Category Archives: Psoriasis

Psoriasis, an autoimmune disease, affects about 7.5 million people in the United States.

Psoriasis is a disease that causes plaques, which are itchy or sore patches of thick, red, dry skin.

While any part of your body can be affected, psoriasis plaques most often occurs on the elbows, knees, scalp, back, face, palms, and feet.

Like other autoimmune diseases, psoriasis occurs when your immune system which normally attacks infectious germs begins to attack healthy cells instead.

According to the American Academy of Dermatology, about 7.5 million people in the United States have psoriasis, with the disease affecting Caucasians more than any other race.

The disease occurs about equally among men and women.

People with psoriasis generally see their first symptoms between 15 and 30 years of age; however, developing the disease between 50 and 60 years of age is also common.

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

For some, psoriasis can clear up for months or even years at a time. This is known as remission.

Others experience psoriasis flares (or flare ups) in cyclical patterns; for instance, the disease will improve in the summer and worsen in the winter.

Psoriasis flares can be triggered by:

Stress: Stress is a major trigger for some people with psoriasis, either causing psoriasis to flare up for the first time or to make it worse after youve been diagnosed.

According to the National Psoriasis Foundation, a study of people who used light therapy for psoriasis found that listening to relaxation tapes during the therapy may help clear a psoriasis flare faster.

Cold weather: A trip to the Caribbean might be a good idea during the winter months if you have psoriasis and live in a cold climate,because the suns ultraviolet light turns off the skins immune system, which is overactive in people with psoriasis.

Dry skin: Anything that injures the skin can cause a psoriasis flare, including excessively dry skin.

The solution: Keep your skin moisturized. If youre allergic to the fragrances in moisturizers, use a product thats fragrance-free to avoid a rash.

Vaccinations: As with dry skin, puncturing the skin during a vaccination may cause a psoriasis flare, but thats no reason to skip a needed shot.

One thing to keep in mind: If youre on a potent psoriasis medication that suppresses your immune system (such as a biologic treatment), you shouldnt take a live vaccine. Your body may not be able to fight off a live virus because of the medication youre taking.

In that case, ask your doctor for a vaccine that contains a deactivated virus.

Beta blockers and lithium: Beta blockers to treat high blood pressure or lithium for a mental disorder can make psoriasis worse.

If you have high blood pressure, your doctor may be able to switch your medication to another drug that wont affect your psoriasis.

If youre taking lithium, your dermatologist may consider having you try light treatment or a topical therapy for psoriasis.

Upper-respiratory infections: Colds and other infections, especially strep throat, activate the immune system and can cause psoriasis to flare.

If you have psoriasis and develop a sore throat, get it treated and be sure to have a culture taken to check for strep. Long-term antibiotics may be an option for someone who has psoriasis and frequent sore throats.

Smoking: Theres some evidence that smoking can make psoriasis worse.

Diet: Studies havent shown any beneficial effects of taking nutritional supplements for psoriasis, but avoiding certain foods may reduce inflammation and help your psoriasis.

Additionally, studies have shown that many people with psoriasis may also have a gluten sensitivity, and eating a gluten-free diet can help reduce psoriasis symptoms.

In general, if you find that a certain food makes your psoriasis worse, try to avoid it.

Alcohol: For some people with psoriasis, having more than one or two drinks a day has been shown to cause psoriasis flares but the association is not a strong one. Flares from alcohol use could also be linked to psychological stress.

There are five types of psoriasis, yet people most often have only one type of psoriasis at a time. Each type has its own set of symptoms.

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

Plaque psoriasis (also called psoriasis vulgaris) is the most common form. It appears as raised, red patches covered with a silvery white buildup of dead skin cells or scale.

The itchy, painful patches can crack and bleed, and commonly affect the scalp, knees, elbows, and lower back.

Guttate psoriasis often begins in childhood or young adulthood and is the second most common type of psoriasis.

Nearly 10 percent of people who get psoriasis develop guttate psoriasis, reports the National Psoriasis Foundation (NPF).

Inverse psoriasis, also known as intertriginous psoriasis, causes red lesions in folds of the body that may look smooth and shiny.

These lesions can occur on the genitals or areas near the genitals like the upper thighs and groin.

It's common for people with inverse psoriasis to have another type of psoriasis somewhere else on their body at the same time.

Pustular psoriasis causes white blisters of pus that surround red skin. The pus consists of white blood cells.

When pus-filled bumps cover the body, you may have bright-red skin and feel ill, exhausted, have a fever, chills, severe itching, rapid pulse, loss of appetite, or muscle weakness.

