Category Archives: Psoriasis

Psoriasis is often perceived as just a skin problem by many.

This chronic condition, which causes red, flaky and crusty patches covered with silvery scales on the skin, is usually considered a cosmetic or aesthetic issue.

However, consultant dermatologist Dr Chng Chin Chwen says: It can be disfiguring and disabling.

Even if it is just on the skin, for some people, it can affect their palms and soles.

If this is severe and the skin cracks, it can affect how a person walks and works, especially for those people who need to work with their hands, e.g. bakers and nurses.

She notes that for patients whose nails are significantly affected, it can even affect their ability to pick up things as their nails can be too painful to do so.

And not to mention that psoriasis can also affect the genitals of a patient you can imagine how this can affect a male patient in their marriage and their social life, she adds.

While some psoriasis patches cause no additional sensation or feeling, some can be very itchy, and even painful as mentioned above.

Some patients may also bleed easily after scratching their affected skin.

This, in addition to the constant shedding of skin flakes with uncontrolled or untreated psoriasis, can cause the patient embarrassment and might lead to stigmatisation.

Other than skin

Present at the official launch of Tremfya was (from left) Janssen senior product manager Seri Naga Leong, Dr Chin Chwen, Dr Peter and Janssen marketing head Sophia Lim.

Consultant dermatologist Dr Peter Chng points out that psoriasis is a systemic, immune-mediated, inflammatory disease.

This means that we know it is due to our immune system and it causes inflammation.

It predominantly affects the skin and joints, he says.

Psoriasis in the joints known as psoriatic arthritis can occur before skin symptoms for some patients.

Dr Chin Chwen shares: There is an old study done in 1987, which shows that one in five patients with psoriatic arthritis will have significant deformity affecting their daily function.

And if you follow up patients for 10 years, more than half of them will have five or more deformed joints.

In addition, psoriasis is associated with abdominal obesity, high cholesterol and triglyceride levels, high blood pressure, diabetes, inflammatory bowel disease (especially ulcerative colitis), cancer and venous thromboembolism, as well as lung and kidney disease.

As some of these conditions are risk factors for heart disease and stroke, this means that psoriasis patients are also at higher risk for these two conditions.

Mental health is another aspect that can be significantly impacted, potentially affecting a persons social and working or schooling life.

The visibility of the condition and public ignorance can combine to create stigmatisation of the patient.

This can in turn lead to depression, social isolation, and even suicidal tendencies, as well as seriously impacting on the patients career or studies.

The stigmatisation, the loss of work, and also schooling etc, will affect the patients heath significantly, notes Dr Chin Chwen.

Diagnosed by sight

Psoriasis is often diagnosed by examination alone.

It is actually based on, number one, appearance; number two, distribution, which means which part of the skin is involved; and also, a lot of the time, progression we need to ask the patient what the skin looked like before and after, and even better if there are photos, she explains.

Psoriasis can appear anywhere on the body, although it commonly affects the scalp, ears, elbows, knees, umbilicus, back and areas of friction like the waist where a belt rests against.

It can be classified into a number of types according to appearance.

The most common types include plaque psoriasis, which appears as thick scaly patches on the skin; erythrodemic psoriasis, which can cover up to 90% of the body in red patches; pustular psoriasis, where the affected areas are covered with pus-filled blisters or pustules; and guttate psoriasis, which appears as multiple teardrop-shaped patches.

The problem is, patients arent confined to one type of psoriasis, says Dr Chin Chwen, adding that psoriasis can change from one type to another over time.

While psoriasis can occur at any age, it typically manifests in adulthood.

Sometimes, the symptoms are triggered by a particular incident, such as stress, trauma, an infection, or overindulgence in alcohol or tobacco.

Guttate psoriasis, for example, typically occurs after an episode of streptococcal throat infection.

She adds: There are many environmental factors that can worsen psoriasis, e.g. trauma sometimes patients can have a fall and then they will develop psoriasis plaques on the site of trauma.

It is not uncommon for a patient to go for surgery and subsequently develop psoriasis plaques on the site of surgery.

Any form of stress, whether it is mental or physical, can trigger the onset of psoriasis.

She notes that while psoriasis is gene-related, the method of inheritance is complex with multiple genes involved.

The (method of) inheritance is not completely understood up to today, as every now and then, scientists discover a new gene that is associated with psoriasis.

Lifestyle and medication

While there is no cure for psoriasis, it can be controlled.Chin notes that the PsO Much More campaign is aimed at helping psoriatis patients realise they can effectively manage their disease with lasting efficacy, thus regaining their self-esteem and leading quality lives.

According to Dr Chin Chwen, the first priority is to live healthily.

Generally, a healthy lifestyle helps to control the psoriasis better.

Stop smoking; reduce or even stop alcohol; eat a better diet; do regular exercise; manage the weight, especially for those who are overweight; and wherever possible, try various methods whether its music or yoga or whatever to reduce stress.

And of course, see your dermatologist, discuss your problems and take the recommended treatments, she says.

She notes that treatment is usually tailored to each patient based on their condition and circumstances.

Individualised treatment is very important.

So we will actually treat each person based on the severity of the disease, the type of psoriasis, when the patient presented, their general health status whether the patient has diabetes, high blood pressure, etc and of course, how much the psoriasis burdens a person, she says.

She notes that: Psoriasis can burden everyone differently.

For example, a person who needs to go out, socialise and meet clients in their workplace, psoriasis involving their hand is important to them, because they have to take it out to shake hands.

For an influencer or celebrity, even a small psoriasis plaque on the face or a visible area will impact the person very much, because it will affect their work.

Treatment for psoriasis consists of topical agents, phototherapy and systemic treatments.

Topical agents are creams, ointments, soaps and shampoos, which are all applied directly onto the psoriasis patches.

