Category Archives: Psoriasis

May 22, 2017 TWEAK regulates inflammation in atopic dermatitis and psoriasis. Left: Normal skin. Middle: Skin inflammation in atopic dermatitis. Right: Blocking TWEAK reduces skin inflammation in atopic dermatitis. Credit: Courtesy of Dr. Daniel Sidler, La Jolla Institute for Allergy and Immunology

Superficially, psoriasis and atopic dermatitis may appear similar but their commonalities are only skin deep. Atopic dermatitis, also known as eczema, is primarily driven by an allergic reaction, while psoriasis is considered an autoimmune disease. Nevertheless, researchers at La Jolla Institute for Allergy and Immunology were able to pinpoint a common driver of skin inflammation in both diseases.

Their findings, published in the May 22, 2017 issue of Nature Communications, showed that TWEAK, a protein related to tumor necrosis factor (TNF), plays a major role in inducing pro-inflammatory signaling molecules that recruit immune cells to the skin. TNF is already a drug target in psoriasis.

"Atopic dermatitis and psoriasis are two distinct diseases that are induced by alternate immune responses and the factors involved are quite different," explains Michael Croft, Ph.D., professor and head in the Division of Immune Regulation, who led the research. "Showing that TWEAK is a critical mediator in both conditions, makes it a potential therapeutic target for the treatment of inflammatory skin diseases in general."

Over 30 million Americans have some form of atopic dermatitis, which typically develops during childhood but can occur at any age. Most people outgrow the itchy condition but some will continue to suffer from eczema in adulthood.

It is believed to result from a combination of genetics and environmental factors such as irritants and allergens that drive T lymphocytes to produce factors that cause abnormal changes in keratinocytes, the predominant cell type in the outermost layer of skin, as well as changes in other cells in the underlying dermis.

In psoriasis, T lymphocytes also drive an alteration in healthy keratinocytes, accelerating their life cycle. As a result, new keratinocytes move to the outer layer of skin faster than old skin cells can be sloughed off. The build-up of extra cells forms patches of red, itchy skin that are covered with silvery scales and can range from a few spots to major flare-ups that cover large swathes of skin.

"Atopic dermatitis and psoriasis are very common diseases and can have debilitating affects on people's daily lives," says the study's first author Daniel Sidler, M.D., Ph.D, formerly a postdoctoral researcher in the Croft lab and now a Primary Investigator at the University of Bern in Switzerland. "Understanding the molecular basis of these diseases is crucial before we can seek new treatments for these and other inflammatory skin diseases."

In their current study, Croft and his team, in collaboration with researchers at the biotechnology company Biogen, focused on TWEAK and its receptor, Fn14, which had previously been shown to participate in several inflammatory conditions such as inflammatory bowel disease, arthritis and lupus-like kidney disease. "TWEAK and its signaling receptor, Fn14, have emerged as a fundamental molecular pathway regulating tissue responses after acute tissue injury and in many different contexts of chronic injury and disease" said Linda Burkly, Ph.D., Senior Distinguished Investigator, VP, Biogen, Inc., and co-senior author on the current study.

When Sidler measured TWEAK signaling in skin, he found that the expression of both the receptor and ligand was upregulated in atopic dermatitis and psoriasis.

Keratinocytes and dermal fibroblasts, which form the connective tissue in skin, responded to increased TWEAK activity by producing a number of chemoattractive and pro-inflammatory factors commonly found in atopic dermatitis and psoriasis. It also amplified disease-specific cytokines, namely IL-13 and IL-17, further explaining why it can contribute to two fundamentally different diseases.

"TWEAK alone doesn't cause atopic dermatitis or psoriasis but it triggers the production of chemokines that recruit pathogenic inflammatory cells to the skin regardless of the condition," says Sidler. "Blocking TWEAK activity, alone or in combination with other treatments, may sufficiently control skin inflammation to clear up the debilitating symptoms and restore quality of life in severe cases of those diseases."