Erythrodermic psoriasis is a dangerous and rare form of the disease characterized by a widespread, fiery redness and exfoliation of the skin that causes severe itching and pain.

This type of psoriasis occurs once or more in 3 percent of people with psoriasis, according to the NPF.

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Psoriasis Triggers & Types | Everyday Health

Symptoms

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

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

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

There are several types of psoriasis. These include:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Psoriasis - Symptoms and causes - Mayo Clinic

Like many other conditions, a one-size-fits-all therapy does not apply to patients with plaque psoriasis. Now, there is another treatment option for those not responding to current available therapies.

Janssen Biotech, Inc., a division of Johnson & Johnson, has announced U.S. FDA approval of guselkumab (Tremfya) for the treatment of moderate to severe plaque psoriasis.

Approval comes after an expedited regulatory review following application of an FDA Priority Review Voucher. Its the first drug approved that selectively blocks interleukin (IL)-23, a cytokine thought to play a role in the disease.

The treatment is administered as a 100 mg subcutaneous injection every eight weeks, following two starter doses at weeks 0 and 4. It is indicated for adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

Regulators made the approval based on results from Phase III clinical studies that included more than 2,000 patients. The VOYAGE 1, VOYAGE 2, and NAVIGATE studies showed 7 out of ten patients receiving the treatment achieved at least 90 percent improvement in skin clearance at week 16.

The VOYAGE 1 AND VOYAGE 2 trials tested guselkumab against placebo and adalimumab (Humira).

Patients receiving guselkumab experienced significant improvement in skin clearance and greater improvement in symptoms of plaque psoriasis including itch, pain, stinging, burning and skin tightness when compared with placebo at week 16.

In a head-to-head analysis against adalimumab, more than seven out of ten patients treated with guselkumab reported at least 90 percent clearer skin at week 24 compared with more than four out of ten patients treated with adalimumab.

NAVIGATE findings demonstrated the effectiveness of guselkumab in patients who had an inadequate response to treatment with J&Js IL-12 and IL-23 antagonist ustekinumab (Stelara). At week 28, 31 percent of guselkumab-treated patients were considered cleared or almost cleared versus 14 percent of ustekinumab-treated patients 12 weeks after randomization to continue ustekinumab or transition to guselkumab.

Tremfya represents a significant milestone in the treatment of moderate to severe plaque psoriasis as evidenced by the proven skin clearance demonstrated in the majority of study patients receiving this IL-23specific therapy at week 16 and up to week 48," said Andrew Blauvelt, M.D., M.B.A., President of Oregon Medical Research Center, and study investigator in the companys announcement. "We continue to make progress in understanding the science of psoriasis and the important role IL-23 plays in the pathogenesis of this disease, which is another reason why today's approval of Tremfya is exciting, both as a researcher and a practicing dermatologist."

"The approval of new and effective treatment options is always welcome news for the plaque psoriasis patient community, as not all patients respond similarly to currently available treatments," said Michael Siegel, Ph.D., Vice President of Research Programs for the National Psoriasis Foundation in a statement from Janssen. "For the more than one million Americans living with moderate to severe plaque psoriasis, the approval of Tremfya is a meaningful addition and offers physicians and patients an effective new, first-in-class therapy that selectively inhibits IL-23."

There is an ongoing Phase III study evaluating guselkumab as a treatment for active psoriatic arthritis and a Phase III trial evaluating efficacy compared to secukinumab (Cosentyx) for moderate to severe plaque psoriasis.

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J&J's New Psoriasis Drug Approved by FDA - Drug Discovery & Development

The Food and Drug Administration has granted US market approval to Janssen Biotech/MorphoSys IL23 blocker guselkumab (Temfya) as therapy for moderate to severe psoriasis.

The authorisation triggered an milestone payment from Janssen Biotech, Inc. to MorphoSys AG (Martinsried, Germany), which had discovered and licenced the first ever approved IL23-blocking antibody to treat moderate to severe plaque psoriasis to the US company. The approval of the immunosuppressive antibody, which will be sold under the tradename Tremfya, comes after an expedited regulatory review following application of an FDA Priority Review Voucher.

In the pivotal studies VOYAGE 1 and VOYAGE 2, the subcutanously administered antibody proved to be superior to standard of care (adalimumab) in PASI 90 after 16-48 weeks of treatment. Improvements were also demonstrated in psoriasis involving the scalp and in symptoms of plaque psoriasis including itch, pain, stinging, burning and skin tightness at week 16. MorphoSys announced its partner Janssen will commence marketing of the drug in Q3/2017.

