Category Archives: Psoriasis

In mid-August, the Centers for Disease Control and Prevention (CDC)recommended that people who have compromised immune systems get an additional dose of the COVID-19 vaccine.

This includes people who have received organ transplants or are undergoing cancer treatment, as well as some individuals with chronic health conditions who are taking drugs that can suppress their immune response, raising their risk of serious, prolonged COVID-19.

If you have psoriasis and are taking an immunosuppressive medication, such as high-dose steroids or a biologic, you may wonder what the new vaccine guidance means for you and when, how, or even if, you should get a booster shot.

Here are some answers to your most pressing questions, with insights from two leading psoriasis experts.

RELATED: Coronavirus Alert: The Latest News, Data, and Expert Insight on the COVID-19 Pandemic

Anyone with psoriatic disease who is being treated with immune-modulating drugs and has already received two doses of a COVID-19 vaccine from Pfizer-BioNTech or Moderna is eligible for a third dose, says Joel Gelfand, MD, the cochair of the National Psoriasis Foundation and a professor of dermatology and epidemiology at the University of Pennsylvania Perelman School of Medicine in Philadelphia.

Among those patients, Dr. Gelfand believes the following are most likely to benefit from a third shot:

Right now, psoriasis patients and other immune-compromised people who received the Johnson & Johnson (J&J) single-dose vaccine are not eligible for a booster shot.

Since the J&J vaccine has only been available since March 2021, the CDC is waiting for more data before making a recommendation about additional doses for people who are immune-compromised, as well as for the general population.

Preliminary data released by J&J on August 25 suggest that a booster shot could be highly protective.

RELATED: Living With Psoriasis During the Pandemic Can Have a Side Effect: Chronic Guilt

You should talk to the physician you see for psoriasis treatment to [get their input] and determine if you are on an immunosuppressive medication prior to getting the booster shot, saysLisa Zaba, MD, PhD, a clinical associate professor of dermatology at Stanford University School of Medicine in Palo Alto, California.

You dont need a prescription or a doctors note to get a third shot, but you should bring your vaccination card. The dose will be the same as the first and second shot, and the side effects should be similar, says the CDC.

If possible, yes, says Gelfand. The CDC is recommending that people get the same vaccine they received for their first two shots, so if you are already inoculated with either Pfizer or Moderna, you should get the same for your third shot.

If that isnt feasible, or you dont know which vaccine your received for your first two doses, the agency says you should get your additional dose with either the Pfizer or Moderna vaccine.

For people who are immune-compromised or taking immune-suppressing medications, its recommended that they wait at least 28 days after they had the second dose before getting a booster, says Zaba.

Not necessarily, says Gelfand. Of the treatments commonly used for psoriasis, only methotrexate has been found to result in modest reductions in antibody response to the mRNA [messenger RNA] vaccines [from Pfizer and Moderna]. And the clinical significance of this finding is not known.

Gelfand also notes that the U.S. Food and Drug Administration (FDA) authorized expanded use of two-dose Pfizer and Moderna vaccines on the basis of data from patients who received an organ transplant and, as a result, were significantly immunosuppressed.

Research has shown that these patients were not able to mount a significant immune response to the initial two-dose vaccine and that a third dose could help increase the amount of protective antibodies in their blood.

RELATED: Study Finds That People on Methotrexate Mount a Weaker Immune Response to a COVID-19 Vaccine

Its very important to talk to your doctor before making any changes in your psoriasis medication, says Gelfand.

He notes that patients taking methotrexate with well-controlled disease may in consultation with their doctors consider pausing their medication for two weeks after getting the booster.

While this approach may improve antibody response, its not known if it will result in any meaningful benefit in terms of the risk of contracting COVID-19 or developing severe disease, he says.

Because the effects of pausing methotrexate after getting a COVID-19 vaccine arent yet known, people with psoriasis who paused their medication after the first two COVID-19 vaccine doses should still consider getting a third shot, says Zaba.

A third dose will likely provide you with better protection, but how much better is not yet clear, says Zaba.

Some studies have found that people who were severely immunocompromised and had virtually no protection from the Pfizer or Moderna vaccine had an improved antibody response after a third shot of the same vaccine, says the CDC.

Right now, we dont know if a third or booster shot has clinically meaningfully benefits [for psoriasis patients on immunosuppressive medication], says Gelfand. But given the emergence of the Delta variant, which is much more transmissible than previous variants, its likely that booster vaccines will be necessary and helpful.

Even after receiving a third dose of the vaccine, youll need to take extra precautions to avoid exposure to COVID-19, such as wearing a mask (especially inside) and avoiding crowds.

To reduce your odds of exposure, its also important that your family members and other close contacts get vaccinated.

If they are already immunized, they too will be eligible for a third shot beginning on September 20. Thats when the federal government is planning to roll out boosters for all Americans who received their second vaccine dose at least eight months prior.

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Psoriasis and COVID-19 Vaccine Boosters - Everyday Health

A game-changing treatment for moderate to severe psoriasis could become available on the NHS within four weeks after being approved by the UK drugs regulator.

The Medicines and Healthcare Products Regulatory (MHRA) has given the go-ahead for Bimekizumab to be used for adults with moderate to severe plaque psoriasis.

The regulator authorised the drug after a major trial found it effectively cured 62 per cent of moderate to severe cases of the disease.

The breakthrough has the potential to transform the lives of hundreds of thousands of people in the UK, who frequently feel physically uncomfortable and self-conscious because of their condition.

Psoriasis is a skin disease that affects more than 1.3 million people in the UK, causing red, itchy scaly patches, most commonly on the knees, elbows, trunk and scalp.

It is a common, long-term disease with no cure. About 200,000 people in the UK have a moderate to severe form of the disease.

We have witnessed first-hand the mental strength and resilience need to live with this condition and look forward to making this new treatment option available to patients, said Claire Brading, managing director UK and Ireland at UCB, the Belgium pharma company that developed the drug.

Doctors have welcomed the development.

Psoriasis impacts every part of the lives of people living with the condition, from work to relationships, said Professor Richard Warren, consultant dermatologist at Salford Royal NHS Foundation Trust.

Bimekizumab has shown strong results in head-to-head trials with higher rates of skin clearance achieved versus some of the most prescribed therapies, a key outcome for patients. Its a highly effective option for patients suffering from moderate to severe plaque psoriasis, he said.

Existing treatments have improved the lives of thousands of people but these only work for a minority of patients and the effect often wears off after a year or so and symptoms return.

But trials of bimekizumab sold under the brand name Bimzelx show it is working well after two to three years and the researchers are confident that, for the vast majority of those patients who benefit, the effect will last for as long as it is needed, over many years.

As such, while its not a cure as it will come back if the treatment is stopped it completely removes the symptoms while the drug is taken, for the 62 per cent of patients it works for.

The new drug is initially given through an injection that is self-administered once a month to begin with and then every two months after 16 weeks.

Psoriasis is caused when an overactive immune system causes skin cells to grow too quickly. The drug works by dampening down its activity.

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Psoriasis treatment: effective new medicine available on NHS within weeks - iNews

Courtesy of Lauren Scholl

Chicago-area resident Lauren Scholl, 33, was diagnosed with psoriatic arthritis four years ago. Heres her story.

About five years ago, I started experiencing extreme pain in my feet. I was a competitive ballroom-dance instructor and professional dancer at the time, and I just assumed the pain was because I was constantly on my feet at work. But this pain was tough to work around.

I had intense stiffness in my feet, and my toes could not flexthere was no range of motion at all. I couldnt even get into a lunge position or kneel and put my toes on the ground because they just wouldnt move that way. When I walked, it felt like my feet had bruises all over them, even though they looked fine from the outside.

I was shockedI was just 28 at the time. Could arthritis really affect me at such a young age?

I finally decided it was time to see a podiatrist. He took X-rays of my legs and feet and spotted specific arthritis patterns in my toes. I was shockedI was just 28 at the time. Could arthritis really affect me at such a young age?