According to Dr Chin Chwen, these include tar, steroids, acids, calcipotriol (vitamin D) and calcineurin inhibitors.

Meanwhile, phototherapy utilises UVA (ultraviolet A) and UVB (ultraviolet B) light, and is usually administered two to three times a week.

For systemic therapy, she shares that there are standard immunosuppressants such as methotrexate, acitretin and cyclosporine, which are given to patients with severe disease; small molecules, which are not yet available in Malaysia; and biologics.

A targeted approach

Biologics are medicines made from whole or parts of living organisms, which target a specific part of the immune system.

There are just under a dozen biologics on the market for the treatment of psoriasis, with the majority available in Malaysia.

One of the latest to be introduced here is the monoclonal antibody Tremfya, also known by its generic name guselkumab.

Tremfya is the first biologic to target and block interleukin-23 (IL-23), and is approved for use in adult patients with moderate to severe plaque psoriasis.

IL-23 is a cytokine a small protein involved in cell signalling that is involved in inflammation (to help fight invading microorganisms) and the formation of blood vessels.

Dr Peter explains that our immune system is like an army, with IL-23 being one of the messenger soldiers.

In psoriasis, he says: This IL-23 goes crazy when theres nothing and its very peaceful, it suddenly goes and tells the general that there are enemies coming and that the army needs to fight.

So the general will start asking all the soldiers to get ready and start to fight, causing a lot of inflammation.

Thus, blocking this messenger soldier will help decrease unnecessary inflammation in the body that results in psoriatic symptoms.

He notes that a number of studies have already been done on the effectiveness of Tremfya.

One study known as Voyage 1, looked at the Psoriasis Area and Severity Index (Pasi).

The results showed that 84.3% of participants had a Pasi score of 90 for up to about four years.

This means that over four out of five patients in the phase 3 clinical trial had 90% of their psoriatic patches cleared after taking the biologic.

And this was maintained for about four years with regular administration of the injectable drug.

In fact, 57.1% of patients had a Pasi score of 100, meaning that they were totally cleared of their symptoms up to four years after they first started taking the biologic.

However, Dr Peter notes that Tremfya is not a cure for psoriasis as IL-23 is only one soldier.

We know that you can capture one, but after some time, there may be another crazy soldier, so you have to continuously capture all these problematic soldiers, he says.

He adds that Tremfya has a good safety profile, especially when it comes to opportunistic diseases like tuberculosis that were a concern with older psoriasis biologics.

And one advantage to the targeted approach is that our immune system as a whole is still functional.

Which means that if a real enemy comes, you can still fight the enemy, the infection, he says.

Another advantage to Tremfya, he points out, is that it only needs to be injected once every eight weeks.

Like other recent biologics, it can also be self-administered.

As biologics are generally the most expensive of all psoriasis treatments, Johnson & Johnson Malaysia has a patient access programme to help make Tremfya more accessible to psoriasis patients.

Patients can utilise the programme via their dermatologist.

The company, which owns Janssen Pharmaceuticals that produces the biologic, has also launched the Pso Much More patient awareness programme.

Says Johnson & Johnson Malaysia managing director Chin Keat Chyuan: Through this programme, we seek to help patients better understand their medical condition and know how they may effectively manage it with clinically-proven treatment options.

The awareness programme is themed PsO Much More because psoriasis is so much more than a skin disease.

It also affects patients wellbeing from a social and psychological aspect, which is beyond skin deep.

Both Dr Chin Chwen and Dr Peter were speaking to the media at the virtual launch of Tremfya in Malaysia.

Original post:
Psoriasis Is More Than Skin Deep - The Star Online

Keep your skin moisturized throughout the day to help prevent a post-workout psoriasis flare-up.

Image Credit: FreshSplash/E+/GettyImages

Working up a good sweat during an intense bout of exercise can feel cleansing and invigorating. But if you're living with psoriasis, that post-workout endorphin rush can be overshadowed by an uncomfortable flare-up.

While you'll want to follow the specific recommendations of your doctor, you probably shouldn't cut exercise out of your day-to-day routine. After all, regular workouts can bust stress and keep your weight in check, both of which may help control psoriasis. Indeed, an October 2018 review in Cureus recommends exercise as an adjunct treatment for the skin condition.

To combat exercise-related psoriasis irritation, stick to a post-workout routine that can help soothe your sensitive skin.

How Exercise Affects Psoriasis

Generally, psoriasis shows up as dry, red patches on the skin that may itch, burn or hurt, according to Harvard Health Publishing. Like many other skin conditions, though, the severity of psoriasis varies from person to person.

It can also show up nearly anywhere on the body, including the torso, arms, legs, elbows, knees and even nails, depending on the type of psoriasis you have.

As a result, the type of exercise you do can be more or less painful for your skin, depending on where your psoriasis is located on your body, Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City, tells LIVESTRONG.com.

For instance, the chlorine in a pool can dry your skin, making it more prone to flare-ups, while running or jogging can cause your skin to rub together, causing chaffing and inflammation, particularly on your inner thighs and underarms, Dr. Zeichner says.

"When you exercise, blood vessels dilate, allowing for greater circulation of oxygen and nutrients to your muscles and skin," he says. "This may lead to redness of the skin and, in some cases, can make psoriasis more itchy."

However, that doesn't mean people with psoriasis should skip their favorite swimming or running workouts. Actually, vigorous exercise might actually help reduce the risk of psoriasis, according to an August 2012 study in JAMA Dermatology.The thinking is that people who exercise this way have less overall inflammation.

So, how can you counteract the drying effects of some workouts? The answer lies in a diligent post-workout skincare routine. Follow these three steps after each sweat session to help soothe your psoriasis flare-ups.