Explore further: Vitamin D levels not linked to asthma or dermatitis

More information: Daniel Sidler, Ping Wu, Rana Herro, Meike Claus, Dennis Wolf, Yuko Kawakami, Toshiaki Kawakami, Linda Burkly, and Michael Croft. "TWEAK mediates inflammation in experimental atopic dermatitis and psoriasis", 2017. Nature Communications (2017). DOI: 10.1038/NCOMMS15395

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Psoriasis is complex to treat.

In fact, Physician Paul Bechet once said its the antidote to a dermatologists ego (1).

Its an autoimmune disease that causes chronic pain and itching that can severely impact quality of life.

Many foods and supplements are rumored to help with psoriasis treatment. But does research support these claims?

This article examines the evidence surrounding the relationship between diet and psoriasis.

What is Psoriasis and Its Symptoms?

Psoriasis is a chronic autoimmune disease that causes patches of skin to become inflamed and scaly.

It affects up to 4% of the worlds population (2).

Symptoms occur in flares, and include itching, pain, and skin lesions. Psoriasis may also cause pitted fingernails and toenails, as well as mouth sores.

There are six types of psoriasis. Each type causes a distinctive rash:

Plaque psoriasis.Image source.

Guttate psoriasis.Image source.

Inverse psoriasis.Image source.

Pustular psoriasis.Image source.

Erythrodermic psoriasis.Image source.

Summary: Psoriasis is a chronic condition that causes distinctive skin rashes, itching, inflammation, and pain. Symptoms occur in flares.

Psoriasis Causes

Psoriasis is caused by a combination of genetic, environmental, and immunological factors (3).

One large study found that a persons risk increases up to 65% if their parents have psoriasis, and up to 83% if both their parents and siblings have it (4).

Not everyone who carries the gene will develop psoriasis. However, exposure to certain environmental stimuli may increase a persons likelihood of developing the disease.

These stimuli include:

In the presence of both environmental and genetic factors, the immune system malfunctions.

T cells, which normally respond to infection and injury, are mistakenly activated as a result. These cells recruit other immune cells and trigger the release of inflammatory cytokines (13).

This causes the skin cells to die off and regenerate more quickly than they should.

Onset of psoriasis. Image source.

The same environmental factors that cause psoriasis can also lead to flares, so its best to limit exposure to them when possible.

Summary: Psoriasis occurs when the immune system mistakenly attacks healthy skin cells. Many people carry a gene for the disease and develop it after exposure to certain environmental factors.

Diet and Psoriasis Treatment

The standard treatments for psoriasis involve topical and oral medications, as well as ultraviolet light therapy.

There is no scientific proof that diet is an effective treatment for psoriasis on its own.

However, patient testimonials and studies have shown certain diet strategies may help relieve psoriasis symptoms, especially when combined with traditional therapies.

The following sections will focus on foods and nutrients that affect psoriasis severity.

Achieve and Maintain a Healthy Body Weight

Overweight (in a clinical setting) is characterized by a body mass index (BMI) greater than 24.9.

A BMI greater than 29.9 is classified as obese.

Many studies have found a possible link between obesity and psoriasis.

In one long-term study of more than 67,000 females (14):

Even weight gain of just 10 pounds (4.5 kg) appears to increase risk by up to 8%, regardless of BMI classification (15).

In addition to risk, obesity is also linked to disease severity. This is likely because excessive fat tissue increases production of inflammatory cytokines, which contribute to inflammation and lesions in psoriasis (16, 17).

It makes sense then that studies have shown that calorie restriction paired with medication is more effective in reducing psoriasis symptoms than medication alone (18).

Notably, most studies on obesity and psoriasis are observational. This means that researchers arent exactly sure if obesity causes the disease or vice versa.

In any case, psoriasis is linked with several other heart disease risk factors, including high cholesterol, diabetes, and high blood pressure.