Psoriasis is a chronic skin disorder characterised by epidermal hyperproliferation and dermal inflammation that vary in severity. It affects about 23% of the global population, making it one of the most prevalent autoimmune diseases worldwide, and can be associated with other inflammatory conditions, such as psoriatic arthritis, inflammatory bowel disease and coronary artery disease.

GlobalData estimates the psoriasis market to grow from currently US$7.5bn to US$13.3bn by 2024. GlobalDatas analyst Nikhilesh Sanyal predicts that recently approved immunosuppressive antibody drugs such as guselkumab or Eli Lillys IL-17 blocker ixekizumab annual sales might exceed US$1bn. However, the psoriasis market is crowded, with other biologics such as Sun Pharmas IL23p19 blocker tildrakizumab and AstraZeneca/Valeants (NYSE: VRX) brodalumab, which, however, had been linked to suicidal thoughts. Furthermore, outgoing patent protection for J&Js infliximab, Abbvies adalimumab, and Amgens etanercept has triggered development of several biosimilars, which may come with a significant pricing advantage.

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Psoriasis: FDA approves guselkumab - European Biotechnology

FDA Approves Tremfya for Moderate to Severe Plaque Psoriasis P&T Community The FDA has approved guselkumab (Tremfya, Janssen Biotech) for the treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy. Tremfya is the first approved biologic therapy that selectively ...

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FDA Approves Tremfya for Moderate to Severe Plaque Psoriasis - P&T Community

Scalp psoriasis is a common skin disorder that causes raised, reddish, scaly patches on the scalp and can extend beyond the hairline onto the forehead, the back of the neck and around the ears. It can vary from being very mild and unnoticeable, with slight fine scaling, or very severe with thick crusted plaques covering the entire scalp.

Dr Conal Perrett, dermatologist and founder of the Devonshire Clinic and one of London Medical Concierge's network of doctors, answers your questions on scalp psoriasis.

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As with other types of psoriasis, we don't know what causes it and ongoing research is being done to try and identify why it occurs. Doctors believe it comes from a deficiency within the immune system that causes skin cells to grow too quickly and build up into patches. You may be more likely to get scalp psoriasis if it runs in your family.

Scalp psoriasis is not contagious but it is incredibly uncomfortable, itchy and can cause confidence issues in many people.

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Are we ignoring the psychological impact of skin conditions?

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Symptoms of mild scalp psoriasis may include only a light fine scaling. Whereas, moderate or severe scalp psoriasis symptoms can include:

Sometimes it can be difficult to distinguish between dandruff and scalp psoriasis as they both have similar symptoms. You may be able to tell by the thickness and colour of the flakes but if you are in any doubt and think your dandruff may indicate scalp psoriasis scaling then I would advise speaking with your GP.

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What your skin says about your health

There are many treatment options, such as lotions, creams and shampoos, which can help scalp psoriasis and often a combination approach using a number of different treatments may be required until the symptoms have settled. It is important to remember to treat scalp psoriasis even if you experience hair loss, as the hair will grow back once the inflammation settles.

Treatments can be time-consuming so I would recommend choosing one that suits your lifestyle and carrying out extensive treatments over the weekend. Remember to treat psoriasis daily when it is active. It can take at least eight weeks until you are able to gain adequate control of the plaques, whichever treatment you choose to use.

Once you have achieved clearance, it is important to maintain the improvement, and this can usually be done with regular use of a tar shampoo and or by moisturising the scalp occasionally with an oil or emollient. If you have no success in controlling your scalp psoriasis, ask your GP to refer you to a specialist.

Visit http://www.londonmedicalconcierge.com for more information on how you can get quick access to an appointment with a leading dermatologist to discuss any skin concerns.

Related Article

8 ways to manage psoriasis

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A dermatologist reveals the best way to deal with scalp psoriasis - Netdoctor

BSA bureau

FDA Approves Tremfya for Moderate to Severe Plaque Psoriasis ... Managed Care magazine The FDA has approved guselkumab (Tremfya, Janssen Biotech) for the treatment of adults with moderate to severe plaque psoriasis who are candidates for ... FDA actions on psoriasis, alopecia top dermatology reads for weekHealio U.S. FDA approves Janssen's TREMFYA for the treatment of ...BSA bureau (press release) all 4 news articles »

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FDA Approves Tremfya for Moderate to Severe Plaque Psoriasis ... - Managed Care magazine

People with psoriasis will have a new treatment option for the itchy, sometimes painful condition, after the federal Food and Drug Administration approved a new psoriasis drug.

The FDA approved Tremfya for treatment of moderate to severe plaque psoriasis.