I was referred to a rheumatologist, who ran blood work, examined my X-rays, and asked about my personal and family history, taking careful note of the fact that autoimmune diseases run in my family. Eventually I was given a diagnosis: I had psoriatic arthritis.

I didnt know it at the time, but psoriatic arthritis is a chronic inflammatory disease that causes swelling in the joints. It usually happens in conjunction with psoriasis, a chronic skin condition that causes itchy, scaly patches of irritated skin. I had been diagnosed with psoriasis about five years prior, which helped my doctor make the connection.

By the end of the day, I was physically and emotionally exhausted from fighting through agony.

The initial medication I was put on didnt work well for me. I suddenly developed depression, which I had never had in my life. I didnt even know how to identify it when it first showed up, but eventually I realized that the way I was feeling wasnt normal. So my doctor switched my medication after six months.

It didnt help that I was also struggling a lot at work as a dance instructor because of the pain. I tried to ignore it, but by the end of the day, I was physically, mentally, and emotionally exhausted from fighting through so much agony. On top of that, I got pregnant. The extra stress of pregnancy on my expanding and changing body made things that much harder.

Around this same time, I was introduced to an online arthritis support organization called CreakyJoints, where I met people who helped me deal with my illness. They also helped me make tweaks to my everyday lifestyle. I learned to track my symptoms to identify triggers; eliminate certain foods from my diet that contained sugar, gluten, and dairy; and schedule my work days and social calendar around the times I was least symptomatic, to minimize the pain as best as I could.

Unfortunately with my condition, I experienced discomfort both when I was active and when I was at rest. I took a lot of over-the-counter (OTC) anti-inflammatories and I tried ice, heat, and any type of OTC topical cream that stood a chance of making me feel better. But the pain persevered, and it started spreading to other areas of my body, like my knees and shoulders. Each day was a struggle, but I loved dance so much and it was the one thing I didnt want to give it up. I remember giving myself daily pep talks about how I could get through this and tough it out, even though it was becoming increasingly clear that I couldnt.

Finally, my body was not able to handle it anymore. I decided to leave dance. I was devastateddance was a part of my identitybut I had to make a change. I couldn't take the intense daily agony.

I found a way to work around my illness that was holding me back.

I was a stay-at-home mom for a bit, but I learned that just wasnt for me. I felt like I had more to share with the world, and I wanted to continue to pursue my career. I realized that what I loved most about performing was being activeand I wasnt going to let psoriatic arthritis take that away from me. So I decided to get my personal training certification, and later went on to become a certified nutrition coach, too. I now train clients full-time and in person, and help others that I cant see in person through comprehensive fitness and nutrition online coaching.

Courtesy of Lauren Scholl

Personal training is a way for me to continue to be active, and its more manageable than constantly demonstrating dance moves (or doing them in competitions). For example, if I need to sit on a bench while Im working, I can sit on a bench. That wasnt an option when I was teaching people to danceI would need to physically dance with someone to teach them the steps. Now I use my words a bit more than my body to help people get to where they need to be. Ive found a way to work around an illness that was holding me back, and I try to instill that in the people I work with now, too. You may get injured or experience another roadblock along your journey, but that doesnt mean you have to stop exercising or working toward your goalsyou just have to get creative and find ways around it.

Im still battling my illness. I have good days and bad days. And Im still trying to find the right medication or combination of medications that can get my inflammation markers down. But overall, Im trying to find the right balance of living my life to the fullest while minimizing my pain, and Im hopeful that Ill be able to do just that.

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I Never Thought Arthritis Would Derail My Career. Here's What I Wish I Had Known. - ELLE.com

AbbVies megablockbuster Rinvoq ambition suffered a blow thanks to an updated safety warning and treatment restriction from the FDA. But pharma watchers have different opinions on just how significant the impact will be on AbbVie's JAK inhibitor.

In an announcement Wednesday, the FDA is revising Rinvoqs boxed warning to include information about increased risks of serious heart-related events, cancer, blood clots and death. The agency is also limiting the drugs use to patients whove tried but failed on at least one TNF inhibitor. Pfizer's Xeljanz and Eli Lilly's Olumiant, both also JAK inhibitors, were hit with the same limitations.

If Rinvoq is only used in second or later lines, it could mean a $1 billion to $3 billion reduction from AbbVies $8 billion 2025 sales estimate for the drug, SVB Leerink Geoffrey Porges wrote in a Wednesday note to investors. For his part, Bernstein analyst Ronny Gal reined in his 2030 sales projection for Rinvoq to $11.2 billion from the previous $17.2 billion.

To Porges, the updated safety language, which stemmed from findings from a postmarketing study by Pfizers fellow JAK inhibitor Xeljanz, wasnt too surprising. But he didnt foresee the post-TNF restriction.

Still, as Porges, Evercore ISI analyst Josh Schimmer and Piper Sandler analyst Christopher Raymond noted in their separate analyses, doctors are already reserving JAK inhibitors for arthritis patients who failed on TNF inhibitor out of a sense of abundant caution for safety and also due to payer restrictions.

RELATED: JAK inhibitors from Pfizer, AbbVie and Lilly hit with dreaded FDA heart safety, cancer warnings

As Schimmer pointed out, the majority of current and projected Rinvoq use is indeed in the post-TNF inhibitor treatment setting. A recent survey of 100 high-volume U.S. rheumatologists that Piper Sandler conducted with Spherix Global Insights showed that only 14% of patients are getting Rinvoq as prior to TNF inhibitors. And a large number of physicians are avoiding JAKs for patients with high or moderate blood clot risks.

Rinvoq is currently approved to treat moderate to severe rheumatoid arthritis after failure on methotrexate. Its label before the FDA update already included a boxed warning on blood clots, lymphoma and other malignancies and serious infections.

While Porges said Rinvoqs U.S. potential is almost certainly reduced, he still thinks its feasible that the drug can get to the $3.5 billion to $4.5 billion U.S. sales required for AbbVie to hit its $8 billion worldwide goal. If the U.S. market turns out to be more challenging, AbbVie could turn to Europe, where Rinvoq just won a go-ahead in atopic dermatitis without safety pushback from the European Medicines Agency, Porges suggested.

For its part, AbbVie is seeking FDA's blessing to expand Rinvoq into atopic dermatitis, psoriatic arthritis and ankylosing spondylitis plus expects a potential filing in ulcerative colitis. But because the FDA is now pushing Rinvoqs use behind TNF in all approved indications, earlier use for those diseases are off the table, Porges said.

RELATED: AbbVie's big Rinvoq ambitionsand the larger JAK classface even more uncertainty with latest FDA delays

But Gal is less optimistic. The Bernstein analyst now sees higher risks that the JAK inhibitor class may not win FDA approvals in less severe dermatological diseases such as atopic dermatitis and psoriasis. Besides Rinvoq, Xeljanz and Olumiant are also awaiting FDA decisions on their atopic dermatitis filings.

He sees a bigger problem than just the anti-TNFs. In other indications that Rinvoqs eyeing, Gal suspected that the FDA will likely also sequence it behind other classes of drugs such as Johnson & Johnsons IL-23 inhibitor Stelara, Sanofis IL-4/13 inhibitor Dupixent and even S1P modulators such as Bristol Myers Squibbs Zeposia.

It may also be that FDA will choose to prevent or further curtail use of the JAK inhibitors in disease conditions where the risk-reward is lower, Gal wrote in a note Wednesday.

By comparison, Piper Sandlers Raymond maintained his 2025 sales estimate for Rinvoq at $8.13 billion. In rheumatoid arthritis, Raymond viewed the label revisions as affecting Rinvoq on the margin. As for eczema, he has long been putting Rinvoqs future use to be after Dupixent.