Your 3-Step Post-Workout Routine to Manage Psoriasis Flares

Step 1: Take a Warm Shower, and Keep It Brief

Showering too often can cause skin dryness. But if you exercise every day, that's kind of inevitable, right? Luckily, there are a few shower guidelines you can follow to help prevent your psoriasis from feeling painful, itchy or dry.

While you may love a super-hot shower after a grueling workout, keep the water lukewarm, Dr. Zeichner says. Keeping steam in the bathroom will help prevent dryness, too, so keep your bathroom door closed and avoid using a fan, recommends the American Academy of Dermatology (AAD). Also, limit your shower to five or 10 minutes.

Afterward, avoid rubbing your skin dry with your towel, Dr. Zeichner says. Instead, pat or blot your skin gently with a clean towel to avoid extra friction on your skin, especially in the areas you may have itchy or painful psoriasis patches.

Step 2: Use a Gentle Body Wash

While you're in the shower, avoid harsh cleansers, soaps or body wash products, Dr. Zeichner says. If you have any doctor- or dermatologist-recommended products, you'll definitely want to use those on your psoriasis.

If not, choose cleansers that don't dry your skin. Avoid ingredients like alcohol, alpha-hydroxy acid (AHA), retinoids and fragrance, per the AAD. These ingredients can dry out your skin's natural oils, causing more itchiness, redness or a burning feeling.

"Make sure to use a gentle, hydrating cleanser that won't strip the skin or disrupt the outer skin layer," Dr. Zeichner says.

When searching for a cleanser, look for products that have the National Psoriasis Foundation's Seal of Recognition. These cleansers have been tested and are safe to use on psoriasis.

Step 3: Apply a Hydrating Moisturizer ASAP

Once you've stepped out of the shower and dried off, apply a hydrating moisturizer on your psoriasis (and whole body, if you'd like) within five minutes post-shower, Dr. Zeichner says. This will help lock in hydration and prevent dryness.

Avoid moisturizers with fragrance or other harsh ingredients, like those noted above for body wash. Prioritize products your dermatologist or doctor recommends, then supplement with psoriasis-friendly products at your local drug store if you wish.

Look for lotions or creams that help prevent itching and repair skin, recommends the National Psoriasis Foundation. Some brands even make psoriasis-specific moisturizers that are free of harmful or harsh ingredients.

Read more:
How to Treat and Prevent a Post-Workout Psoriasis Flare-Up - LIVESTRONG.COM

What is light therapy?

Pills, creams, and invasive treatments arent the only answer to health problems. Whether youre dealing with depression or skin disorders, migraines or other chronic pain, sometimes you just need to turn to the light. Depending on the condition, there may be something along the colorful spectrum of light therapy to alleviate your symptoms and give you relief.

As anyone whos ever used a prism or looked at a rainbow knows, white light isnt really white at allits all colors of the rainbow, from red to violet. Each color is determined by the wavelength of the light, and there are even some wavelengths that arent visible to the human eye.

Some wavelengths can be damaging to human healthlike ultraviolet (UV) waves, which can harm your skin and eyeswhile others may actually be good for your health.

For example, green light therapya type of LED, or light emitting diode therapy, that doesnt contain UV raysis thought to help migraine and other chronic pain. Blue light therapy can be prescribed for acne. Red light is thought to help rejuvenate skin by minimizing wrinkles, fine lines, and other signs of aging.

Dermatologists treat skin conditions like psoriasis, eczema, and rosacea with different types of light. And light without harmful UV rays can be used to help treat seasonal depression.

Heres a look at the types of light therapy and what the science says about how they work.

When winter sets in and the days get shorter, it can feel as if someones turned the lights out on your happiness. Just convincing yourself to go out, talk to your friends, or take care of yourself in ways that would benefit your well-being can be a challenge.

If this sounds like you, its possible you might find reliefand a new energy for the seasonwith light therapy for depression.

Light therapy involves the use of light, either from sunlight or an artificial UV light source, such as a light box or therapy lamp. (Here are the 10 best light therapy lamps on Amazon.)

Also known as light treatment, phototherapy, or heliotherapy, light therapy is often used in the treatment of seasonal affective disorder (SAD). If your mood and behavior change significantly with the change in seasons, you may have SAD. A type of depression, it most often strikes in the late fall or early winter, and then lifts again with the arrival of spring. It can also happen in the reverse pattern, with depression in the summertime.

You may suspect you have winter SAD if, in addition to depression symptomslike low energy, loss of interest in activities, and feelings of hopelessness or worthlessnessyou also begin to oversleep, overeat, gain weight, and avoid social situations. Experts believe that winter SAD is brought on, in part, by reduced exposure to natural light as the days grow shorter, which may affect mood-regulating neurotransmitters like serotonin.

About one in 20 Americans get depressed in winter, says Michael Terman, PhD, professor of psychiatry at Columbia University in New York City and president of the Center for Environmental Therapeutics. Another three [in 20] feel lousy in winter but not at clinical severity. And many more feel symptoms associated with SAD, like overeating with significant weight gainwithout any decline in mood.

During light therapy, youre exposed to a bright light box daily for 30 to 45 minutes in the morning starting in the fall and continuing into the spring.

There is a wealth of research showing that people with SAD feel better with light therapy. In fact, this is the first-line treatment for SAD. Thats because light stimulates nerve fibers along the optic nerve (located in the back of your eye) and activates a particular part of your brain called the lateral habenula, which directly elicits mood elevation, says Terman.

Terman says that theyve seen rapid results in patients.

If the timing and dosing are correct from the start and do not require adjustment, we have seen relief from deep depression in just a couple of days, and most often within a week, he says. That is far quicker than antidepressant medication, which can take weeks or months to show similar results.