Weight loss can reduce heart disease risk for people who are overweight or obese, so it makes sense to maintain a healthy weight (17).

You can calculate your BMI here.

Summary: Those who are very overweight are more likely to have psoriasis, although researchers arent sure if obesity causes it directly. Maintaining a healthy bodyweight also lowers risk of heart disease which is more common in psoriasis patients.

The Autoimmune Protocol, Gluten, and Alcohol

The autoimmune protocol (AIP) is a diet that eliminates gluten, soy, dairy, legumes, grains, added sugars, nightshades, and alcohol for at least 30 days.

The goal is to identify foods that trigger undesirable autoimmune reactions.

Theres a strong link between psoriasis and other autoimmune diseases. In one large study, those with psoriasis had higher rates of 14 different autoimmune disease than the general population (19).

Patient testimonials suggest that the AIP is helpful for many conditions, including psoriasis.

There have been no clinical trials on the AIP, so theres no scientific evidence to support it. But certain foods eliminated in the AIPincluding gluten and alcoholhave been reported to worsen psoriasis symptoms.

Some small studies have shown a gluten-free diet to improve psoriasis symptoms, but only in those with antibodies against gliadin (a protein found in gluten). These antibodies would be seen in those with celiac disease or non-celiac gluten sensitivity (20).

Although other studies found no benefits at all, so its all quite unclear at this stage (19).

A stronger link has been suggested between alcohol intake and psoriasis severity.

One review of 28 studies found that alcohol is likely a risk factor for developing psoriasis, and that those with the disease drink more than healthy adults (11).

Its best to avoid alcohol if you have psoriasis, or a strong family history of it.

Summary: Patient testimonials suggest that the autoimmune protocol may help with psoriasis, but this hasnt been formally studied. You should definitely avoid alcohol and potentially gluten too if you are sensitive.

Anti-Inflammatory and Mediterranean Diets

A Western diet high in fat, sodium, and added sugars has been linked to inflammation and autoimmune disease (21).

For this reason a so-called anti-inflammatory diet may ease psoriasis symptoms.

Theres no universal definition for anti-inflammatory diet, but it generally refers to a style of eating that (22, 23, 24):

An anti-inflammatory diet hasnt been studied in psoriasis specifically, but systemic inflammation is a key feature of the disease.

This diet pattern has also been shown to help with certain autoimmune diseases, so in theory and based on patient testimonials it may be beneficial (18, 25, 26).

Patient testimonials also indicate that an anti-inflammatory eating pattern is helpful for arthritis. As such, it may be useful for relieving pain and stiffness in those with psoriatic arthritis (27, 28).

The diet is similar in many ways to the Mediterranean diet, which includes fish and lean meats, vegetables, fruits, healthy fats, whole grains, and legumes.

In one study, stronger adherence to the Mediterranean diet was associated with fewer psoriasis symptoms. Further, those with fewer symptoms ate more fruit, vegetables, legumes, nuts, and fish and less meat (29).

More human studies are needed to know if the Mediterranean diet is beneficial for psoriasis. But given its other health benefits, such as reducing heart disease risk, it makes sense to eat this way regardless of its effects on skin (30).

Summary: Anti-inflammatory and Mediterranean diets emphasize healthy fats, fruits, vegetables, and whole grains. One study linked the Mediterranean diet with improved psoriasis symptoms.

Supplements for Psoriasis

Several dietary supplements have been reported tohelp with psoriasis treatment.

Fish Oil

Fish oil capsules contain the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA).

Its known for its anti-inflammatory properties.

In one literature review, 12 of 15 studies found fish oil to improve psoriasis severity (31).

The strongest evidence is in support of high-dose intravenous (IV) omega-3 infusions for plaque and guttate psoriasis. However, this isnt a typical therapy, and wouldnt be readily available to most patients (32, 33).