RELATED: AbbVie's Rinvoq marches toward blockbuster ulcerative colitis nod even as JAK delays drag on

AbbVie has an option to dig itself out of the safety mess. As the FDA acknowledged, Rinvoq and Olumiant were dragged into the same safety warning and use limitation because they share similar mechanisms as Xeljanz. AbbVie could therefore conduct a large postmarketing study for Rinvoq, similar to the Pfizer trial, to prove its case to the FDA.

While the Xeljanz trial took seven years to complete, Gal suggested five years would be a reasonable estimate for a similar Rinvoq trial. Porges pointed out the study needs to show definite proof of the absence of harm to be able to reverse the troublesome labeling. Porges expects AbbVie wont decide on whether to run such a trial until early 2022.

AbbVie did not respond to a request for comment.

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FDA's new JAK safety restrictions spell trouble for AbbVie's Rinvoq, but to what extent? - FiercePharma

Pityriasis rosea is a skin condition that causes a Christmas tree rash. It starts with one patch, known as the mother patch, and branches out with smaller daughter patches on other parts of the body.

Although the rash will go away on its own with time, some people turn to medication, topical treatments, and dietary changes in an attempt to improve their symptoms (1, 2).

This article explores whether any diet, supplements, or other treatments can help treat pityriasis rosea.

Pityriasis rosea is a skin condition. It causes scaly, oval-shaped rashes that begin on the stomach, back, or chest and branch out onto the neck, arms, and legs (1, 2).

Its considered a self-limiting condition, meaning that it goes away on its own. It typically lasts 68 weeks, though it can last longer in some people (1, 2).

In most cases, the rash does not return once it has gone away, although one small study estimated that around 25% of people will experience recurrence (3).

Some, but not all, people with pityriasis rosea experience mild itching. Other symptoms of the condition are fatigue, nausea, headaches, fever, and sore throat. These symptoms can occur before or at the same time as the rash (2).

Sometimes, pityriasis rosea is mistaken for other skin conditions such as psoriasis, eczema, or ringworm. Your doctor may order blood tests to rule out other conditions before confirming a pityriasis rosea diagnosis.

The cause of pityriasis rosea is not known. Some speculate that it could be associated with a viral infection because it has been shown to spread through communities (2).

Anyone can get pityriasis rosea, but its most common between the ages of 10 and 35 and in those who are pregnant (2, 4).

Pityriasis rosea in pregnancy may be linked to miscarriage, especially during the first 15 weeks, although this correlation is not confirmed (1).

Because the rash goes away on its own with time, treatment is typically focused on symptom relief. Medical treatment can include antihistamines, topical steroids, and light therapy, all of which aim to reduce the intensity of itching (1).

Pityriasis rosea is a skin condition associated with a rash that can be itchy. The rash goes away on its own, often after 68 weeks, and treatment typically focuses on symptom relief.

No research directly supports the idea that dietary changes can help manage pityriasis rosea.

Still, some people believe that eating an anti-inflammatory diet might improve itching. An anti-inflammatory diet is high in foods that provide antioxidants, beneficial compounds that help prevent oxidative stress in your body (5).

Because pityriasis rosea is thought to be associated with increased oxidative stress, eating a diet high in antioxidants theoretically makes sense. However, there is currently no research supporting this idea (5).

Similarly, some people believe that the Autoimmune Protocol a diet that aims to lower inflammation could reduce pityriasis rosea symptoms (6).

In theory, a diet that decreases inflammation in your body might help manage the itching associated with the condition. However, no research supports this idea.

Current research doesnt suggest that any specific dietary changes can treat pityriasis rosea. Still, some people theorize that anti-inflammatory or antioxidant-rich diets might help relieve itching.

Pityriasis rosea usually goes away on its own, without requiring treatment. Still, certain supplements, topical treatments, medications, and lifestyle changes may offer some relief for those who experience irritated, itchy skin.

No strong evidence indicates that any supplements could help treat pityriasis rosea. However, certain supplements may relieve itchy skin in general.

Research suggests that vitamin D may relieve skin itch associated with eczema, a condition that makes skin red and itchy. One study found that taking 1,5001,600 IU of vitamin D per day reduced the severity of the symptoms (7, 8).

Fish oil is another supplement that has been shown to benefit the skin. One study in rats found that a daily fish oil supplement relieved itchiness associated with dry skin (9, 10).

Taking turmeric as a supplement and applying it topically may also help relieve itchy skin thanks to turmerics anti-inflammatory and antioxidant properties (11, 12, 13).

Lastly, animal studies have found that compounds in bilberry may relieve itchy skin (14).

Keep in mind that although these potential anti-itch benefits of vitamin D, fish oil, turmeric, and bilberry are promising, more research in humans is still needed.

Further, these supplements have not been studied specifically in relation to pityriasis rosea. If youre experiencing itchy skin from the rash, its best to talk with your doctor to see if any of these supplements are worth a try.

Certain topical treatments may relieve some of the itching caused by pityriasis rosea.

Hydrocortisone is a cream that reduces your skins immune response to relieve itching, swelling, and redness. However, its not recommended for long-term use, so its a good idea to check with your doctor if youre interested in trying it (15).

Another option is calamine lotion. It contains zinc oxide, an essential mineral that can help with itching. It does so by decreasing the effects of histamine, a compound thats part of your bodys immune response and is associated with symptoms like itching (16).

Applying aloe vera may also cool and calm itchy skin. You can find bottled aloe vera in stores or use the gel from a fresh aloe vera leaf. When looking for aloe vera products, check out the ingredients and choose one that has aloe vera listed first (17).

Interestingly, oatmeal has been found to have antioxidant and anti-inflammatory properties that may soothe irritated skin. Simply add 12 cups of oats to a bath and soak for 1520 minutes. You can also look for lotions containing oatmeal to enjoy its benefits (18, 19).

While these topical remedies may provide some relief, they wont treat the condition. Further, even though theyre generally considered safe, its best to talk with your doctor before trying them, especially if youre pregnant or breastfeeding.

Your doctor may be able to prescribe a stronger topical treatment if none of these over-the-counter options do the trick.

Over-the-counter antihistamines like diphenhydramine (Benadryl) and cetirizine (Zyrtec) can relieve itching by blocking the effects of histamine. Keep in mind, though, that some types may make you sleepy (20, 21).

Acyclovir, a drug often used to treat chickenpox, may also help those with pityriasis rosea. In fact, research has found that it may reduce skin redness, relieve symptoms, and even reduce the duration of rash (22, 23, 24).

A type of anti-inflammatory medications known as corticosteroids may also improve symptoms, although they are recommended only for severe or lingering cases of the condition. One study found that relapse rate was higher in those who were treated with a corticosteroid (25).

Some lifestyle factors may affect your skin, especially if youre dealing with a rash.

Try to avoid hot temperatures, as they can cause sweating, which might irritate your rash. Hot baths and showers and perfume-containing soaps and lotions may also cause irritation.

Because symptoms such as fatigue, nausea, fever, and sore throat can occur before or at the same time as the rash, be sure to get plenty of rest, stay hydrated, and check in with your doctor to make sure youre staying healthy.

Although pityriasis rosea cant be cured, certain medications, topical treatments, supplements, and lifestyle changes may reduce your symptoms.

There is currently no research to suggest that dietary changes can help treat or manage pityriasis rosea.

However, remedies such as antihistamines and topical treatments can help relieve itchy, irritated skin. And avoiding hot temperatures may help you avoid further irritating your skin.

Its best to talk with your doctor to find out which options may work best for you especially if youre pregnant or breastfeeding.

Remember, the rash usually goes away on its own without treatment.

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Pityriasis Rosea and Diet: Is There a Connection? - Healthline

If you're living with psoriasis, you probably already know how frustrating and challenging it can sometimes be to cope with the condition. Symptoms like itchy, scaling skin can affect your ability to perform daily activities, take a toll on your emotional health, and impact your quality of life.

The good news: There are ways to make life with psoriasis easier. Follow these dos and donts to help get your symptoms under control.

