panelists also addressed the concerns surrounding patient preferences for nonsteroidal treatment options, with Stein Gold emphasizing the need to consider alternative therapies, stating, I think of steroids as a short-term solution to a long-term problem. Its really a Band-Aid. This sentiment underscores the evolving perspectives on steroid-based treatments and the need to explore nonsteroidal alternatives to address patient preferences and concerns. Additionally, Cameron provided insights into the prevalence of steroid phobia, saying, I find that [for] most of my patients, whether they [have] mild, moderate, or severe [disease], I dont want them using steroidslong term.
Psoriasis management guidelines serve as a critical resource, providing evidence-based recommendations for the management of psoriasis. Stein Gold addressed the limitations of current treatment guidelines and said, The problem is the guidelines are not for psoriasis. Theyre being done for atopic dermatitis right now. This observation sparked a conversation about the need for updated and comprehensive guidelines that align with the evolving landscape ofpsoriasis management.
The panelists also addressed the implications of treatment guidelines on patient care, with Kircik emphasizing the need for individualized treatment approaches, stating, We are looking for new topicals that are steroid freeor nonsteroidal.
Shahriari expressed the importance of defining disease severity in treatment guidelines and noted, I think we need to talk more about the definitions of mild, moderate, [and] severe psoriasis. This perspective highlights the need for clear and comprehensive definitions of disease severity to guide treatment approaches and optimize patient outcomes.
The panel noted that guidelines are often used against providers by attorneys and insurance companies and can be prescriptive rather than informative. The entire panel agreed that guidelines should be based on a review of the literature and provide a comprehensive overview of available treatments rather thanspecific recommendations.
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When we talk about evolution in treatment for psoriasis, we have come a long way, April W. Armstrong, MD, MPH, told attendees at the Society for Pediatric Dermatology Pre-AAD Meeting.1
April W. Armstrong, MD, MPH
Armstrong, Chief of the Division of Dermatology at the UCLA Health and the David Geffen School of Medicine, added that through this evolution we are looking for treatments that are effective, convenient and safe. Not too long ago, arsenic was used to treat psoriasis,2 she told attendees. Yes, it killed psoriasis but also killed a lot of other things.
Fortunately, she shared there are now options that are meet the 3 important criteria: safe, effective, and even convenient. For instance, biologics have emerged as a good option for treating psoriasis, especially in adults, Armstrong explained. In general, there are a number of factors she considers when choosing among the biologics, which when grouped include tumor necrosis factor (TNF) inhibitors (ie, etanercept, infliximab, adalimumab, certolizumab), interleukin (IL)-17 inhibitors (ie, ixekizumab, secukinumab, brodalumab, bimekizumab), and IL-23 inhibitors (ie, guselkumab, risankizumab, tildrakizumab, ustekinumab [a IL12/23 inhibitor]).
The IL-17 and IL-23 inhibitors are a good choice for robust psoriasis efficacy. In addition, guselkumab, risankizumab, ustekinumab have been shown to be effective for psoriatic arthritis, while IL-17 inhibitors have been shown to be effective for peripheral and axial psoriatic arthritis. There is evolving evidence for the use of IL-23 inhibitors in psoriatic arthritis of the spine. She cautioned that IL-17 inhibitors should be avoided in patients with a history of inflammatory bowel disease and can be associated with increased risk of oral candidiasis.
Meanwhile, Armstrong noted TNF inhibitors should be avoided in patients with hepatitis B and demyelinating disease. They also are not preferred when there is a history of latent tuberculosis or advanced congestive heart failure. Like the other biologics, TNF inhibitors can be effective for psoriatic arthritis (peripheral and axial) and she added that certolizumab has been great in pregnant patients.