One small observational study found that oral fish oil supplements significantly reduced psoriasis severity and improved quality of life when paired with prescription ointment. Volunteers in this study received 640 mg of DHA plus EPA per day for eight weeks (34).

Change in Psoriasis Area and Severity Index (PASI) over duration of study for fish oil plus ointment group compared to ointment only group. Lower score is better. Click to enlarge.

Larger clinical trials are needed to confirm these effects but it looks promising.

Probiotics

Probiotics are beneficial bacteria that we eat.

They have been the focus of many studies recently because of the interaction between the gut microbiome and various health conditions, including psoriasis.

One study found adults with psoriasisespecially psoriatic arthritisto have less diversity in gut bacteria than healthy adults. The researchers likened the bacterial profile in psoriasis to that of inflammatory bowel disease, which often responds well to probiotics (35, 36).

In another study, 23 patients with mild to moderate plaque psoriasis received the probiotic Bifidobacterium infantis 35264 at a dose of 11010 colony forming units (CFU) per day for eight weeks.

Researchers found that most blood markers of inflammation (CRP and TNF-) were significantly lower at eight weeks (37).

Other probiotic strains havent been studied specifically in psoriasis yet.

Vitamin D

Vitamin D helps regulate the immune system by inhibiting T cell multiplication and limiting cytokine production (38).

Because T cells and cytokines play key roles in psoriasis, and because vitamin D deficiency is common among those with autoimmune disease, its been studied as a possible psoriasis treatment (38).

One literature review found vitamin D supplements and ointments to be as effective as corticosteroids in easing symptoms. The benefits were even greater when vitamin D was used with a high-dose steroid ointment (39).

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Psoriasis Treatment: Does Your Diet Matter? - Care2.com

Kelly Bensimon says shes dealt with psoriasis her entire life, and the condition made her scared to bare all for her 2010 Playboy shoot.

The former Real Housewives of New York City star and model tweetedabout her psoriasis on Friday as she was getting ready for a new photoshoot.

Ive had psoriasis since I was a kid. I hated it. I found it so embarrassing, Bensimon, 49,writes on Twitter. When I was a teen, I would spend hours in tanning beds, trying to get dark enough to cover it up. Not healthy! And not something I would recommend to anyone! But I was desperate. I thought that I couldnt be pretty with this issue.

She ended up becoming asuccessful model, but Bensimon says even then she doubted herself up until age 41, when she posed for Playboy.

Even as an adult, especially when I was modeling, I felt terrible about my skin. When I had a breakout, I wanted to hide from the world, she says. So, when Playboy asked me to bare it all, there was a part of me that was scared not because of the nudity, but because of the psoriasis!

But a funny thing happened when I took off my clothes and got in front of that camera. I forgot about all my imperfections I forgot about the itchies and flaws. I just felt beautiful. Like, if Playboy thought I was beautiful, then maybe I really was! I realized that my flaws were part of my whole, and that my whole was pretty great! Showing so much allowed me to finally drop my judgement[sp].

RELATED VIDEO:Kelly Killoren Bensimon Gets Real about the Public Judgment on Breastfeeding

Bensimon said in February that she wants to pose nude for Playboy again.

I am 49 and I did the cover 10 years ago [in 2010]. So I feel like I look better now, she told Page Six. I am glad that they are going back to showing women naked, it was a beautiful layout. And it would be a test to show that you can still look good at any age.

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Kelly Bensimon Reflects on Having Psoriasis and Her Nude Playboy Shoot: 'No One Is Perfect' - PEOPLE.com

Dr Maithili Kamat, Consultant Dermatologist at Jaslok Hospital and Research Centre helps us in understanding the latest treatment options for psoriasis.

Research in psoriasis treatment often doesnt hog the headline, unlike how the breakthrough researches in cancer or heart stroke does. But, in the recent past, it is interesting to note how psoriasis is categorised as immune system disease. Dr Maithili Kamat, Consultant Dermatologist at Jaslok Hospital and Research Centre helps us in understanding the latest treatment options for psoriasis.