Do talk to a dermatologist.Make an appointment with a dermatologist who specializes in treatingpsoriasis he or she will be aware of the latest developments regarding treatment plans. Be prepared to discuss the details of your condition withyour doctor, including when you first noticed it, what your symptoms are, any situations that seem to make your symptoms worse, and what treatments have and have not worked for you in the past.

Do moisturize.Dry skin is more susceptible to outbreaks of psoriasis, so keep your skin well lubricated. After bathing or showering, seal in moisture by applying a generous amount of moisturizing cream or ointment to your skin. Vaseline, Cetaphil cream, and Eucerin cream are a few commonly available moisturizers reported to provide good results. Avoid lightweight lotions, which don't contain enough emollients.

If over-the-counter products don't help, your doctor may prescribe a moisturizing cream that contains medication.

Be especially diligent about moisturizing during the winter months, when cold outdoor weather and overheated buildings are a particularly drying combination. "In psoriasis, the epidermis builds up rapidly, producing a thick scale," saysJames W.Swan, MD, professor of medicine in the division ofdermatology at Loyola University Medical Center in La Grange Park, Illinois.

When the skin is hydrated, the scales soften and fall away, alleviating itch and dryness. But not using anything on the skin for three days will allow the scale to get very thick," says Dr. Swan.

Do take a soak.Soaking in a warm (not hot) bath for 15 minutes can help loosen scales and help reduce the itching and inflammation caused by psoriasis. Adding sea salt, oatmeal, bath oil, or a bath gel containing coal tar to the water can further soothe and moisturize your skin. If you live or vacation in an area with mineral or salt baths, take a dip in one. Both are associated with relieving psoriasis.

Do get some sun.For reasons experts still don't fully understand, psoriasis lesions often diminish when exposed to ultraviolet light. So while sunbathing is discouraged for most people because of the risk ofskin cancer, it can be helpful for those with psoriasis. The trick is to make sure that only the areas affected by psoriasis are exposed.

Cover unaffected skin with clothing or a sunscreen with an SPF (sun protection factor) of at least 30. Limit sun exposure to 15 minutes, and be careful to avoid sunburn, which will only make matters worse. It may take several weeks to see an improvement. Avoid tanning beds, which don't produce the same healing effect and may actually be harmful.

Your doctor may also recommend ultraviolet light therapy, either in the doctor's office or at home. According to Swan,"One of the gold standards for treatment of psoriasis is phototherapy," which involves exposing the skin to ultraviolet light on a regular basis and under medical supervision. According to the National Psoriasis Foundation, UVB light in particularpenetrates the skin and slows the growth of affected skin cells.

Ultraviolet B (UVB) light reduces the inflammatory cells from the skin thatiscausing psoriasis, says Swan. It also slows the cell proliferation that results in the scaling.

Do reach out.Having psoriasis isn't just physically tough it can be difficult emotionally as well. Feelings ofdepression, frustration, and isolation are common. Body image issues related to the appearance of psoriasis lesions are normal. While it may feel as if you're the only person struggling with this condition, in fact the World Health Organization reports that at least100 million people are affected worldwide.

Discuss your feelings about the disease with your family, friends, and doctor. In-person and online support groups for those with psoriasis can also provide support and help you remember that you're not alone. Psoriasis organizations, such as theNational Psoriasis Foundation, can connect you with others who are living with psoriasis, as well as keep you informed about research developments and opportunities to get involved in fundraising walks and other events.

Don't overdo it.The best way to handle psoriasis is to do so gently. Avoid the temptation to scratch or scrub lesions, which will only irritate them, making them worse. Try not to pick at scales, which can cause bleeding and increase your risk of infection. Instead, talk with your doctor about creams and ointments that can gently remove the thick scale. Bathing in very hot water or using abrasive cleaners can also make your symptomsflare up.

Don't stress out.Some people with psoriasis say their condition worsens when they're under stress. Avoid stressful situations when you can, and take extra steps to take care of yourself such as eating well, exercising, and getting enough sleep when you can't avoid stress. Hypnosis, relaxation, meditation, biofeedback, and other stress management techniques may also help.

Don't ignore flare-ups.Psoriasis is a lifelong condition, and one that tends to wax and wane over time. But that doesn't mean you just have to live with it. If your psoriasis returns after a period of being under control, schedule a visit with your doctor to find out why, and to decide what can be done to treat it.

Don't give up.One of the most frustrating things about treating psoriasis is that something that works well for one person may not work at all for another. It may take some time to find the right therapy or combination of therapies that works best for you. Be patient and don't give up. It's important to be consistent with your treatment plan, day in and day out, even when your symptoms aren't so bad. With psoriasis, slow and steady wins the race.

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Psoriasis Dos and Don'ts: Baths, Vaseline, and More ...

Definition

Psoriasis is a skin condition that causes skin redness, silvery scales, and irritation. Most people with psoriasis have thick, red, well-defined patches of skin with flaky, silver-white scales. This is called plaque psoriasis.

Plaque psoriasis; Psoriasis vulgaris; Guttate psoriasis; Pustular psoriasis

Psoriasis is common. Anyone can develop it, but it most often begins between ages 15 and 35, or as people get older.

Psoriasis isn't contagious. This means it doesn't spread to other people.

Psoriasis seems to be passed down through families.

Normal skin cells grow deep in the skin and rise to the surface about once a month. When you have psoriasis, this process takes place in 14 days rather than in 3 to 4 weeks. This results in dead skin cells building up on the skin's surface, forming the collections of scales.

The following may trigger an attack of psoriasis or make it harder to treat:

Psoriasis may be worse in people who have a weak immune system, including people with HIV/AIDS.

Some people with psoriasis also have arthritis (psoriatic arthritis). In addition, people with psoriasis have an increased risk of fatty liver disease and cardiovascular disorders, such as heart disease and stroke.

Psoriasis can appear suddenly or slowly. Many times, it goes away and then comes back.

The main symptom of the condition is irritated, red, flaky plaques of skin. Plaques are most often seen on the elbows, knees, and middle of the body. But they can appear anywhere, including on the scalp, palms, soles of the feet, and genitalia.

The skin may be:

Other symptoms may include:

Psoriasis on the knuckles

There are five main types of psoriasis:

Your health care provider can usually diagnose this condition by looking at your skin.

Sometimes, a skin biopsy is done to rule out other possible conditions. If you have joint pain, your provider may order imaging studies.

The goal of treatment is to control your symptoms and prevent infection.

Three treatment options are available:

TREATMENTS USED ON THE SKIN (TOPICAL)

Most of the time, psoriasis is treated with medicines that are placed directly on the skin or scalp. These may include:

SYSTEMIC (BODY-WIDE) TREATMENTS

If you have moderate to severe psoriasis, your provider will likely recommend medicines that suppress the immune system's faulty response. These medicines include methotrexate or cyclosporine. Retinoids, such as acetretin, can also be used.

Newer drugs, called biologics, are more commonly used as they target the causes of psoriasis. Biologics approved for the treatment of psoriasis include:

PHOTOTHERAPY

Some people may choose to have phototherapy, which is safe and can be very effective:

OTHER TREATMENTS

If you have an infection, your provider will prescribe antibiotics.

HOME CARE

Following these tips at home may help:

Some people may benefit from a psoriasis support group. The National Psoriasis Foundation is a good resource: http://www.psoriasis.org.

Psoriasis can be a lifelong condition that can be usually controlled with treatment. It may go away for a long time and then return. With proper treatment, it will not affect your overall health. But be aware that there is a strong link between psoriasis and other health problems, such as heart disease.

Contact your provider if you have symptoms of psoriasis or if your skin irritation continues despite treatment.

Tell your provider if you have joint pain or fever with your psoriasis attacks.

If you have symptoms of arthritis, talk to your dermatologist or rheumatologist.