Currently, there arebiologics approved for use in pediatric patients. Ustekinumab which inhibits p40 subunit of IL12/23, has been approved for pediatric plaque psoriasis in patients aged 6 years and older. She pointed to the CADMUS Trial, which found that nearly 70% of patients aged 12 years or older with moderate to severe plaque psoriasis achieved sPGA0/1 (vs 5.4 in the placebo group).3
Secukinumab is approved for pediatric patients aged 6 years and older, she said. She shared results from a study comparing secukinumab versus etanercept in this patient population, noting she especially appreciates head to head comparisons of agents because it speaks to the superiority of one medication over another over a time period. In the study, which was present at the EADV Virtual Congress in 2020, 85% of the patients on secukinumab achieved (and maintained) clear (IGA 0/1) at 52 weeks vs 72% on etanercept.
Approved in pediatric patients 6 years and older for moderate to severe psoriasis, Armstrong said ixekizumab has shown high efficacy when compared with placebo, with 50% of patients achieving PASI 100 by week 12 (vs 2% on placebo).
Bimekizumab, the newest approved biologic for adult patients, has shown fast onset, high efficacy, and robust maintenance of response, Armstrong told attendees. Treatment consists of two 160 mg doses every 4 weeks for the first 16 weeks and then every 8 weeks afterwards. She reminded attendees that labs (ie, tuberculosis, liver enzymes, alkaline phosphatase, and bilirubin) should be checked prior to treatment. Oral candidiasis is the most common adverse event, but she said it is manageable without discontinuation with 100 mg to 200 mg fluconazole for 7 days.
Meanwhile, a phase 2 trial of bimekizumab (NCT04718896) is currently underway to assess safety and efficacy in adolescents with moderate to severe plaque psoriasis.
Another important treatment to consider is the tyrosine kinase 2 (Tyk2) inhibitor deucravacitinib, Armstrong told attendees. Currently, deucravacitinib is approved by the US Food and Drug Administration as an oral medication for the treatment of moderate to severe plaque psoriasis in adults. She shared data demonstrating Psoriasis Area and Severity Index (PASI) 75, PASI 90, and Static Physician's Global Assessment (sPGA) 0/1 response sustained through 3 years for patients on the agent, which she added is really impressive.
The tolerability is really where it shines, Armstrong told attendees. It has rates of diarrhea and nausea similar to placebo, and there are low rates of acne and zoster, she explained, but overall the discontinuation rates was lowest for patients on deucravacitinib when compared with patients on placebo or apremilast.
Before initiating treatment, Armstrong noted patients should be evaluated for tuberculosis and baseline liver and hepatitis serologies should be checked in patients with known or suspected liver disease. However, ongoing monitoring is only needed if the patient has liver disease or unmanaged triglycerides.
Im very excited about the possible extension to our pediatric population in the future, Armstrong said. She detailed a phase 3 trial (NCT04772079) is currently underway for pediatric patients with moderate to severe plaque psoriasis looking at safety and efficacy in that patient population. The study is looking at 2 doses across 2 cohorts based on ages (4 to 12 and 12 to 18 years).
The oral phosphodiesterase 4 (PDE4) inhibitor apremilast is also a new medication that has shown efficacy in pediatric patients, according to Armstrong. It currenly is approved for adults regardless of severity, she said. She shared results of a placebo-controlled study of patients with moderate to severe plaque psoriasis aged 6 to 17 years that found almost one-third were clear or almost clear at week 16 (vs 11% for placebo).
Armstrong briefly noted 2 innovative products in the pipeline. JNJ-77242113 is an oral therapeutic peptide selectively targeting IL-23R, she told attendees.4 DC-806 allosterically blocks the same biochemical step as the anti-IL-17 antibodies.
In the topical category, Armstrong pointed to tapinarof and roflumilast as novel non-steroidal agents. Tapinarof, currently approved for adult patients, is an aryl hydrocarbon receptor (AhR) agonist that reduces TH17 cytokines; increases antioxidant activity via Nrf2 pathway; increases filaggrin, loricrin, and involucrin, and decreases Th2 cytokines. The PSOARING 1 study found that 40% of patients on tapinarof 1% cream daily achieved PASI 75 by week 12. Armstrong added that when tapinarof is stopped, patients are able to maintain clear/almost clear status for about 4 months. My opinion is it is probably similar to or stronger than a class 3 topical steroid, she told attendees. Armstrong is hopeful it will become available for pediatric patients in the near future.
