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I have never had any skin problems before in all my life. Then I was put on a beta-blocker drug and one of the side effects I got was some patches on my body and scalp. The doctor said it was psoriasis. What is that?

Psoriasis is actually a common skin condition.

It develops when the life cycle of your skin cells is speeded up, causing them to die and build up on your skin surface quickly.

These extra skin cells form scales on your skin, as well as red patches, which can be itchy, and even painful.

What is the difference between psoriasis and eczema?

Psoriasis has well-defined, thick, red and scaly patches, especially at your elbows and knees.

The patches can also appear on your face, buttocks, palms, soles and scalp.

Your skin is thicker and more inflamed than those with eczema.

Eczema also causes your skin to be red and inflamed. It is sometimes scaly, but it can also be oozing or crusty.

There may be swelling or dark, leathery patches.

Eczema tends to appear in the crooks (or inner parts) of your knees and elbows, i.e. the parts of your body that bend.

However, it can also appear on your neck, wrists, ankles and other places on babies.

Eczema is more commonly associated with children.

The itching in eczema is also more intense than in psoriasis.

Stress is one of the major factors that contribute to the triggering or worsening of psoriasis. VisualHunt.com

I heard that there are many types of psoriasis. Is this true?

Yes, everyone has different manifestations of psoriasis.

We know already that the distinct common feature is red, scaly patches on your skin due to overproduction of skin cells.

Plaque psoriasis is the commonest form. The red, silvery scaly patches are called plaques.

These plaques can occur on any part of your body, including inside your mouth and on your genitals.

There is also nail psoriasis. Obviously, this affects your fingernails and toenails, and can cause abnormal nail growth, pits (little holes) and discolouration of your nails.

Your nails can also separate from your nail bed, or even crumble entirely.

When the psoriasis patches are not formed in plaques, but in waterdrop-shaped lesions instead, it is called guttate psoriasis.

This affects young children and young adults. It is usually triggered by a bacterial infection such as a sore throat.

The skin lesions are not as thick as plaque psoriasis.

Then there is inverse psoriasis, which affects the skin on your armpits, groin, under your breasts or around your genitals.

These become worse with friction or sweating, like if you wear tight clothing.

This one has a correlation with fungal infections.

One uncommon type is pustular psoriasis. This one has pus-filled blisters on top of your red skin.

It can get quite bad because it may be associated with fever, severe itching and diarrhoea.

The rarest type is also one of the worst due to the way it looks, called erythrodermic psoriasis.

This one covers your entire body with a red rash that peels easily. It can also unfortunately itch or burn badly.

I know a relative with psoriasis who also has joint pain. Does psoriasis give rise to joint pain?

Some psoriasis patients can also suffer from joint pain due to their condition. TPNYes, this is called psoriatic arthritis. It does not happen in all psoriatic cases.

It is not as bad as rheumatoid arthritis, but can be severe as well.

This type of joint pain affects any joint. The underlying issue is inflammation and erosion of your joints.

This leads to stiffness, swelling and worsening deformity.

What is the cause of psoriasis?

No one really knows, but it is believed to be an autoimmune disease.

Your white blood cells called T lymphocytes and neutrophils attack healthy skin cells by mistake.

They travel to your skin, causing your blood vessels to dilate and your skin cells to overproduce.

That is why you have redness, swelling, and even pus it is as though your body is fighting off a skin infection.

There is also a genetic element in psoriasis. If your parents had psoriasis, you are more likely to have it too.

Is there anything that triggers psoriasis? I was told it was because of the medication I took.

Many things can trigger psoriasis, especially if you have an underlying genetic predisposition for it already.

We have already discussed that sore throats caused by bacteria, especially Streptococcus, can trigger it.

So can skin infections and injuries, like burns, sunburns, bites and cuts.

Stress can also trigger psoriasis. So can smoking and alcohol.

The types of medicines that can trigger it include beta-blockers, used for high blood pressure; lithium, used for psychotic disorders; and drugs used for malaria.

There is unfortunately no cure for psoriasis, but you can moisturise your skin, give up smoking and alcohol, stop taking those medications giving you psoriasis, and manage your stress levels, to help manage your condition.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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Thick, scaly patches appearing on your skin? It's psoriasis - The Star Online

According to the National Psoriasis Foundation, more than eight million Americans suffer from psoriasis, a chronic skin condition marked by flare-ups onthe knees, elbows and scalp. Psoriasis is the byproduct of genetic factors exacerbated by stress, depression, trauma and other medical conditions.

Not focusing on the relationship between other comorbidities, a study published in October by JAMA Dermatology analyzed the link between cancer and organ-specific psoriasis, a correlation not been thoroughly established before.

As per scientists, since psoriasis is developed through inflammation, also linked to cancer risk, there could be an association between the two diseases. Smoking, drinking and obesity are known risk factors for people with psoriasis, apart from immunomodulatory and potentially carcinogenic treatments.