Go to the emergency room or call the local emergency number (such as 911) if you have a severe outbreak that covers all or most of your body.

There is no known way to prevent psoriasis. Keeping the skin clean and moist and avoiding your psoriasis triggers may help reduce the number of flare-ups.

Providers recommend daily baths or showers for people with psoriasis. Avoid scrubbing too hard, because this can irritate the skin and trigger an attack.

Armstrong AW, Siegel MP, Bagel J, et al. From the Medical Board of the National Psoriasis Foundation: treatment targets for plaque psoriasis. J Am Acad Dermatol. 2017;76(2):290-298. PMID: 27908543 http://www.pubmed.ncbi.nlm.nih.gov/27908543/.

Dinulos JGH. Psoriasis and other papulosquamous diseases. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 8.

Lebwohl MG, van de Kerkhof P. Psoriasis. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson IH, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 210.

Van de Kerkhof PCM, Nestl FO. Psoriasis. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 8.

Read the rest here:
Psoriasis | UF Health, University of Florida Health

Psoriasis care at Mayo Clinic

Your Mayo Clinic care team personalizes your psoriasis care to ensure an accurate diagnosis, an effective treatment plan that works for you and the very best service.

Mayo Clinic dermatologists are very experienced in diagnosing and treating children and adults who have psoriasis, even the most rare and complex types. If you need another specialist, such as a rheumatologist to manage psoriatic arthritis, your Mayo Clinic care team works together to provide whatever you need.

Psoriasis is unique for everyone, and the effects range from mild to almost totally disabling. Your doctor will work with you to determine the correct diagnosis for your type of psoriasis, which is essential for effective treatment.

Mayo Clinic offers all treatments for this disease, including the Goeckerman treatment invented at Mayo Clinic for moderate to severe psoriasis. The Goeckerman treatment is not available in many places. This very effective therapy involves receiving daily ultraviolet light exposure and applying coal tar over the whole body.

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

For more information on visiting Mayo Clinic, choose your location below:

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.

See more here:
Psoriasis - Care at Mayo Clinic - Mayo Clinic

Introduction

Psoriasis is a chronic disease with intermittent flares and remissions. Aside from genetic predisposition and immunological disorders, psychological stress, emotional conflicts, and a tendency to suppress ones emotions are principal factors modifying the diseases course.14

Given the chronic and recurrent character of psoriasis and multiple triggering factors, treatment of this condition requires a thorough insight into health problems of a given patient, and a physician in charge needs to be experienced in terms of therapy selection. While many anti-psoriatic treatments exist, the therapy should be tailored in each case; the treatment lasts long, and excellent patient-physician cooperation is needed to achieve the desired outcome.5

Psoriasis may lead to physical disability (psoriatic arthritis), has an unfavorable effect on the patients comfort and quality of life, and disrupts normal functioning to various degree. Not infrequently, the disease, especially its severe form (erythroderma),24 is associated with pain and suffering. In other forms of psoriasis, the diseases impact depends on the area of the skin being affected; patients whose skin lesions are visible to others often withdraw from social activities, stay in isolation and may even develop depression. Such persons experience dissatisfaction, guilt, fear and embarrassment, which has a detrimental effect on their quality of life (QOL). Due to the deterioration of QOL, patients with psoriasis may be reluctant to involve in social, family and occupational activities.1,2,6 Furthermore, anti-psoriatic treatment requires self-discipline and can be burdensome, especially in the case of topical therapies.5

Psoriasis is a challenge and requires the patient to face a new reality. Coping with the disease and normal functioning are to a large extent dependent on ones level of illness acceptance.7 Each individual perceives the disease, its somatic effects, resultant dysfunction and related problems differently. This attitude is primarily determined by ones characterological traits and type of illness. A primary response to the diagnosis can be denial, underestimation, acceptance or overestimation of the disease.8 Some patients accept their illness and self-motivate themselves to participate in the therapeutic process; in such cases, a higher level of illness acceptance is associated with better adjustment to the disease and lesser psychological discomfort. If the disease causes mobilization of ones resources and despite experiencing health problems the patient can pursue his/her objectives and satisfy all vital needs, the level of illness acceptance increases and the QOL is better.9,10 However, some patients do not accept their diagnosis and respond with a rebellion, lack of medication compliance, emotional instability and denial. This eventually leads to a low level of illness acceptance and the resultant deterioration of life quality.11,12

Acceptance of the illness enables the patients to function normally despite various risks, constraints and problems associated with health loss. Knowing the causes and consequences of their illness, and potential complications thereof, the patients are capable of adequate self-control and can undertake health-oriented behaviors to improve their quality of life and longevity.9,10

Therefore, to improve the quality of life in chronically ill persons, healthcare providers should not merely monitor their somatic symptoms, but also assess their current needs, psychosocial, emotional and spiritual wellbeing, and illness acceptance level.

The aim of the study was to analyze the level of illness acceptance and its effect on the quality of life in moderate psoriasis depending on sociodemographic and clinical characteristics of the patients.

The study included patients recruited at private clinic of dermatology and medical cosmetology in Bialystok (Poland). The study group consisted of 186 patients with plaque psoriasis, including 103 of women (55.4%) and 83 of men (44.6%). The study participants were recruited by experienced dermatologist who determined their Psoriasis Area Severity Index (PASI) scores and recorded them in the patients documentation. The inclusion criteria of the study were: PASI 10, duration of psoriasis >2 years, age 18 years, and lack of other somatic or mental disorders during three months preceding the study.

Two hundred and twenty-five patients were invited to complete a questionnaire. Eighteen patients those who did not express their consent to participate were excluded from the study, and 21 patients did not provide complete answers. Final response and rejection rates were 82.7% (n=186) and 17.3% (n=39), respectively.

The study was conducted from June to September 2020. The respondents received questionnaires along with the instructions on how to complete them. The responses were self-reported or filled in by an investigator, either at the clinic or home. Respondents who completed the questionnaire at home received a self-addressed return envelope.

The research conformed with the Good Clinical Practice guidelines, and the procedures followed were in accordance with the Helsinki Declaration.

The study protocol of the was approved by the Local Bioethical Committee at the Medical University of Bialystok (decision no. APK.002.212.2020).

The study patients completed Acceptance of Illness Scale (AIS), Dermatology Life Quality Index (DLQI) and a survey developed by the authors of this study, containing questions about sociodemographic characteristics of the participants (gender, age, place of residence, marital status, education, employment status) and information about their disease (location of psoriatic lesions, time elapsed since the diagnosis of psoriasis).

The level of illness acceptance was measured with the AIS developed by BJ. Felton, TA. Revenson and GA. Hinrichsen and adapted to Polish conditions by Z. Juczyski.13

Given its psychometric characteristics, AIS is considered an accurate predictor of health-related quality of life, reflecting ones satisfaction with life and actual health status.13

The scale measures the respondents ability to cope with the illness based on eight statements regarding his/her actual status of health. Each statement is graded on a 5-point Likert-type scale, from 1 (definitively agree), to 2 (agree), 3 (do not know), 4 (disagree) and 5 (definitively disagree). The level of illness acceptance, being the sum of scores for all eight statements, can range from 8 pts (lack of acceptance) to 40 pts (high level of acceptance).

DLQI contains 10 single-choice questions referring to the quality of life in dermatological disorders. The answer to each question is scored on a scale from 0 to 3, where 3 corresponds to very much, 2 to a lot, 1 to a little, and 0 to not at all. The overall DLQI score can range from 0 to 30. The higher the score, the worse the quality of life in a given patient.14

To obtain a better insight into the problem in question, the levels of illness acceptance were analyzed according to the respondents sociodemographic characteristics: gender, age, place of residence, marital status, education and occupation, as well as according to clinical characteristics: duration of psoriasis and location of psoriatic lesions. Statistical significance was verified with the Students t-test in the case of comparison between two groups or ANOVA if the number of compared groups was larger than two. The results were considered statistically significant at p<0.05.