Light therapy might also treat non-seasonal depression. Terman points to a randomized, placebo-controlled clinical trial, published in JAMA Psychiatry in 2016. The study compared light therapy for 30 minutes per day in the early morning plus a placebo pill; fluoxetine (Prozac), an SSRI antidepressant alone; a combination of the two; or a placebo in the treatment of major depressive disorder.

Light therapy outperformed the drug by a mile, says Terman. The drug did no better than an inactive placebo. However, when the light was combined with the drug, the improvement in depression was greatest of all.

There is also evidence that bright white light therapy can help treat bipolar depression, according to a randomized double-blind placebo-controlled trial, published in 2017 in The American Journal of Psychiatry. Researchers found that nearly 70 percent who were treated with bright white light for four to six weeks experienced remission in symptoms, a reality for just 22 percent of the placebo light group. The bright light group also had lower depression scores compared to the placebo.

In addition, light therapy is also tapped to treat circadian rhythm disorders. Thats when your sleep-wake cycle is out of sync with your environment. For instance, you might go to sleep at an extremely late hour or wake up at an unusually early time. And, as a result, your daily functioning is affected.

Circadian rhythm disorders are partially treated with light exposure in the morning or at night to shift your clock, notes Lawrence Jay Epstein, MD, clinical director of the division of sleep and circadian disorders at Brigham and Womens Hospital in Boston.

The most potent form of light is sunlight, but if you need to deliver light at times when the sun is not available, then you can use a light box, he says.

Its possible to do light therapy at home, as long as you follow the rules for timing, dosing, and light box design, says Terman. There are so many products on the market, but not all will be effective. The Center for Environmental Therapeutics, which provides light box selection guidelines, suggests looking for the following: a high dosage (10,000 lux) that remains effective at a comfortable seating distance (so you dont have to put your face extremely close to the device); transparency on product specifications; and a polycarbonate UV filter, to protect eyes and skin.

A miniature light box is unlikely to be effective. These devices have not been clinically tested, says Terman.

Light therapy is not regulated by a medical society or federal standards, he adds. So unfortunately, anything goes.

The Center for Environmental Therapeutics also recommends placing the box directly in front of you and making sure the light is coming from above eye level to limit glare. The center also advises reading or eating breakfast when using the light box, which helps you keep your eyes open enough to make treatment effective.

The risks of bright light therapy include skin and eye damage. If you have preexisting medical conditions of your eyes and skin (such as diabetic retinopathy) or are taking certain photosensitizing medications, you should talk to your doctor before using light therapy.

In order to make sure that youre doing light therapy correctlywith the right dose, at the right timeits best to talk to your physician first rather than trying to determine this for yourself. You also dont want to stop medication youre currently taking to treat depression. Ask your doctor about how light therapy might fit in with your current treatment plan.

Sometimes topical creams arent enough to heal stubborn acne. Blue light therapy may be able to kill several types of common bacteria responsible for causing acne. The blue light wavelength also can slow down oil production in the sebaceous glands. Oil plugs the hair follicles, which can cause acne.

In one study published in the Journal of Drugs in Dermatology, 33 people with mild to moderate acne received blue light therapy treatment twice a day for eight weeks. They also used a cleanser before treatments and a serum each evening. More than 90 percent of participants reported improvements in their skins appearance, clarity, tone, texture, and smoothness after treatment.

Another study in the journal Drug Resistance Updates found that 77 percent of people with acne who had five weeks of blue light therapy treatment saw improvements in their skin.

Rarely is light therapy the only thing youll need to clear acne however, according to the American Academy of Dermatology (AAD). It usually works best along with a topical cream or some other treatment. Youll usually need several applications to see results.

Side effects can include temporary redness and swelling, stinging and burning. Long-term pain, blistering, and scarring is rare, but possible.

Blue light therapy typically isnt helpful for blackheads, whiteheads, acne cysts, or nodules, according to the AAD.

Red light therapy can be used on its own or in conjunction with blue light to treat acne, according to the AAD. Its not as common, however, as blue light as a solo therapy for acne.

Red light is believed to act on skin cells called fibroblasts, which help produce collagen. Collagen is the supportive protein structure in the skin that plays a role in aging.

Because of this connection, red light therapy is sometimes used in an attempt to rejuvenate skin. It can target wrinkles, fine lines, roughness, and other signs of aging.

In a study published in the Journal of Photochemistry and Photobiology B: Biology, people with facial wrinkles received varying wavelengths of red light therapy or no treatment twice a week for four weeks. Those who received red light therapy had improved measures of elasticity and fewer visible wrinkles.

In another study, published in Photomedicine and Laser Surgery, people receiving red light therapy had visible changes in wrinkles and skin roughness.

Red light therapy can also cause temporary redness, swelling, and burning. Long-term pain and scarring is also possible, but rare.

Green light therapy shows some promise for easing the pain of migraines and some chronic conditions.

In a small study published in Cephalgia in 2020, researchers recruited 29 patients with chronic or episodic migraines and exposed them to white light for two hours daily for 10 weeks as a control. After a two-week break, they exposed them to two hours of green light daily for 10 weeks.

During green light therapy, episodic migraines decreased from 7.9 to 2.4 headaches monthly and chronic migraines from 22.3 to 9.4 headache days each month.

But its not just headaches. In another study, published in Pain Medicine in 2020, 21 adults with fibromyalgia were exposed to white light daily for 10 weeks, then exposed to green light therapy. Fibromyalgia is a condition characterized by overall pain, fatigue, and sleep issues. During green light treatment, patients reported a significant reduction in pain intensity.

Studies in rats found that exposing the animals to green light seemed to decrease their levels of pain, according to a study in a 2017 issue of Pain. Researchers discovered that enkephalinsa molecule that acts as a natural pain reliever in the bodyincreased by three times in the rats when exposed to green light.