In fact, a systematic review done in the past was limited to only people with psoriatic arthritis, and omitted autoimmune conditions. The recent comprehensive meta-analysis by University of Manchester aimed to ascertain susceptibility to cancer among people who suffering from psoriasis.

What The Study Found

The review included 58 observational studies, of which 50 had participants with cancer, 15 reported cancer mortality and 7 studieshad both. These studies were adjusted and grouped together based on several overlapping factors. Studies were grouped into level 1 based on adjustments for age and sex. Level 2 studies were adjusted based on age, sex and risk factors such as smoking, alcohol and obesity.

The overall risk of developing cancer was significantly elevated in people with psoriasis and for a number of site-specific cancers; the risk of cancer mortality was found to be elevated in those with severe psoriasis, the researchers stated in the paper.

With regard to site-specific cancers, we observed elevated incident cancer risks for lymphoma, keratinocyte, esophageal, liver, and pancreatic cancers in studies of severe psoriasis and in those involving people with all severities of psoriasis. Similarly, esophageal, liver, and pancreatic cancers also demonstrated an increased risk when considering cancer mortality in studies of severe psoriasis, the researchers added further in the paper.

Evidence from cohort studies of severe psoriasis indicated a 1.22-fold increased risk of developing cancer when compared with populations without psoriasis, a result not significantly different from that of all psoriasis severities. With regard to cancer mortality, a 1.22-fold increased risk of dying due to cancer compared with psoriasis-free populations was observed in studies of severe psoriasis, the researchers explained.

The evidence from this meta-analysis not only suggests that cancer should be given more consideration as an important comorbidity of psoriasis but also begins to present evidence that this risk could be alleviated to some extent through lifestyle behavior change, they concluded.

Plaque psoriasis can be itchy and painful. Image courtesy of Pixabay, public domain

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Cancer And Psoriasis: Is There A Link Between The Two? - Medical Daily

A recent retrospective cohort analysis explored the association between risk of serious infection and initiation of interleukin (IL)-17, IL-12/23, and tumor necrosis factor (TNF) inhibitor among real-world patients with psoriasis or psoriatic arthritis (PsA).

Commercially insured patients diagnosed with psoriasis or PsA between 2015 and 2018 were included in the study. The exposure was defined as dispensation for IL-17 (ixekizumab or secukinumab), IL-12/23 (ustekinumab) or TNF (adalimumab, certolizumab pegol, etanercept, golimumab and infliximab). The primary outcome was infection requiring hospitalization after biologic initiation. The researchers calculated incidence rates (IRs) per 100 person-years. Cox proportional hazards regression models were adjusted for inverse probability of treatment-weighted propensity scores.

Final analysis included 11,560 new treatment episodes; during 9,264 person-years of follow-up, 190 serious infections (2% of treatment episodes) were reported. Between IL-17 and TNF, class-specific IRs did not significantly differ, but were significantly lower for IL-12/23. In adjusted analyses, infection risk with IL-17 was not significantly greater compared to TNF (hazard ratio [HR]=0.89; 95% CI, 0.48 to 1.66) or IL-12/23 (HR=1.12; 95% CI, 0.62 to 2.03). Compared to TNF, IL-12/23 was associated with a reduced risk of infection (HR=0.59; 95% CI, 0.39 to 0.90).

Relative to TNF and IL-17, IL-12/23 inhibitors were associated with a reduced risk of serious infection in biologic-nave patients with [psoriasis] or PsA, the researchers concluded. In biologic-experienced individuals, there was no difference in infection risk across TNF, IL-17 or IL-12/23 inhibitors.

The rest is here:
Serious Infection Risk in Psoriasis and PsA Patients Using Biologics - DocWire News

OBJECTIVE:

To assess the immunogenicity and safety of vaccination against seasonal influenza in psoriatic arthritis (PsA) patients treated with secukinumab versus healthy controls (HC).

PsA patients administered secukinumab for 3months and HC received the Sanofi Pasteur vaccine composed of 3 antigens (H3N3, H1N1, and B) and underwent clinical and laboratory assessments on the day of vaccination and 4-6weeks later. Immunogenicity of the vaccine was evaluated by hemagglutination inhibition assay against those 3 antigens. Responders to each antigen were defined by a 4-fold increase in the antigen titer or by seroconversion in patients whose baseline level was <1/40.

Thirty-two consecutive PsA patients treated with secukinumab for 3months comprised the study group, 10 of whom received concomitant conventional synthetic disease-modifying drugs, mostly methotrexate. There were 17 age- and gender-matched HC (median age 48.5years, 6 females). The geometric mean titers of each antigen increased significantly in both groups. The number of responders in each group was similar for H3N2 and H1N1, and significantly higher for B/Brisbane in the PsA group. The proportion of patients with a seroprotective level (a titer >1/40) was high and similar in both groups. There was no correlation between the response rate and age, gender, or selected parameters of disease activity (tender/swollen joint counts, Leeds enthesitis index, physician and patient global assessment, psoriasis area severity index, and C-reactive protein). No disease exacerbation was observed following the vaccination. No serious adverse effects were observed in both groups during the study period.