Roflumilast is a PDE4 inhibitor approved for patients aged 6 years and older, Armstrong said. Overall it is quite well tolerated. In my opinion, it is probably similar to a class 3 topical steroid, she said. She uses it in clinical practice, but there are some tricks to make sure your patient has access to it, and knowing which local pharmacies are used to working with it.
References
1. Armstrong A. Updates in Psoriasis Management and New Therapeutics. Presented at: 36th Annual Pre-AAD Meeting of the Society for Pediatric Dermatology; March 7, 2024. San Diego, California.
2. Sarfraz R. H16 Arsenic to biologics: psoriasis treatment through the ages. British Journal of Dermatology. 2023; 188(Supplement 4. ljad113.298
3. Landells I, Marano C, Hsu MC, et al. Ustekinumab in adolescent patients age 12 to 17 years with moderate-to-severe plaque psoriasis: results of the randomized phase 3 CADMUS study. J Am Acad Dermatol. 2015;73(4):594-603. doi:10.1016/j.jaad.2015.07.002
4. Bissonnette R, Pinter A, Ferris LK, et al. An Oral Interleukin-23-Receptor Antagonist Peptide for Plaque Psoriasis. N Engl J Med. 2024;390(6):510-521. doi:10.1056/NEJMoa2308713
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Evolution and Innovation in Treating Psoriasis in Pediatric Patients - Dermatology Times
Most people are familiar with the common skin condition, psoriasis, which causes a scaly, lumpy rash on the backs of elbows, front of knees, the scalp and other parts of the body. But, the autoimmune disease, psoriatic arthritis, which about a third of people with psoriasis also suffer from, is much less well known.
There is currently no diagnostic blood test for psoriatic arthritis.
A group undertaking an international study is seeking to better understand the links between the two conditions, with the aim to find out why some people with psoriasis go on to develop psoriatic arthritis and what treatment would work best to halt its development.
Prof Oliver Fitzgerald, research professor in rheumatology at the Conway Institute at University College Dublin and Prof Steve Pennington, professor of proteomics at UCD, are leading the Irish arm of the Hippocrates consortium study. We have about 350 patients so far, but we are keen to have 2,000, so we are interested in anyone aged 18 or over diagnosed with psoriasis to join the study, says Prof Fitzgerald.
Prof Oliver Fitzgerald.
Those who choose to partake in the study will be required to fill out a questionnaire every six months over three years. Details required are the extent of their psoriasis, current treatments and if they have noted any emerging symptoms of arthritis.
Prof Fitzgerald says that, ultimately, the identification of distinct biomarkers for psoriatic arthritis could lead to earlier treatment and possibly even prevention of the condition. The researchers also hope to identify a potential blood test which would diagnose psoriatic arthritis. It shares some symptoms of joint pain, swelling and loss of function with rheumatoid arthritis but it has some features which are different, says Prof Fitzgerald.
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These distinguishing features include how the toes and fingers swell to look like little sausages, pain and stiffness in the spine that gets worse with rest yet improves with exercise. And pain and inflammation in the tendon and ligaments attached to the bone, for example, in the Achilles tendon attached to the heel.
I always tell my students that you have to be hunting for psoriatic arthritis to find it and the psoriasis doesnt always have to be very severe to have it. It could be between the buttocks, under the arm pits or under the breasts in women, he explains.
Some studies have found that scalp psoriasis may be a risk factor for psoriatic arthritis. And both conditions also have a genetic component as they tend to run in families. A delayed diagnosis can result in treatments starting later, allowing the joints to deteriorate further in the intervening time.
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Some of the newer biologic treatments seen as a game changer in the treatment of rheumatoid arthritis work very well in clearing the psoriasis but dont improve the condition of the joints. The problem is that we dont know which patients suit which treatment. We also want to find this out in the study, says Prof Fitzgerald.
The information submitted by those who join the study will be reviewed every six months and individuals will be given feedback on their submissions.