Latesttopical treatments for psoriasis Topical treatment for psoriasis is medication applied to the skin. These are usually the first line of therapy in treating psoriasis. Topical treatments slow down or normalise excessive cell reproduction and reduce psoriasis inflammation.There are many OTC products like moisturisers and products containing Salicylic acid, Coal Tar etc.Prescription-based medicines containing Corticosteroids (steroids) or non-steroid drugs like anthralin, Vitamin D analogue- Calcipotriol, Calcineurin inhibitor-Tacrolimus, Retinoids- Tazarotene. Prescription-based topical drugs should strictly be monitored by a dermatologist.

Topical corticosteroids are effective for treating psoriasis Topical Corticosteroids (TCS) are used as anti-inflammatory agents to reduce the swelling and redness of psoriasis lesions.

TCS are available in a wide variety of strengths, right from super strong or superpotent (Class 1) to extremely weak or least potent (Class 7). The choice of the steroid potency depends on the site and severity of psoriasis. TCS have to be used for limited time periods and strictly under the supervision of a dermatologist. Read more aboutPsoriasis: Not just skin deep; linked to 10 other chronic diseases

Newest available oral treatment for psoriasis -The newest available oral treatment for psoriasis and psoriatic arthritis is Otezla (apremilast).It is an oral pill that helps your immune system fight inflammation in psoriasis by inhibiting a substance called phosphodiesterase.Otezla is also used to treat moderate to severe plaque psoriasis in people who may also receive phototherapy or other treatments for psoriasis. Before giving you the medicine, your doctor will check for your past history of depression or suicidal thoughts; kidney disease; or if you take seizure medication.

Oils can be good for psoriasis Fish oil containingomega-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) taken orally can be adjuvant treatment in psoriasis care.

Top 3 therapies for treating psoriasis

Narrow band UVB therapy treatment Present in natural sunlight, ultraviolet B (UVB) is an effective treatment for psoriasis. UVB penetrates the skin and slows the growth of affected skin cells. The treatment involves close-fitting the skin to a synthetic UVB light source on a regular schedule. This treatment is controlled in a medical setting preferably. Read here5 foods you should NOT eat if you suffer from psoriasis

Goeckerman therapy First formulated in 1925 by American dermatologist William H. Goeckermans, the regimen is for treatment of moderate to severeplaque psoriasisusing a combination of crudecoal tar andartificialultraviolet radiation.It is a specialized form oflight therapy.

Photochemotherapy or psoralen plus ultraviolet A radiation (PUVA) PUVA is a combination treatment which consists of Psoralens (P) and then exposing the skin to UVA (long wave ultraviolet radiation). Psoralens are compounds found in many plants which make the skin temporarily sensitive to UVA.For oral PUVA, methoxsalen capsules are taken two hours before the UVA exposure. In most cases, treatment is undertaken two or three times each week.The patient should always wear goggles to protect the eyes from exposure to the radiation.

Image source: Shutterstock

Published: May 18, 2017 10:36 am | Updated:May 18, 2017 11:16 am

Disclaimer: TheHealthSite.com does not guarantee any specific results as a result of the procedures mentioned here and the results may vary from person to person. The topics in these pages including text, graphics, videos and other material contained on this website are for informational purposes only and not to be substituted for professional medical advice.

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Oral and therapy treatment for psoriasis - TheHealthSite

1. In a prospective observational study of over 1100 patients with moderate to severe plaque psoriasis, long-term use (156 weeks) of apremilast was not associated with an increase in common or serious adverse events compared to short-term use (52 weeks).