An integral part of the study was to analyze the relationship between illness acceptance and quality of life. The analysis was based on Spearmans coefficient of correlation between the two psychometric variables, which is an appropriate statistical measure to investigate non-linear relationships of a monotonous (positive or inverse) type.

The statistical analysis was carried out with STATISTICA 12.5 package.

The study group consisted exclusively of adult patients (Me=36; SD=12,0; Min./Max.=18/74 years), with the mean age of 39.4 years.

Mean duration of psoriasis in the study group was 14.8 years (Me=14; SD=10,3; Min./Max.=2/57 years).

The study group included 52.7% of married persons, 23.6% of singles, 12.4% of divorcees and 11.3% of widows/widowers. The proportions of respondents with higher and secondary education were 50% and 32.8%, respectively, the proportion of participants with primary or vocational education was 18.2%. The vast majority of the study participants were city-dwellers (75,2%). The largest occupational group were blue-collar workers (46.8%), followed by white-collar workers (38.7%). The remaining 14.5% are: retirees and pensioners (6.5%), students (4.8%), farmers (2.2%) and the unemployed (1.1%).

The illness acceptance scores (AIS) of the study patients were summarized as descriptive statistics. Mean AIS score for the study group was 24.3 pts (Me=24; SD=6,1; Min./Max.=10/40). However, based on the values of the lower and upper quartiles values, most participants scores between 20 and 28 on the AIS scale.

The majority of the respondents (64%) scored 1929 pts on the AIS. The proportions of patients presenting with full acceptance of the illness and complete lack of illness acceptance were similar, 19% and 17%, respectively.

The level of illness acceptance correlated significantly with some sociodemographic characteristics of the study participants (Table 1). Patients older than 40 years presented with lower levels of illness acceptance than younger persons (p=0.0311). Also, patients sex and duration of psoriasis significantly affected the acceptance of the illness, with lower AIS scores found in women (p=0.0092) and persons with a longer history of the disease (p=0.0362). The illness acceptance scores for patients living in the cities and countryside were similar (24.2 pts vs 24.3 pts), whereas the mean scores for married persons and singles were the same (24.3 pts).

Table 1 Relationships of Sociodemographic and Clinical Characteristics with AIS Scores

DLQI is a scale that measures the negative impact of the disease on QOL; hence, the higher the DLQI score, the more unfavorable the effect of the illness.

Mean DLQI score for the study group was 13.3 pts (Me=13; SD=8,1; Min./Max.=030). Based on the values of the lower and upper quartiles values of the DLQI measure ranged from 6.5 to 19 pts.

More than half (58%) of the respondents scored no more than 14 pts on the DLQI, which suggests that their quality of life was better than in the remaining 42% of the patients with DLQI scores higher than 15 pts.

Respondents with primary, vocational or secondary education had worse quality of life than those with higher education (14.8 pts vs 11.6 pts). Also, persons with longer duration of the disease presented with higher DLQI scores, corresponding to worse quality of life (Table 2).

Table 2 Relationships of Sociodemographic and Clinical Characteristics with DLQI Scores

An integral part of the study was to analyze a link between the level of illness acceptance (AIS score) and the quality of life (DLQI score). The relationship was analyzed based on Spearmans coefficient of correlation between the two psychometric measures.

A lower level of illness acceptance turned out to exert an unfavorable effect on the QOL in psoriasis. While not strong (R=0,33), the correlation between these two psychometric measures was statistically significant (p = 0.0015) - Figure 1.

Figure 1 Correlation between the level of illness acceptance and the quality of life.

The DLQI scores were also stratified according to the level of illness acceptance, and the significance of between-group differences was verified on variance analysis (Table 3). The between-group differences in DLQI scores were shown to be statistically significant (p = 0.0202).

Table 3 Relationship Between the Level of Illness Acceptance and the Quality of Life

Spearmans coefficients of correlation were also used to analyze the effects of age and duration of psoriasis on the levels of illness acceptance and DLQI scores. The correlation coefficients between AIS and age and AIS and duration of the disease were 0.03 (p=0.7793) and 0.09 (p=0.4016), respectively, and did not reach the threshold of statistical significance. The correlation coefficients between DLQI and age and DLQI and duration of the disease were 0.00 (p=0.9764) and 0.12 (p=0.2723), respectively, and also did not reach the threshold of statistical significance.

We analyzed DLQI and AIS scores according to the location of psoriatic lesions (face, arms, legs, trunk); we restricted the analysis to those four body areas as more detailed stratification would produce too small subgroups, and hence, negatively affect the accuracy of the results. Statistical significance was verified with the Students t-test for independent samples. No statistically significant relationships were found between the location of psoriatic lesions, quality of life and illness acceptance.

Adaptation to a chronic illness, including acceptance of the disease, is a complex process modulated by many factors. However, only a few studies analyzed the level of illness acceptance in patients with psoriasis; instead, researchers centered around the quality of life in this disease. We combined these two aspects in our present study, using selected demographic and clinical parameters as exploratory variables, patients with psoriasis.

Aside from somatic morbidities, patients with psoriasis may also present with mental problems, such as anxiety, dissatisfaction, sense of guilt, fear and embarrassment,1519 and psychological disturbances, eg lowered self-esteem, inability to establish social contacts, which may contribute to a substantial deterioration of the QOL.2024 Frequently, a problem is not the disease itself but its perception by the patients, their involvement in the diagnosis and treatment, and finally, acceptance of the illness. Therefore, attempts to improve the quality of life in psoriasis should not be limited merely to the monitoring of somatic symptoms, but also expand onto the assessment of patients needs, their psychosocial, emotional and spiritual wellbeing, and illness acceptance.25

Illness acceptance is a positive attitude towards chronic disease, strengthening the patients and preventing deterioration of their quality of life. Previous studies highlighted the beneficial effects of illness acceptance in terms of psychological and physical comfort.9,26,27

In the study conducted by Zieliska-Wiczkowska et al28 psoriasis patients presented with a high mean level of illness acceptance (30.377.936 pts). High levels of illness acceptance were found in 62.4% (3040 pts) of the patients with psoriasis, whereas moderate and low levels were documented in 26.7% (1929 pts) and 10.9% (818 pts), respectively.

The mean level of illness acceptance in our present study was lower than the one mentioned above (246 pts); also, the distribution of AIS scores differed, with 19% of the patients scoring 3040 pts, and 64% and 17% having the results in a bracket of 1929 pts and 818 pts, respectively.

The difference in the levels of illness acceptance might be associated with the fact that the majority of patients examined by Zieliska-Wiczkowska et al28 were persons aged 5160 years and older, who constituted 56.4% of the entire study group. In our present study, the respondents were stratified into different age groups, up to 40 years and older. One could hypothesize that longer duration of psoriasis and older age facilitate coping with the disease and promote its acceptance. According to Harrison et al29 and Mniszewska et al7 the disease with skin manifestations is less likely to negatively affect interpersonal relations of older persons, who have usually achieved stability in their social life and professional career.

However, our findings do not seem to support the hypothesis mentioned above, as these were older respondents who presented with lower levels of illness acceptance.

Similar findings were also reported by Hawro et al30 who showed that the sense of guilt, shame and social rejection in psoriasis increased with age. Older persons were shown to feel rejected, avoided social contacts with their relatives and friends, and presented with lower illness acceptance levels.

However, it needs to be stressed that in the studies conducted by Basiska et al10 the levels of illness acceptance in psoriasis did not correlate significantly with patients age.

Patients with longer duration of psoriasis were shown to present with lower illness acceptance levels, a phenomenon also observed in our present study. According to van Beugen31 and Ogarczyk,32 patients with a longer history of psoriasis reported more difficulties in social functioning, which corresponded to the lack of illness acceptance and worse quality of life.