Rosacea is an inflammatory skin condition characterized by facial redness. Doctors sometimes suggest light therapy for rosacea to help ease some of the symptoms. Targeted light therapy decreases inflammation on a cellular level by promoting healing.

According to the AAD, light therapy may be an option, especially if you have visible blood vessels. Most patients see a 50 percent to 75 percent decrease in visible blood vessels after one to three treatments. Results typically last three to five years.

Theres typically redness or a rash immediately after treatment that usually fades within two weeks. You may also have pain, itching, or tightness during treatment.

In a study, published in 2020 in the journal Lasers in Surgery and Medicine, people with rosacea who had facial redness were given a form of light therapy and/or a prescription cream. Those who were treated with both the light therapy and the cream saw the greatest improvement in their redness.

Light therapy may not be as effective if your rosacea symptoms are primarily pimples or pustules (papulopustular rosacea), thickening of the skin (phymatous rosacea), or a bulbous growth around the nose (rhinophyma).

There are different types of laser therapy for rosacea including pulsed dye lasers and intense pulsed light (IPL) therapy, which use several colors of light at once.

Different wavelengths of UV light may be a treatment for eczema and psoriasis. Eczema is an umbrella term for a group of skin conditions noted for itchiness, redness, and rashes. Psoriasis is a common skin condition that causes scales and itchy, dry patches.

Phototherapy uses different wavelengths of UV light targeted to treat itchiness and redness and other symptoms. Because UV rays can be harmful to skin, its important that you follow a short-term treatment plan under the care of a health care professional.

For eczema, dermatologists most commonly will use narrowband ultraviolet B (NB-UVB) light, according to the National Eczema Association. Other options may include ultraviolet A (UVA) light.

Researchers arent sure exactly how UV therapy works but it reduces inflammation in the skin, having an impact on the immune system, reports the National Eczema Society. To have an effect, it takes several weeks of treatments at least 2-3 times per week to show an improvement. Once your skin is nearly clear and/or itching has stopped, your dermatologist will reduce the frequency of treatments gradually.

Phototherapy is used with adults or children who have moderate to severe eczema that isnt responding to standard treatments like steroids and topical creams. Side effects may include temporary redness and dryness. Long-term use can result in accelerated aging and an increased risk of skin cancer and cataracts.

UV light therapy can be prescribed by dermatologists for psoriasis to slow skin cell growth, reduce inflammation, ease itching, and suppress immune system activity, according to the AAD. The excimer laser, which offers narrowband UVB light, has been approved by the Food and Drug Administration (FDA) for treating chronic, localized psoriasis plaques, reports the National Psoriasis Foundation. It may be safely used on many parts of the body including elbows, knees, scalp, ears, armpits, and the groin.

Phototherapy is typically given 2-3 times a week for several weeks in order to be effective. UV therapy is most often prescribed for mild to moderate psoriasis and has been found to be particularly effective for scalp psoriasis.

It can cause short-term redness, burning, and itching. Long-term use can lead to aging, cancer, and freckles.

Here are stories of people who used light therapy to treat a variety of conditions:

Avoid Seasonal Affective Disorder

Signs of Seasonal Affective Disorder

I Used a Light Therapy Lamp

The post What Is Light Therapy? How Light Can Heal a Variety of Health Problems appeared first on The Healthy.

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What Is Light Therapy? How Light Can Heal a Variety of Health Problems - AOL

Newswise In a major register-based study, scientists at University of Gothenburg, Sweden, have now demonstrated a connection between inferior physical fitness in young adults and elevated risk of the autoimmune disease psoriasis. For the male recruits to compulsory military training who were rated as the least fit, the risk of developing psoriasis later was 35 percent higher than for the fittest.

The study was based on data on more than 1.2 million men conscripted, aged 18, into the Swedish Armed Forces between the years 1968 and 2005. During the enrollment process, all these young men underwent the same fitness test on an exercise bicycle. The researchers divided the data, according to how fit the men were, into three levels (low, medium, and high fitness). They then merged the data with other registers, using Sweden's National Patient Register to obtain diagnostic codes for psoriasis and the joint disease psoriatic arthritis. The men who had already received one of these diagnoses before conscription were excluded from the study.

Later in life, between the ages of 37 and 51, just over 23,000 of the conscripts developed psoriasis or psoriatic arthritis. In the low-fitness group, 2.5 percent developed one or both of these diseases, while only 1.7 percent in the high-fitness group did so. In calculating this risk differential, the scientists adjusted for other risk factors, such as body mass index (BMI).

Association not causal

Thus, the less fit the men were when they were recruited, the higher the proportion of them who later fell ill with psoriasis or psoriatic arthritis. In the low-fitness group, the risk of developing psoriasis was 35 percent higher, and that of developing psoriatic arthritis 44 percent higher, than in the high-fitness group.

"We show that there's an association between lower fitness and raised risk of developing psoriasis and psoriatic arthritis, but we don't show a causal connection. So we can't say that these health conditions can be prevented by exercising," says the study's first author Marta Laskowski, a doctoral student in dermatology at the University of Gothenburg and resident physician (specialist trainee) at Sahlgrenska University Hospital.

Group in need of monitoring

The group of men who were least fit was also the smallest: just under 48,000 or 3.9 percent of all the conscripts in the study. This is a group that healthcare services should try to monitor regularly.

"Low fitness was already known to boost the risk of incurring cardiovascular disease, and psoriasis as such is linked to raised cardiovascular disease risk, too. The results from our study confirm the reasons for assessing people's fitness early in life, to identify individuals at a higher risk for adverse health outcomes later in life," Laskowski says.

Previous research has indicated that, in general, people with psoriasis are less fit than those without it who engage in an equal amount of physical activity. However, the reasons for this difference have not been fully clarified.