We will advise those who we identify with symptoms of psoriatic arthritis to seek medical assessment, but we also advise people with psoriatic to remain as active as they can to prevent further loss of function of their joints, he adds.
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Understanding the links between psoriasis and psoriatic arthritis - The Irish Times
A range of treatments are available for psoriasis, from skin ointments to drugs that alter your immune system. But can easing the symptoms of this common condition be as simple as changing the foods we eat?
For the more than 8 million people in the U.S. who live with psoriasis, diet may play a bigger role than we think in how our bodies handle inflammation. Margaret Wesdock, a registered dietitian at Johns Hopkins Medicine, offers insight on which foods to eat and which to avoid if you have psoriasis.
Psoriasis is a chronic (long-term) autoimmune skin disorder. The body mistakenly attacks its own tissue, explains Wesdock. It starts overproducing skin cells, which lays down plaques on your skin. Plaques are red, scaly patches that can be itchy or painful. Sometimes psoriasis is accompanied by psoriatic arthritis, an inflammatory joint condition.
Neither of these conditions is caused by anything you eat, but theres an important link between your diet and psoriasis. Many foods are known to cause inflammation throughout the body. In some people, this widespread irritation can make the symptoms of psoriasis worse.
Studies are ongoing about how certain foods trigger an inflammatory response. Research suggests that some foods, especially highly processed ones, put your bodys defense mechanisms into overdrive.
For example, fatty foods can increase inflammation in adipose tissue (body fat), which is throughout your body. Ongoing fat tissue inflammation (common in people who are overweight or obese) greatly increases your risk of psoriasis. It also increases your risk of type 2 diabetes, heart disease and other chronic health conditions.
Many of the same high calorie foods that can lead to weight gain and increase the risk for obesity, diabetes and heart disease are also inflammatory. There are several categories of inflammatory foods that can make psoriasis symptoms worse.
Excessive alcohol consumption makes your liver work overtime. It has to produce chemicals to metabolize the alcohol, which can lead to long-term inflammation if you drink heavily or regularly. Alcohol can also damage the good bacteria in your gut, which can lead to inflammation in your colon and intestines.
Many dairy products tend to be high in fat, which can lead to inflammation. Products that contain cows milk also contain casein, a protein that some people have trouble digesting. People who are lactose intolerant dont have enough of the digestive enzyme lactase. Chronic gastrointestinal irritation from these conditions can make inflammation worse. For some people, psoriasis symptoms improve when they cut dairy from their diet.
Refined carbohydrates are highly processed (think white bread, white rice, pasta, pastries and some breakfast cereals). Theyve been stripped of fiber and whole grains and tend to contain a lot of sugar, which can cause your blood sugar to spike. Refined carbohydrates also increase advanced glycation end products, which are substances in your blood that can lead to inflammation.
Fats in red meat, cheese, fried food, margarine, fast food and many processed snacks are known to trigger inflammation in the body. These fats increase the amount of low-density lipoprotein (LDL) in your blood, also called bad cholesterol. Studies suggest there may be a link between excess fat in the body and development of psoriasis and worsening of psoriasis symptoms.
Added sugars in soda, fruit juices, candy, baked goods and other sweets are different from natural sugars in food such as fruit. Our bodies produce insulin to process sugar, but too much added sugar forces our bodies to store that extra energy in fat cells and inflame the fat tissue. Foods with lots of added sugars can also lead to increased levels of inflammatory proteins called cytokines. Some studies suggest that artificial sweeteners such as aspartame may also lead to chronic inflammation.
Research suggests that people with psoriasis tend to have higher rates of celiac disease. In people with celiac disease, gluten (a protein in wheat and some other grains) triggers an autoimmune response that causes the body to attack tissues in the small intestine. People with celiac disease need to avoid gluten completely, though some people without the disease have found that reducing gluten in their diet lessens psoriasis flare-ups.
While certain foods are known to cause inflammation, not everyone reacts the same way to these foods. Ive had some patients who felt that wheat was making their psoriasis worse. Another patient noticed more flare-ups when she ate nuts, says Wesdock.