Johnson & Johnson said that, in one patient study, about seven in 10 patients getting Tremfya had clear or nearly clear skin after 24 weeks of treatment.

That compares with about four in 10 patients receiving rival AbbVies Humira, which treats several immune disorders and is the worlds top-selling drug. AbbVie is based in North Chicago.

The drug, which has the chemical name guselkumab, will cost $9,684 per dose, or about $58,100 per year, without insurance. Thats comparable to Humira, which costs about $59,200 a year.

Tremfya, which is injected every eight weeks, can cause infections and other serious side effects. Because it suppresses part of the immune system, it can increase the risk of developing tuberculosis and some types of cancer.

More than 7.5 million Americans are estimated to have psoriasis, a chronic inflammatory condition in which overproduction of skin cells causes raised red lesions called plaques, along with frequent pain, itching and burning sensations. Tremfya was able to both clear up lesions and help relieve those symptoms.

Johnson & Johnson, based in New Brunswick, New Jersey, sells other immune disorder treatment such as Remicade and Stelara for conditions including Crohns disease, ulcerative colitis and rheumatoid arthritis.

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People with psoriasis will have new treatment option instead of Humira - Chicago Sun-Times

Psoriasis is unpredictable, infuriating and among the most perplex skin disorders. It is a condition in which your skin cells start multiplying at a rate ten times faster than the normal one. When the underlying cells skin cells move towards the surface of the skin and die, they cause red plaques all over the skin due to their sheer volume.

About 7.5 million people are said to get affected by psoriasis in America. Not only does this disease harm the skin, it can also result in several other complications such as psoriatic arthritis, inflammatory bowel disease, diabetes type 2 and cardiovascular problems. Therefore, it is important to know the manifestations and diagnosis of psoriasis in order to deal with this irritating skin disease as fast as possible.

What Happens In Psoriasis

As mentioned before, psoriasis occurs when the skin production process is sped up. In a typical individual, it takes a month for the skin cells to grow in the skin, rise to the surface and fall off eventually.

In people with psoriasis, this process is sped up to a few days only. This means that the skin cells are not given enough time to fall off in a normal way. An overproduction of these cells occurs which causes the development of plaques in them.

Scales are usually seen in the body of such patients. The most common areas where they can be seen are elbows, joints and knees. Scales can also grow on other parts of the body such as neck, hands, scalp, feet and face.

Less commonly, psoriasis can also be seen attacking the mouth, nails and the area surrounding the genitals.

Causes Of Psoriasis

Scientists have categorized the reasons for psoriasis according to the two key factors- the immune system and the genetic makeup.

Immune System

Psoriasis is an autoimmune disease in which the body starts attacking its own cells. In this disease, the white blood cells or the T cells present in your blood start harming the skin cells.

In a normal individual, white blood cells are designated to destroy all the bacteria that make their way into your body and to fight them before they start spreading infection. These cells mistakenly start targeting the normal skin cells leading to overdriving of their production. New skin cells are quickly generated and start piling up on the surface of the skin.

Plaques are formed that are normally surrounded by inflammation in this case.

Genetic Makeup

The genetic makeup of a certain individual also makes him more vulnerable to developing psoriasis. If any one of your immediate family members is suffering from a skin disease, you are more prone to acquire psoriasis as well. However, only 2 to 3 percent of the people suffer from psoriasis due to genetic setup is quite less.

Is Psoriasis Transmissible?

Psoriasis is not generally contagious and the patient is unable to transmit this disease to the people surrounding him. Even if you come in direct contact with a psoriatic lesion, you will not acquire it.

Signs And Symptoms Of Psoriasis

The symptoms of this skin disorder can vary from person to person. However, the most commonly seen manifestations are mentioned below:

Treatment Options For Psoriasis

In general, psoriasis is untreatable. Medications can be prescribed to decrease the scales, slow down the growth cycle of skin cells and to reduce inflammation.

Several ointments and creams are given to be applied on the infected area. These topical treatments may include the use of topical retinoids, topical corticosteroids, salicylic acid and vitamin D analogues.

Systemic treatments are given to people who have moderate to severe form of psoriasis and do not respond to the topical treatment. The commonly prescribed medicine groups are biologics, cyclosporine and retinoids.

This treatment regimen involves the use of ultraviolet light or even the natural light to stop overactive T cells in the body. Symptoms of psoriasis are said to be reduced using UVA and UVB light.

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Psoriasis- What You Need To Know - Reports Healthcare

Positive five year efficacy and safety results for Cosentyx (secukinumab) from a Phase III long-term

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Post-marketing data reinforce sustained efficacy and safety of Cosentyx in psoriasis - The Pharma Letter (registration)