In the study conducted by Basiska et al10 patients with psoriasis presented with higher levels of illness acceptance (27.46 pts) than in our present study (24.3 pts). The authors did not find a significant difference in the illness acceptance levels of female (26.49 pts) and male patients (28.41 pts). This observation is consistent with the results of some previous studies, conducted by Sampognab et al33 Mniszewska et al34 and other authors, which also did not demonstrate a significant effect of patients sex on QOL.35,36 In the study conducted by Zieliska Wiczkowska et al28 female patients had lower AIS scores than male psoriatics (54.2 pts vs.73.8 pts), but the difference was not statistically significant. Also, in our present study women scored lower than men in terms of illness acceptance (24.9 pts vs 23.6 pts).

According to Hawro et al30 female psoriatics also presented with lower quality of life scores. Psoriasis makes female patients feel embarrassed, frustrated and irritated. Due to the altered appearance of their skin, women with psoriasis found themselves unattractive and avoid contacts with others. Similar results were also reported by Zachariae et al37 and Kowalewska et al.27 However, according to other authors, these were male patients with psoriasis who presented with lower QOL scores than female patients.7,26

To summarize, the results of previous studies analyzing the effects of age and sex on illness acceptance and quality of life in psoriasis are inconclusive.20,37,38

Location of psoriatic lesions is known to influence both the illness acceptance and QOL.30,31,39 Krueger et al2 demonstrated that the lesions on exposed body parts attracted more attention from the others and had a negative effect on the social relationships of patients with psoriasis. To cover their skin lesions, patients with psoriasis not infrequently wear uncomfortable clothing. Hiding psoriatic lesions from others is considered an unpleasant duty and was shown to have a detrimental effect on QOL, especially in female patients.1,2 According to Hrehorw et al40 psoriasis exerts an unfavorable effect on the social contacts of the patients. Patients with visible skin lesions experience a growing sense of shame and embarrassment since they believe that other healthy persons avoid them not to be infected.

Our present study showed that visible psoriatic lesions were a factor contributing to the lack of illness acceptance.

This problem was previously highlighted by Orzechowska et al41 according to whom psoriatic lesions are a primary factor resulting in the stigmatization of the patients and resultant disruption of their social functioning. The patients who do not approve their disease-altered appearance may share a common misbelief that their image is also not accepted by others; thus, such patients not infrequently may self-stigmatize themselves. According to Russo et al, up to 89% of patients with psoriasis experienced shame and embarrassment because of their skin lesions.42

In Devrimci-Ozguvens et al43 Hrehorw et al40 opinion, psoriasis may have a detrimental effect on a patients mood, and some patients with psoriasis may even have suicidal thoughts. Such persons cannot accept their self-image and are exhausted with long-term treatment of skin lesions. Another risk factor for the suicidal ideation in patients with psoriasis is social rejection resulting from the lack of acceptance from others.40,4244

Education and occupation do not seem to influence the level of illness acceptance in psoriasis,28 which has also been confirmed in our present study. Perhaps, this phenomenon resulted from a relative stability of work environment.

In our study, married persons and singles have the same mean Scale AIS scores (24.3 pts), and hence, marital status was not confirmed as a significant determinant of the illness acceptance. However, in previous studies, conducted by Lu et al36 van Beugen et al31 and Ginsburg et al45 singles were shown to be more prone to stigmatization, which was also reflected by their worse quality of life.

Published data show unequivocally that psoriasis exerts a detrimental effect on the QOL. The disease constitutes a considerable burden for the vast majority of the patients, which is reflected by unfavorable changes in their quality of life. In turn, acceptance of the illness was associated with a better quality of life in psoriasis,46 the relationship also observed in our present study (p = 0.0015).

The persistence of psoriatic skin manifestations instead of treatments could deeply influence the patient attitude toward the disease.5,25 According to Verhoeven et al47 deterioration of the quality of life in psoriasis is associated with somatic manifestations of the disease. As emphasized by Ograczyk et al32 persistent itchiness and flares of the disease contribute to the escalation of anxiety and psychological discomfort. According to Hrehorw et al46 itchiness is the main obstacle in illness acceptance. Persons with clinical manifestations of psoriasis were shown to have lower self-esteem and lower levels of satisfaction with life. Patients with psoriasis are well aware that their illness is chronic and incurable, with symptomatic treatment and maintenance of the remission being the only viable therapeutic options. Patients perspective is important not only in terms of symptoms but also on the well-being impact.25

According to literature, the higher the level of illness acceptance, the better the adjustment to the disease and the lesser the negative emotions experienced by patients with psoriasis.26,27,40,42 Thus, the patients who give less meaning to their condition are more likely to accept the illness and to choose more appropriate coping strategies to avoid unfavorable negative psychosocial consequences of psoriasis.

In this study, patients with moderate psoriasis presented with a moderate level of the illness acceptance, and a significant correlation was found between this parameter and QOL. This implies that both illness acceptance and subjectively assessed QOL are accurate psychometric measures that should be considered during anti-psoriatic treatment planning.

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Compliance with ethics guidelines: the protocol of the study was approved by the Local Bioethics Committee at the Medical University of Bialystok. Informed consent was obtained from all individual participants included in the study.

The authors would like to thank the patients who participated in the survey.

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Barbara Jankowiak was a major contributor in writing the manuscript and supervised this study. Was responsible for patient recruitment, data collection, data analysis, and drafting the manuscript.

Beata Kowalewska was a major contributor in writing the manuscript, was involved in the development of the idea, data analysis, and drafting the manuscript.

Elbieta KrajewskaKuak was involved in the development of the idea and revised the manuscript critically for important intellectual content.

Rafa Milewski was involved in the development of the idea and revised the manuscript critically for important intellectual content.

Maria Anna Turosz was involved in the development of the idea and revised the manuscript critically for important intellectual content.

This study and the Rapid Service Fee were funded by Medical University of Bialystok, Poland. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis. Neither honoraria nor other forms of payments were made for authorship.

The authors report no conflicts of interest for this work.

1. Ferreira BI, Abreu JL, Reis JP, et al. Psoriasis and associated psychiatric disorders a systematic review on etiopathogenesis and clinical correlation. J Clinic Aesthet Dermatol. 2016;9(6):3643.

2. Krueger G, Koo J, Lebwohl M, et al. The impact of psoriasis on quality of life: results of a 1998 national psoriasis foundation patient- membership survey. Arch Dermatol. 2001;137(3):280284.

3. Langley RGB, Krueger GG, Griffiths CEM. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005;64(Suppl2):ii18ii23. doi:10.1136/ard.2004.033217

4. Christophers E. Psoriasis epidemiology and clinical spectrum. Clin Exp Dermatol. 2001;26(4):314320. doi:10.1046/j.1365-2230.2001.00832.x

5. Scala E, Megna M, Amerio P, et al. Patients demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis. PLoS One. 2020;15(8):e0237267. doi:10.1371/journal.pone.0237267

6. Gelfand JM, Feldman SR, Stern RS, et al. Determinants of quality of life patients with psoriasis: a study from the U.S. population. J Am Acad Dermatol. 2004;51(5):704708. doi:10.1016/j.jaad.2004.04.014

7. Miniszewska J, Juczyski Z, Ograczyk A, et al. Health-related quality of life in psoriasis: important role of personal resources. Acta Derm Venereol. 2013;93(5):551556. doi:10.2340/00015555-1530

8. Bowling A, Farquhar M, Browne P. Life satisfaction and associations with social network and support variables in three samples of elderly people. Int J Geriatr Psychiatr. 1991;6(8):549566. doi:10.1002/gps.930060803

9. Zalewska A, Miniszewska J, Chodkiewicz J, et al. Acceptance of chronic illness in psoriasis vulgaris patients. J Eur Acad Dermat Venereol. 2007;21(2):235242. doi:10.1111/j.1468-3083.2006.01912.x

10. Basiska MA, Woniewicz A. Emotional intelligence in psoriasis patients as a determinant of acceptance of illness. Rev Dermat. 2012;99(3):202209.