"One weakness of our study is that we weren't been able to monitor the trends of the men's fitness during the intervening years, between their conscription and the disease onset. We're also lacking data on smoking, which is a known risk factor for psoriasis," Laskowski explains.

Scaly skin patches

Some 300,000 Swedes have psoriasis in a mild, moderate, or severe form. It is a chronic, systemic inflammatory disease that affects women as often as men. What triggers its onset is not entirely clear, but heredity is known to play a large part in combination with external factors. The most common type, plaque psoriasis, causes reddened, flaking, and itchy skin lesions ("plaques").

Psoriasis sufferers also often have other diseases. Some 30 percent get the inflammatory joint condition known as psoriatic arthritis. Examples of other known comorbidities are obesity, cardiovascular disease, diabetes, and depression.

In recent years, treatment options have substantially improved. Today, besides ointments with local effects, there are drugs that have systemic effects. Recent years have also seen the emergence of efficacious biological agents that modulate the signaling cascade in the inflammatory process that drives psoriasis.

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Low fitness linked to higher psoriasis risk later in life - Newswise

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Product spectrum

Application arena

Regional analysis

Competitive landscape

To conclude, the report has meticulously assessed the Psoriasis Drugs Industry market through multiple segments, with a deep-dive investigation of facets including the sales channel & supply chain along with specifications pertaining to upstream suppliers, downstream buyers, raw materials, and distributors.

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Psoriasis Drugs Industry Market size and Key Trends in terms of volume and value - Business-newsupdate.com

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Amgen is partnering with Ann Arbor, Michigan-based EVOQ Therapeutics for a license and collaboration deal to discover and develop drugs for autoimmune disorders. Amgen is paying EVOQ $240 million up front in addition to royalties on subsequent sales.

EVOQs focus is on autoimmune diseases, although its original intent was targeting oncology. It is a spinoff from the University of Michigan (U of M) in 2016. It was co-founded by James Moon and Anna Schwendeman, both from U of M. Moon is the chief scientific officer and Schwendeman is the vice president of preclinical development. William Brinkerhoff is also a co-founder and acts as the chief executive officer. Their technology platform is called NanoDisc, a high-density lipoprotein platform, that they believe can be used to deliver peptides directly into the lymph nodes.

The two companies will work together to use dendritic cells to develop immune tolerance. The companys in-house pipeline includes two compounds that target MOG antibody disease, a new condition that results in neuro-spinal swelling and is typically misdiagnosed as multiple sclerosis (MS), and type 1 diabetes.

A big driver of Amgens autoimmune portfolio is Otezla (apremilast). Amgen acquired Otezla for moderate-to-severe plaque psoriasis and psoriatic arthritis in November 2019 from Celgene. Bristol Myers Squibb acquired Celgene, but was forced by the U.S. Securities and Exchange Commission (SEC) to divest Otezla because of a competing product in their pipeline, deucravacitinib (BMS-986165). In fact, in November 2020, deucravacitinib beat out Otezla in the POETYK PSO-1 Phase III clinical trial in one of the key secondary endpoints. The drug otherwise hit the co-primary endpoints on psoriasis.

Amgen paid $13.4 billion in cash for access to Otezla, which is approved in the U.S. for moderate-to-severe plaque psoriasis patients who are candidates for phototherapy or systemic therapy; adults with active psoriatic arthritis; and adults with oral ulcers associated with Behcets disease. The drug is approved in more than 50 markets outside the U.S. and has patent protection through at least 2028 in the U.S. In 2018, Otezla sales were $1.6 billion.

In other news, Amgen announced new data from its oncology pipeline in lung cancer will be presented at the 2020 World Conference on Lung Cancer (WCLC) from January 28-31, 2021. That will include Phase II data from the CodeBreaK 100 clinical trial of sotorasib in KRAS G12C-mutated advanced non-small cell lung cancer (NSCLC). They will also describe updated Phase I data from AMG 757, a first-in-class BiTE molecule that targets delta-like ligand 3 (DLL3) in small cell lung cancer (SCLC).

We are incredibly excited to present the first complete Phase II non-small cell lung cancer data set for an investigational KRAS G12C inhibitor, including novel biomarker analyses, said David M. Reese, executive vice president of Research and Development at Amgen. This is an historic moment not only for us, but for the scientific community working on the 40-year quest to target KRAS, one of cancer researchs toughest challenges. Additionally, following recent regulatory submissions to the FDA and European Medicines Agency, we remain focused on rapidly bringing this potential foundational KRAS G12C therapy to patients with advanced non-small cell lung cancer harboring this mutation.

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Amgen Inks $240 Million Autoimmune Deal with Tiny EVOQ Therapeutics - BioSpace

This article was originally published here

J Am Acad Dermatol. 2021 Jan 7:S0190-9622(21)00016-5. doi: 10.1016/j.jaad.2020.12.058. Online ahead of print.

ABSTRACT

OBJECTIVE: To update guidance regarding the management of psoriatic disease during the COVID-19 pandemic.

STUDY DESIGN: The task force (TF) includes 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care. The TF was supplemented by non-voting members, which included fellows and National Psoriasis Foundation (NPF) staff. Clinical questions relevant to the psoriatic disease community were informed by inquiries received by the NPF. A Delphi process was conducted.

RESULTS: The TF updated evidence for the original 22 statements and added 5 new recommendations. The average of the votes was within the category of agreement for all statements, 13 with high consensus, 14 with moderate consensus.

LIMITATIONS: The evidence behind many guidance statements is variable in quality and/or quantity.

CONCLUSION: These statements provide guidance for the management of patients with psoriatic disease on topics ranging from how the disease and its treatments impact COVID-19 risk, how medical care can be optimized during the pandemic, what patients should do to lower their risk of getting infected with SARS-CoV-2 (including novel vaccination), and what they should do if they develop COVID-19. The guidance is a living document that is continuously updated by the TF as data emerge.