Evidence Rating Level: 2 (Good)

Study Rundown: Psoriasis is a chronic, inflammatory skin disease associated with a multitude of systemic manifestations and varying degrees of severity. Selecting the optimal therapeutic regimen requires the consideration of numerous factors including efficacy, disease severity, route of administration, cost, feasibility, safety, and tolerability. Due to the chronic nature of the disorder, evaluating the safety profile and tolerability of long-term medication use is critical. Apremilast is a novel oral phosphodiesterase 4 (PDE4) inhibitor that has previously demonstrated efficacy and safety for treating moderate-to-severe plaque psoriasis for up to 52 weeks. The purpose of this study was to assess the safety and tolerability of the long-term use of apremilast in patients with psoriasis.

This study is a prospectively evaluated 1,184 patients with plaque psoriasis from two phase 3 clinical trials evaluating the efficacy, safety, and tolerability of apremilast. At the conclusion of the study, there was no significant increase in common adverse events, serious adverse events, or the rate of drug discontinuation with the study dose of apremilast at 156 weeks compared to 52 weeks. This study is strengthened by its large sample size and the use of multiple trial sites. However, limitations include the lack of comparison to a control group and a sizeable patient dropout rate (21% patients remain at the end of study period), which may limit the external generalizability of these results. Additional prospective studies may be helpful to confirm these results.

Click to read the study in JAAD

Relevant Reading: Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: Results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM]

In-Depth [prospective cohort]: The study prospectively followed patients pooled from 2, similarly designed 52-week, multi-site phase 3 randomized controlled trials evaluating the efficacy, safety, and tolerability of apremilast in patients with moderate-to-severe plaque psoriasis. Overall, 1184 patients were treated with apremilast and 249 (21.0%) patients completed 156-week of treatment. Safety and tolerability was assessed by physical exam, documentation of adverse events, and laboratory tests. Descriptive statistics and exposure-adjusted incidence rates (EAIR) were calculated. Compared to patients treated with apremilast for 0 to 52-weeks, patients treated for >104 to 156-weeks experienced less common adverse events such as diarrhea (1.3% vs. 17.3%), nausea (1.5% vs. 15.7%), upper respiratory tract infections (6.7% vs. 15.5%), nasopharyngitis (6.0% vs. 14.1%), tension headache (1.2% vs. 9.0%), and headache (1.7% vs. 6.3%). The EAIR for major cardiac events (0.4/100 patient-years vs. 0.5/100 patient-years), malignancy (1.6/100 patient-years vs. 1.2/100 patient-years), and serious infections (0.5/100 patient-years vs. 0.9/100) were similar between both the 0 to 52week and 0 to 156week apremilast-exposure periods.

2017 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

2 Minute Medicines The Classics in Medicine: Summaries of the Landmark Trials is available now in paperback and e-book editions.

This text summarizes the key trials in:General Medicine and Chronic Disease, Cardiology, Critical and Emergent Care, Endocrinology, Gastroenterology, Hematology and Oncology, Imaging, Infectious Disease, Nephrology, Neurology, Pediatrics, Psychiatry, Pulmonology, and Surgery.

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Long-term use of apremilast for psoriasis associated with an acceptable safety profile - 2 Minute Medicine

As Quinn Perkins on the hit ABC show Scandal, Katie Lowes is thick-skinned, somewhat terrifying, and seemingly the least vulnerable of the gladiators who toil on behalf of Kerry Washington's crisis manager, Olivia Pope.

In real life, however, Lowes admits to having had many moments of embarrassment and humiliation.

Seven years ago, the actress, 34, was diagnosed with psoriasis, an auto-immune skin disorder that reportedly afflicts about 7.5 million people in the U.S. Symptoms include itchy, red and dry skin that can be painful. The condition can be concentrated on one part of the body, or spread over much of it.

Lowes said she kept her condition secret for years. Recently, however, she decided to step out publicly.

She has partnered with PsoriasisInsideStory.com, a forum of personal essays from people coping with psoriasis, part of a campaign launched by pharmaceutical company Janssen Biotech Inc. and the National Psoriasis Foundation.

"If there are over 7 million people who are struggling with this disease and various levels of it we wanted to find for them a way to use their voice, and to share the treatments that are working for them," said Lowes.