Secukinumab treatment does not affect the humoral response to influenza vaccine of patients with PsA.

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Immunogenicity and Safety of Vaccination against Seasonal Influenza Vaccine in Patients with Psoriatic Arthritis Treated with Secukinumab - DocWire...

After years of feeling self conscious and sore due to her psoriasis, Paula Taylor was willing to try anything to find a cure. And after two weeks of sticking to a vegan diet, she was amazed by the results, as her skin completely cleared.

Paula Taylor, of Ashton, was only 11 when she started to get a severe rash on her skin.

Possibly brought on by grief after losing her nana, doctors thought she had the shingles until she was hospitalised for further treatment.

As she had to undergo a strict and lengthy treatment regime at home, Paula admits to losing part of her childhood.

The 49-year-old, who works at The Hidden Jem, in Lytham, had suffered with the skin condition since she was 11 and had even been hospitalised as she had cold tar treatment.

She recalls: Nobody knew what it was at first, as psoriasis was not widely known.

I lost my nan and it was linked to grief. I had just started high school and I was very conscious about it.

I didnt want to do sport as I didnt want anyone to see me in the shower. It was extremely uncomfortable and itchy, as it was in my hair, under my breasts and down my back.

It came down my hairline and had gone up my neck, so I could not cover it up. My school uniform is black, so I had severe dandruff and I was bullied.

At one time, I was hospitalised for 12 weeks and had to have coal tar baths.

I didnt have much of an adolescence as I was not able to socialise much. I felt very isolated. I did have a few good friends, who I still see now. They would sit around while I was in the house having my treatment put on.

I managed to get better with the treatments until I was 18/19. But as other women were going out and spent ages getting ready, wearing fake tan and perfume, I was putting on cold tar and had greasy hair which smelt. It was not fun.

In her late teens, Paula began to work at The Waterfront pub on Preston docklands, where she met her first boyfriend.

But when they broke up, her psoriasis flared up.

She reveals: I was mortified and the psoriasis came back. I was hospitalised for longer but it got better with treatment.

I had to put the coal tar on and lie there for six hours until I could take it off.

Paula and her boyfriend got back together and they moved to Herefordshire, working in different pubs when she was 21.

She sailed through life again, as they got married and had two children and she set up her own clothes boutique.

Whilst the psoriasis was always there, she was able to keep it under control.

But four years ago, Paula faced a more stressful time, as she split from her husband and moved back to Preston.

She says: I went through a traumatic time as I was going through a divorce. We are still friends but we grew apart and he worked away a lot.

I had all that trauma going on and I was struggling again with psoriasis. I was always sore internally and my body was inflamed. It was getting better in the summer when the sun was getting to my skin and I was eating healthier and doing a lot of exercise. But my skin would be bad in winter.

I would be drinking more as I was uncomfortable and eating unhealthily.

Paula started to get her life back on track and although she struggled at first to find a job, she started working at The Hidden Jem, in Lytham.

But in February, she developed strep throat and she was suffering from anxiety, which caused the psoriasis to return.

She adds: I had to take one day a week off to have an appointment with my GP and start with the steroid cream. It was so soul destroying and painful.

It was beginning to have an impact on my self worth. I never felt clean as I had treatment on. The only place I felt comfortable was in the bath.

So I began researching.

Thats when I found Hanna Sillitoe, who had started her own blog, and it was like reading my own story, as she struggled with psoriasis. I read My Goodness Recipes and Radiant, as she went through the process of elimination in her diet.

She started juicing and cleansing, so I bought a juicer on eBay.

I went cold turkey and juiced every day. I was drinking celery juice, cucumber, apple juice, and spinach juice. I had that three times for three days and I was drinking so much water in between to cleanse. Then I had soups and salads every day for a fortnight.

I had no dairy, meat or alcohol and within 17 days, my psoriasis was clear. It felt like a miracle.

I felt incredible and nothing hurt anymore.

Paula has now been following a vegan-based diet and combined with simple coconut and salt baths, her psoriasis has been kept at bay.

She also lost a significant amount of weight, dropping from a size 20 to a size 10.

She admits: I follow the rules but I fall off the wagon every now and again as you have to have a good life balance. You dont have to be so stringent, so I may have a drink, but I know what to do if I get too bad, as I just go on a juice diet for a few days.

You can stop eating something for a few days, then reintroduce and stop something else.

The feeling I have now is worth giving up a few ingredients, as it is beneficial to my health.

Hanna Sillitoe had suffered from severe psoriasis, eczema and acne for more than 20 years.

When her doctor told her the only remaining treatment was chemotherapy, she began researching diet and skin, which produced dramatic results.

Now free from all skin complaints, she compiled a book, Radiant, which features a detailed 28 day life changing plan alongside more than 100 skin focused recipes.

She has also appeared on Dragons Den, pitching her concept, which also includes natural, botanical skin care products.

For more information visit http://www.hannasillitoe.com.

Read more:
Here is how turning vegan cured Paula's psoriasis - Lancashire Post