PMID:33422626 | DOI:10.1016/j.jaad.2020.12.058

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National Psoriasis Foundation COVID-19 Task Force Guidance for Management of Psoriatic Disease During the Pandemic: Version 2 - Advances in Psoriatic...

BALLERUP, Denmark--(BUSINESS WIRE)--LEO Pharma A/S a global leader in medical dermatology announced today that the first patient has been screened in the first head-to-head clinical trial to evaluate brodalumab (marketed in the European Union as Kyntheum) compared with guselkumab (marketed globally as Tremfya) in adult patients with moderate-to-severe plaque psoriasis who have an inadequate response to ustekinumab (marketed globally as Stelara) treatment.

The COBRA (COmparing BRodalumab And guselkumab in ustekinumab inadequate responders) clinical trial is a randomized, double-blind, parallel-group, multinational study. The primary study endpoint is the proportion of patients who achieve PASI 100 (100% skin clearance) at week 16. The study further includes several secondary and exploratory endpoints, including the key secondary endpoint of time to PASI 100 response while on treatment for up to 28 weeks. PASI scores are used in clinical trials for psoriasis treatments to measure a change in disease severity.

People with moderate-to-severe psoriasis benefit from complete skin clearance, said Prof. Kristian Reich, Professor for Translational Research in Inflammatory Skin Disease at the University Medical Center Hamburg Eppendorf. We have specifically designed this study to help understand which newer mechanism of action is the best option to help patients potentially achieve complete skin clearance when there is an insufficient response to older-generation biologics.

Brodalumab is the only biologic treatment that selectively targets the interleukin-17 (IL-17) receptor subunit A.1 The IL-17 cytokines a family of proteins involved in immune responses send signals through the IL-17 receptors, which cause the inflammation associated with psoriasis.2

Guselkumab is a biologic treatment that selectively targets the interleukin 23 (IL-23) cytokine. IL-23 affects the differentiation, expansion, and survival of T cell subsets and innate immune cell subsets, which represent sources of effector cytokines, including IL-17A, IL-17F and IL-22 that drive inflammatory disease.3

We look forward to learning how brodalumab, in comparison with a treatment that targets the IL-23 pathway, can offer benefits to patients who no longer respond to less targeted therapies, said Dr. Per Sproegel, Vice President, Medical Sciences, Global Research & Development, LEO Pharma.

#ENDS#

NOTES TO EDITORS

About the pathophysiology of psoriasis

Psoriasis is the result of skin barrier cell proliferation and the activation of cytokines (a family of proteins involved in immune responses) that cause inflammation.4 The discovery of the central role of the IL-23/type 17 T-cell axis in the development of psoriasis has led to major paradigm shifts in the pathogenic model for this condition.4 Medical research has further confirmed that the expression of IL-17 cytokines is increased in psoriatic lesion tissue.5

About LEO Pharma

The company is a leader in medical dermatology with a robust R&D pipeline, a wide range of therapies and a pioneering spirit. Founded in 1908 and owned by the LEO Foundation, LEO Pharma has devoted decades of research and development to advance the science of dermatology, setting new standards of care for people with skin conditions. LEO Pharma is headquartered in Denmark with a global team of 6,000 people, serving 92 million patients in 130 countries. For more information about LEO Pharma, visit http://www.leo-pharma.com.

References

1 Campa M et al. Dermatol Ther 2016;6:112.

2 Armstrong A et al. J Drugs Dermatol 2019;18(8 Suppl 2):s202-208.

3 Tremfya Summary of Product Characteristics January 2020. Available at: https://www.ema.europa.eu/en/documents/product-information/tremfya-epar-product-information_en.pdf (Accessed September 2020).

4 Hawkes JA et al. J Allergy Clin Immunol. 2017;140:64553.

5 Martin D et al. J Invest Dermatol 2013;133(1):17-26.

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LEO Pharma initiates head-to-head study to evaluate brodalumab vs. guselkumab in adult patients with moderate-to-severe psoriasis who have inadequate...

If you can identify leading companies in growing industries, you'll be well on your way to finding stocks that will bolster your portfolio's value. Beyond that, it helps to pick companies that have investor-friendly policies -- not to mention favorable tailwinds or upcoming catalysts for growth.

In that vein, after an excellent 2020, the pharma company AbbVie (NYSE:ABBV) is positioned for an encore performance in 2021. Its quarterly revenue is growing faster than 52% year over year, and the company is strongly profitable thanks to its collection of in-demand immunology and rheumatology therapies. But despite three green flags for the upcoming year, it also has one looming red flag that future investors absolutely can't miss if they want to make an informed decision about buying shares. Let's dive in and take a look at what's coming up.

Image source: Getty Images.

Rinvoq, one of AbbVie's drugs for rheumatoid arthritis, is already on the market. But in 2021, it may be approved for as many as three new indications, thereby increasing its pool of potential patients and its revenue-making potential, too.

AbbVie is currently awaiting regulatory review of its evidence that Rinvoq is effective for psoriatic arthritis, atopic dermatitis, and ankylosing spondylitis. The potential approval for atopic dermatitis is especially important, as it would mean that the company could serve a new market that it currently has no presence in.

Sometime this year, AbbVie will provide an update from Skyrizi's phase 3 clinical trial for Crohn's disease. If this update is favorable, it'll mean that the company is continuing to see success with its efforts to build out its immunology pipeline by seeking new indications of its established assets. Given that the global market for Crohn's disease therapeutics was estimated to be worth $14.1 billion in 2020, the company could potentially look forward to a slice of the market share moving forward.