11. Ginsburg IH. Psychological and psychophysiological aspects of psoriasis. Derm Clin. 1995;13(4):793804. doi:10.1016/S0733-8635(18)30043-3

12. Zachariae R, Oster H, Bjerring P, et al. Effects of psychologic intervention on psoriasis: a preliminary report. J Am Acad Dermatol. 1996;34(6):10081015. doi:10.1016/S0190-9622(96)90280-7

13. Juczyski Z. Narzdzia Pomiaru w Promocji I Psychologii Zdrowia[Measurement Tools in Health Promotion and Psychology]. Warszawa: Pracownia Testw Psychologicznych Polskiego Towarzystwa Psychologicznego; 2001:168172. Polish.

14. Szepietowski J, Salomon J, Finlay AY, et al. Dermatology Life Quality Index (DLQI): polish version. Dermatol Klin. 2004;6:6370.

15. Gupta MA. Psychosocial aspects of common skin disease. Can Fam Physician. 2002;48:712716.

16. Gupta MA, Gupta AK. Psychiatric and psychological comorbidity in patients with dermatologic disorders: epidemiology and management. Am J Clin Dermatol. 2003;4(12):833842. doi:10.2165/00128071-200304120-00003

17. Picardi A, Abeni D, Melchi CF, et al. Psychiatric morbidity in dermatological outpatients: an issue to be recognized. Br J Dermatol. 2000;143(5):983991. doi:10.1046/j.1365-2133.2000.03831.x

18. Picardi A, Amerio P, Baliva G, et al. Recognition of depressive and anxiety disorders in dermatological outpatients. Acta Derm Venereol. 2004;84(3):213217. doi:10.1080/00015550410025264

19. Gieler U, Kupfer J, Niemeier V, et al. Psyche and skin: whats new? J Eur Acad Dermatol Venereol. 2003;17(2):128130. doi:10.1046/j.1468-3083.2003.00618.x

20. de Korte J, Sprangers MAG, Mombers FMC, et al. Quality of life in patients with psoriasis: a systematic literature review. J Investig Dermatol Symp Proc. 2004;9(2):140147. doi:10.1046/j.1087-0024.2003.09110.x

21. Finlay A. Psoriasis from the patients point of view. Arch Dermatol. 2001;137(3):352353.

22. Heydendael VM, de Borgie CA, Spuls PI, et al. The burden of psoriasis is not determined by disease severity only. J Investig Dermatol Symp Proc. 2004;9(2):131135. doi:10.1111/j.1087-0024.2004.09115.x

23. Vardy D, Besser A, Amir M, et al. Experiences of stigmatization play a role in mediating the impact of disease severity on quality of life in psoriasis patients. Br J Dermatol. 2002;147(4):736742. doi:10.1046/j.1365-2133.2002.04899.x

24. Gupta MA, Gupta AK. A practical approach to the assessment of psychosocial and psychiatric comorbidity in the dermatology patient. Clin Dermatol. 2013;31(1):5761. doi:10.1016/j.clindermatol.2011.11.007

25. Patruno C, Ayala F, Megna M, et al. Patient-physician relationship in patients with psoriasis. Indian J Dermatol Venereol Leprol. 2012;78(2):228. doi:10.4103/0378-6323.93657

26. Kostya M, Tabaa K, Kocur J. Illness acceptance degree versus intensity of psychopathological symptoms in patients with psoriasis. Postepy Dermatol Alergol. 2013;30(3):134139. doi:10.5114/pdia.2013.35613

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Measure of the quality of life in moderate psoriasis | CCID - Dove Medical Press

Approximately 125 million people worldwide have psoriasis. The widespread prevalence of this skin condition makes it a global health concern, which is why experts have been working rigorously to find a solution for this disease.

There is no proven cure for psoriasis, but there are some ways to treat or manage the symptoms of this disease. One solution that has been discovered recently and has become increasingly popular is CBD oils on the skin affected by psoriasis to heal and consume the CBD oil orally to help with the immune system.

Photo by Catherine Falls Commercial/Getty Images

If you have psoriasis and are looking into using CBD oil for your treatment, wondering what the possibilities of this treatment are, here is all the information you need to make up your mind and understand this new medical approach. Lets talk about the symptoms of psoriasis and how CBD oils can target them before discussing the effectiveness of CBD oils in treating psoriasis.

Psoriasis is a chronic skin condition that results from a disturbance in the autoimmune system and a rapid buildup of unnecessary skin cells. In this condition, the skin becomes inflamed, itchy, dry, and scaly it is harrowing and disruptive as the skin can crack and bleed randomly. It also impacts the body as the joints become inflamed and stiff, and the immune system is compromised.

Here are some ways in which the application and consumption of CBD oils can help treat the symptoms of psoriasis:

Experts claim that the use of CBD oils on the skin impacted by psoriasis, or even the oral consumption of a CBD oil, can help prevent the rapid buildup of skin cells. That is because CBD oils can help restore the balance in the activity of the immune system that causes this to take place.

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CBD oil will penetrate the skin to prevent the buildup on-site when applied directly to the affected area, and CBD oil consumed orally would heal the compromised immune system.

CBD is known for its anti-inflammatory properties and can help heal inflammatory skin conditions, of which psoriasis is one. CBD oils can treat inflammation in the joints and on the skin psoriasis-affected skin when applied directly. Consuming CBD oil can help fight inflammation from within and provide relief as well.

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According to Healthline, it has been proven through rigorous and thorough scientific research that CBD oils can help manage pain effectively. CBD oils react with the endocannabinoid system to block off pain receptors as much as possible and help with excessive pain. Moreover, CBD oils are known for containing relaxants, which can help you feel relaxed and calm.

CBD oil interacts with the endocannabinoid system, responsible for maintaining balance in the body and ensuring that everything functions smoothly. CBD oils react with the plan to help restore balance and help strengthen the immune system, which will help reduce psoriasis the severity of psoriasis and make the body more capable of healing itself.

Psoriasis is a severe medical condition that is often accompanied by mental health concerns like stress and depression. The consumption of CBD oils can help you mentally cope with the stress of dealing with psoriasis and help you feel more relaxed. CBD is known for its effectiveness in alleviating the mood and making a person feel better, which can help you feel low and stressed.

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The best part about using CBD oil for psoriasis? All these benefits come at no added cost as CBD oil is entirely safe, and there are no known side effects that might result from using it.

The only potential side effects you can face are drowsiness and dizziness, which are only temporary and will fade with regular use. Most people dont even experience these side effects, and they only happen in rare circumstances! CBD oil might be the best solution on the market; lets look at what makes it so effective in treating psoriasis.

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CBD is an immune system modulator and has anti-inflammatory properties. As psoriasis is a condition in which the immune system becomes compromised and functions in a way that causes the skin and joint to become inflamed, it only makes sense that CBD oil would be an effective way of countering it.

CBD is also capable of restoring balance in the body as it interacts with the endocannabinoid system in the body, which is responsible for regulating homeostasis in the body and ensuring that everything functions smoothly.

According to an article published by Cutanea, a study conducted by researchers specializing in CBD effects on the body proves that CBD oils can suppress inflammation and excessive growth of skin cells. The effectiveness of CBD for seniors and oils in treating psoriasis is unmatched.

Psoriasis is a chronic medical condition that has severe implications on an individuals physical and mental health, which is why the treatment plan has to be holistic and practical.

Out of all the possible solutions for managing the symptoms of psoriasis, the most holistic and effective one seems to be CBD oil, as it can help heal the skin affected by psoriasis directly while healing the autoimmune system as much as possible internally. Not only that, but CBD oil will also help deal with the mental implications by alleviating mood and making a person feel more relaxed. CBD oils are undeniable, effective in the treatment of psoriasis.

This article originally appeared on Green Market Report and has been reposted with permission.

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CBD Oil And Psoriasis Treatment - The Fresh Toast