Some tests can measure inflammation with biomarkers, which are substances in your blood that spike when your body reacts a certain way to foods such as fats or sugar. For example, a simple test can check for increased levels of C-reactive protein (CRP) in your blood. The liver makes extra CRP if theres inflammation in your body. Doctors might use this test to determine how likely you are to develop a chronic condition like heart disease.
As you adjust your diet to ease psoriasis symptoms, be sure to work with your psoriasis doctor to monitor symptoms and inflammation levels.
Just as some foods trigger inflammation, others can help combat inflammation. In general, having a balanced whole-foods diet is the best approach to reduce inflammation throughout the body. It may reduce psoriasis flare-ups or make your symptoms less severe. Following a Mediterranean diet for psoriatic arthritis or psoriasis can also reduce chronic inflammation that contributes to heart disease, type 2 diabetes, cancer and other conditions.
The best foods if you have psoriasis include:
Theres no evidence that vitamins or supplements help ease psoriasis symptoms. The best way to get all the vitamins and minerals you need is from the foods you eat. But its generally safe to take a daily multivitamin. Talk to your doctor or a registered dietitian about other supplements that might be right for your needs.
If youre going to change your diet to combat psoriasis, Wesdock recommends starting slowly. Jumping into a highly restrictive diet isnt usually sustainable and may deprive you of important nutrients. Instead, start by cutting out some highly processed foods.
Substitute the pastries and cookies with fresh fruit. Opt for herbal tea or water flavored with fresh fruit, mint or cucumber. If you think theres a specific food or ingredient thats triggering psoriasis flare-ups, talk to your doctor or a registered dietitian.
Being overweight or obese can also make psoriasis worse, so you may want to start a weight loss plan that includes fewer calories and smaller portion sizes. Any psoriasis treatment diet should be accompanied by healthy lifestyle choices. Get plenty of sleep and regular exercise, and try to reduce stress in your life. If you smoke, talk to your doctor about a plan to quit.
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Psoriasis Diet: Foods to Eat and Avoid If You Have Psoriasis
The importance of a healthy diet cant be overstated. For example, eating vitamin-packed fruits and vegetables and staying away from foods high in saturated fat is good for your heart.
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Over the years, studies have shown that what you eat can also help reduce the symptoms and impact of certain chronic conditions includingpsoriasis.
Yes, saysdermatologistAnthony Fernandez, MD, PhD, especially if you have obesity or are considered to be overweight. We have great evidence to support that losing weight via a hypocaloric (low-calorie) diet will improve the overall severity of your psoriasis.
Of course, its not justhow muchyou eat butwhatyou eat that also makes a difference when you change your diet.
Its common to see lists of specific trigger foods to shy away from if you have psoriasis. But following those restrictions typically isnt necessary, says Dr. Fernandez. In general, we do not recommend that people living with psoriasis avoid a specific food. In many cases, thats because theres no scientific evidence that certain foods are a psoriasis trigger. For example, Dr. Fernandez notes theres no proof that eggs can cause a flare.
But occasionally, you might feel that eating certain foods does affect your psoriasis. We certainly see people who come in and say, I feel like whenever I eat this certain type of food, my psoriasis flares, says Dr. Fernandez.
In a case like that, you might need to pay more attention to how you feel when you eat this food, or avoid it altogether, and see if it makes a difference over time. Were always open to experimenting with simple, safe things like that, says Dr. Fernandez. Everyones unique and may have a unique trigger for their disease. Well take it seriously if brought up.
With all that being said, Dr. Fernandez notes there are broad categories of foods that can make psoriasis act up.
We needbody fatto survive because it plays an important role in our overall health. But body fat is pro-inflammatory. That means having more of it can encourage more inflammation, which isnt good for psoriasis. Dr. Fernandez recommends staying away from calorie-rich foods that make it more likely youll accumulate body fat in other words, things such as fried fast food or sugar-heavy desserts.
With alcohol, moderation is also key. We know people who drink alcohol are at increased risk for developing psoriasis, says Dr. Fernandez. But abstaining from alcohol doesnt always result in any significant long-term improvement of the disease. Instead, follow doctor recommendations for alcohol intake and dont overdo it.