The bigger picture here is that advancing rapidly with Skyrizi will help AbbVie replace revenue from Humira, the decline of which has loomed for years. Right now, Skyrizi is already approved for psoriasis, and there are ongoing clinical trials to examine its effectiveness for ulcerative colitis and psoriatic arthritis. If it's ultimately approved for those indications, it'd be capable of serving the majority of the markets addressed by Humira.

AbbVie's drug Humira for rheumatoid arthritis is its largest earner, netting the company an estimated $16 billion from its U.S. sales in 2020 alone. And management expects domestic revenue from Humira to keep expanding in 2021, even as it faces rising competition from biosimilars.

Another way of looking at this green flag is that biosimilars haven't eroded Humira's market share as rapidly as many people had expected. Therefore, AbbVie has a bit more time before sales from Humira fall off the cliff. So investors can have a measure of confidence that AbbVie won't need to take defensive financial actions like curbing its dividend anytime soon.

Even though AbbVie is still seeing revenue growth from Humira in the U.S., the same is not true when it comes to international sales. Continuing a trend that started with gusto in 2018 when Humira lost patent exclusivity in Europe, biosimilars will erode Humira's market share throughout 2021 outside the U.S., with management estimating a sharp drop of 45% this year.

In dollar values, this means that after making $3.7 billion in international sales in 2020, this year Humira could make as little as $1.5 billion. That's going to leave a small but noticeable dent in the company's trailing 12-month revenue of $40.65 billion. But if it succeeds in getting its other immunology projects to pick up its market share where Humira leaves off, its stock price could still be secure for the time being.

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3 Green Flags for AbbVie in 2021 and 1 Red Flag - The Motley Fool

James Woody, CEO of180 Life Sciences, pictured above. Photo courtesy of 180 Life Sciences.

Despite a storied career in drug design that has spanned multiple decades, James Woody believes there is still a significant amount of work left to be accomplished with the development of tumor necrosis factor (TNF) inhibitor biologics.

Im excited about developing novel therapies for patients and Im also excited about just discovering things, Woody said in an interview with BioSpace ahead of the virtual J.P. Morgan Healthcare Conference.

Woody, who now serves as chief executive officer of 180 Life Sciences, began his career in drug development as the chief scientific officer and head of research and development at Centocor Biotech, now a part of the Johnson & Johnson family.

During his time at Centocor, Woody led the team responsible for developing Remicade, the first of the TNF inhibitor biologics, which has gone on to become a blockbuster drug with sales of $5 billion in 2019.

Woody was also the founding CEO of OncoMed Pharmaceuticals, Inc. and served as president at Roche Bioscience, where he was responsible for all bioscience research and development, ranging from genetics and genomics to clinical development of numerous new pharmaceuticals.

TNF inhibitors, such as Remicade, are used to stop inflammation. They are popular treatments in disease like rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, ankylosing spondylitis, ulcerative colitis (UC) and Crohn's disease.

Woody said spaces like RA are pretty well covered, but noted there are other areas where this type of medication could benefit millions of people, such as early Dupuytren's contracture, a fibrotic disease of the hand. There are approximately 11 million people in the United States, including Woodys wife, and a similar number in Europe who are afflicted with this painful condition that can cause the hand to curl up into a claw.

180 Life Sciences is currently assessing its TNF inhibitor in a Phase II/III program. Results from this study are expected in the second half of this year. Obtaining results from the ongoing study have been delayed due to the COVID-19 pandemic, Woody said.

Another space 180 is assessing its anti-TNF program is in frozen shoulder, a condition characterized by stiffness and pain in the shoulder joint. Woody said this is an extremely painful condition due to fibrosis in the shoulder joint. They believe the fibrosis process is similar to what has been seen in early Dupuytren's contracture and will assess the companys anti-TNF asset during a study expected to begin in the third quarter of this year.

The third area for 180s anti-TNF program is in post-operative cognitive delirium disorder and dysfunction. This issue arises in older patients who have been under anesthesia for an extended period of time due to some surgical procedures. After the surgery or during the surgery, TNF can be released, which is a cause of dementia, Woody said. The company believes its program can be useful to prevent this condition and will conduct a study using their novel concepts.

In addition to those three areas, Woody said the company is also looking at nonalcoholic steatohepatitis (NASH) as a potential area for its anti-TNF therapy. NASH has been a difficult area for drug developers to crack, but Woody believes his team has found a new approach. Using human tissue from surgeries, 180 Life Sciences research team has been examining the pathways of damage in the liver and they believe a release of TNF plays a role in that damage.

We think we can block that. We definitely need some therapies for NASH, thats for sure, Woody said.

180 Life Sciences also has some interesting programs in preclinical development. The company has a program using pharmaceutical-grade oral synthetic cannabidiol analogs to treat pain that is specifically focused on arthritis. Woody expects this asset to enter the clinic next year. 180 Life Sciences also has an 7 Nicotinic Acetylcholine receptor agonist program, which aims to develop 7nAChR agonists for the treatment of inflammatory diseases, initially ulcerative colitis induced after cessation of smoking.

One of the co-developers of Remicade, Sir Marc Feldmann, a pioneer in anti-TNG therapies, is also part of Woodys team at 180 Life Sciences. Feldmans research helped lead to not only the development of Remicade, but it was also licensed by AbbVie to develop Humira, Woody said. Feldman is intimately involved in the development of two of the three projects being developed by 180 Life Sciences, and is also exploring new uses of anti-TNF and synthetic cannabidiol analogues. Feldman serves as co-chairman of the companys board of directors.

Feldman isnt the only noted researcher to join with 180 Life Sciences. Lawrence Steinman, a professor of Neurology and Pediatrics at Stanford University, whose research led to the development of multiple sclerosis drug Tysabri, serves as co-chairman of the companys board of directors.

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180 Life Sciences Poised to Break Ground with Anti-TNF Program - BioSpace