You mightve heard that taking a supplement thats known to have anti-inflammatory properties, like turmeric, can help with psoriasis. Science doesnt necessarily back this assertion, though. Short of knowing Well, if you take too much of this supplement, it can do something harmful, we will usually say, Go ahead and try taking it, he says. But there simply is no strong evidence at the moment to support any supplements are going to make a difference with psoriasis.
On its own, a specific diet isnt the only way to manage psoriasis. Theres no one diet that we know for sure is the best diet for patients, says Dr. Fernandez. And we dont necessarily recommend this as the only therapy. Most people will not improve with diet alone to the point where they dont need other medicines.
However, some diets are better than others in terms of helping with psoriasis.
Research has shown the positive impact of the Mediterranean diet. Thats probably the one most people recommend when discussing how to change your diet and improve your psoriasis, says Dr. Fernandez. This diet involves foods that have anti-inflammatory properties. Theyre low in fat. Theyre low in calories. Most of them are natural.
With the Mediterranean diet, expect to eat a lot of fruits and vegetables, nuts and grains. Youll get your protein from fish such as salmon and cook with olive oil. You wont eat a lot of dairy, red meat or sweet treats.
An indulgence here or there is OK, though. I never like to tell people that you have to start on the Mediterranean diet and only eat foods within the Mediterranean diet, says Dr. Fernandez. Occasionally, eating foods that are really tasty but maybe heavy in calories is fine as a reward. In general, however, trying to avoid too many of those foods can be very important to controlling psoriasis and minimizing the medication that you need to take to control your psoriasis.
Following a low-calorie diet is another good way to deal with psoriasis. Losing weight has been proven to improve psoriasis severity, says Dr. Fernandez. If youre classified as overweight or have obesity, following a low-calorie diet can be especially helpful to manage psoriasis.
Its less clear whether a low-calorie diet can help you manage psoriasis if you arent classified as overweight or have obesity, though. We dont know yet, says Dr. Fernandez. We need to do research to determine if such a diet will help you in that case.
One of the more common assumptions is that a gluten-free diet can help with psoriasis. However, Dr. Fernandez says thats not the case for most people. In fact, research has even supported that a gluten-free diet wont help your psoriasis.
The reality is a gluten-free diet makes no difference unless you have laboratory evidence that you are sensitive to gluten, he says. And we can test for that when appropriate. That means if youre already showing clinical signs and symptoms of gluten sensitivity, Dr. Fernandez adds. Just having psoriasis is not enough evidence to warrant testing.
You may have read that other diets can help with psoriasis. These might include a veggie-heavy plant-based diet or the high-fatketo diet. Theres also one called the Pagano diet, which shares some similarities with the Mediterranean diet.
Dr. Fernandez stresses that theres not yet any strong evidence that says these diets can help with psoriasis. But researchers are conducting studies to see whether particular approaches to food (such as the keto diet) might help with psoriasis. There is interest in exploring other diets for psoriasis and better evidence may be available in the future, he adds.
As with supplements, however, doctors are OK with people following different diets as long as they wont hurt their health. If you want to try something like the Pagano diet, then as long as we think that diet is healthy in general or its not so extreme that youre going to be limiting yourself from getting some essential nutrients then well say its OK, he says.
Unfortunately, we cant cure psoriasis through diet. In fact, there isnt any cure for psoriasis. But in addition to diet, there are ways to manage the condition.
Exercise is good for your immune system, and can also help promote weight loss because of the calories that you burn, says Dr. Fernandez. Wellness, in general, is good to strive for. Strategies such as eating well, exercising and getting enough sleep are all keys to help minimize the chances youre going to flare.
Dr. Fernandez notes that certain people improve so much with diet and exercise that they dont need medication. But we think of that as more the exception, and we certainly dont say thats all you need to do, he stresses, noting that neither exercise nor diet, in general, are recommended as sole alternatives to medications.
For some people, the improvements they see through exercise and diet might mean all they need is a topical medicine to control psoriasis, as opposed to a pill or an injectable medicine that affects their immune system systemically and can come with other side effects, says Dr. Fernandez.
And, chances are, people with moderate to severe psoriasis will likely always need medication, he adds. However, we do believe we can minimize the medications you need to take through wellness and diet.
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More than 125 million people worldwide deal with psoriasis and the itching and discomfort that comes along with it. The chronic inflammatory skin condition impacts the way skin cells mature, resulting in often red or pink flaky skin lesions where the skin barrier is broken. These dry patches can often seem to come out of nowhere, but according to Ivy Lee, MD, a board-certified dermatologist in Pasadena, California, there are certain things that can lead to flare-ups.
It's important to note that psoriasis is a genetic condition, which means that if you have it, it's not because you did something "wrong"it's simply because you're predisposed. That said, there are a few factors that can make flare-ups worse, so you'll want to be aware of what they are and do your best to avoid them. Keep scrolling for seven biggies that Dr. Lee wants you to look out for.
To avoid psoriasis flare-ups, Dr. Lee says it's key to try to minimize points of friction. "I have players who wear knee pads and you realize their psoriasis is really bad underneath their knee pads, or I have women who wear bras with underwires and it's really uncomfortable, really rubbing that area underneath the breast," says Dr. Lee. "And you realize that their psoriasis is really concentrated, really angry, and flared underneath their breast. And that's because there's a little friction point that people are getting flares at."
"There's a known phenomenon called the Koebner Phenomenon, where any type of traumaso cuts, scrapes, even self-induced trauma, like a scratch or a rubbingcan flare your psoriasis," says Dr. Lee. She explains that oftentimes patients with mild psoriasis will try to get rid of it by scrubbing the area with a loofah or pumice stone, and will then find that the scales got worse or spread to a larger area. "And that's what we call the Koebner Phenomenon, where if you manipulate, scratch, or abrade your psoriasis, it can spread."
When you're stressed out, your skin feels it. "It's fascinating because we're learning a lot more about the immunological basis of psoriasis and skin conditions like atopic dermatitis in eczema, and you realize that any type of inflammation and psychological stress can dampen or ramp up parts of our immune system," says Dr. Lee. When this happens, conditions like psoriasis and eczema can flare as a response to that increased inflammation. "The mind and body are actually very connected," she adds.
In addition to mental stress, physical stress on your body can also have an effect on your skin. "For example, when I ask patients about their overall stress level, they think about their psychological stress and say, 'I feel absolutely fine,' but then they're like 'Oh wait, but I did have that surgery' or 'I was hospitalized for for a week for Covid,'" says Dr. Lee. "That physiological stress can also cause a flare of psoriasis"
5. New medications
"Asking people about any new medications is really helpful because sometimes we realize it may not just be a flare of their regular psoriasis," says Dr. Lee. "Maybe they started a new medication that maybe is flaring their current psoriasis or causing them to develop a rash that looks a lot like psoriasis."
Although this isn't true for everyone, cold weather has the potential to cause flare-ups. "There is a seasonality, usually around the winter months, where we do know chronic psoriasis patients may have a flare," says Dr. Lee. "I have patients who say, 'Every year from November to January is where my psoriasis flares.' And it's hard. I can't predict who has this seasonality or why they have that seasonality. We think that maybe it's because of the drier weather, the ambient humidity, and lack of moisture in the skin that's causing the flares in psoriasis."
"We used to think that psoriasis was only on the skin and now we have a lot more information that it is associated with other conditions," says Dr. Lee. "Psoriasis can affect arthritis. It can be associated with heart disease, heart attacks, and strokes. It can be associated with high blood pressure, diabetes, and high cholesterolall these things that ideally we don't want. And so we realize that it's no longer just affecting the skin and that this is where skin maybe is one of the manifestations of all of this inflammation. We understand a lot more about how psoriasis affects the whole body, and we're also a lot more proactive in finding any associated internal conditions that maybe we can prevent or treat at an earlier point."
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Im a Dermatologist and These 7 Things Could Be Making Your Psoriasis Worse - Well+Good