With her condition now largely under control, Lowes shares what has helped her, and how stress can be the biggest trigger.

It was a really big year in my life. I was newly engaged. I got Scandal and that was far and away the biggest deal that had happened in my career. Simultaneously, the stress from planning my wedding, and being in the public eye for the first time, combined with genetics -- I got the diagnosis that I had psoriasis, and I was completely embarrassed and ashamed. I felt like a lesser person.

He lost 85 pounds in four months and kept it off

At first, it was irritated skin at the base of my neck. And then it started to get bad -- itchy and red. I tried every over-the-counter thing I could. Different shampoos and lotions. I refused to wear my hair up or wear dresses with low-cut backs. And then I realized that I was starting to make these choices without getting to the bottom of what was really going on.

I got the diagnosis that I had psoriasis, and I was completely embarrassed and ashamed. I felt like a lesser person.

Katie Lowes

I'm lucky in that I have a more moderate case, and I could get away with hiding it. But it affected how I felt on the red carpet. I had to have some photos taken for our save-the-date card and had a horrible flare-up of flaking and irritated skin, painful on my neck and back. I had nothing to wear that looked good. I looked bad on the outside and I felt bad on the inside and I called off the shoot. That was the moment I said to myself: "I'm canceling these life moments because of this. I need to be my own best advocate."

I still have to be very careful. The weather, food, the environment they're all triggers. I have to not let my skin get dry. If I spend a week on vacation indulging in a bunch of sugar, my body reacts. Stress is a huge part of it. I'm big on yoga, and of taking care of my mental health. I do Hatha yoga at Yogaworks three times a week, and do two hikes a week. I did a lot of research about nutrition, and the anti-inflammatory stuff works for me: Being very light on sugar, alcohol and dairy, eating clean, sticking to a ton of vegetables and proteins.

The condition is very much under control. I've found a doctor, treatment and lifestyle that work for me. I run into so many people who also have psoriasis and share the same feelings as I had. I tell them that it's about being your own boss, and of not settling until they find whatever it is that works for them, and they have their life look the way they want it to.

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How 'Scandal's' Katie Lowes hid her psoriasis - Los Angeles Times

Endocrinology Advisor

Severe Adrenal Deficiency With Topical Steroid Application for Psoriasis Endocrinology Advisor The patient was a 63-year-old white male with a 23-year history of psoriasis. For 18 years, the patient had been applying Clobetasol Propionate 0.05% topically on several areas of his body every day. Upon presentation to the endocrine clinic for ...

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Severe Adrenal Deficiency With Topical Steroid Application for Psoriasis - Endocrinology Advisor

Metro

Psoriasis sufferer Celia Martinez shares Instagram photos in a bid to ... Metro A psoriasis sufferer is using her Instagram account to empower others dealing with the condition. Celia Martinez, 26, was first diagnosed with the skin complaint ... Woman With Psoriasis Shares Candid Photos Of Body To Prove ...HuffPost UK all 2 news articles »

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Psoriasis sufferer Celia Martinez shares Instagram photos in a bid to ... - Metro

DUBLIN--(BUSINESS WIRE)--Research and Markets has announced the addition of the "Psoriasis - Pipeline Review, H1 2017" report to their offering.

Psoriasis is a chronic skin condition caused by an overactive immune system. Symptoms of the disease include shedding of cells, flared up skin, itchiness, and burning sensation, swollen and stiff joints. Predisposing factors include heredity, side effects of certain medicines, stress, infections and environmental conditions. The condition may be controlled by topical or systemic medications and phototherapy.

Pharmaceutical and Healthcare latest pipeline guide Psoriasis - Pipeline Review, H1 2017, provides comprehensive information on the therapeutics under development for Psoriasis (Immunology), complete with analysis by stage of development, drug target, mechanism of action (MoA), route of administration (RoA) and molecule type. The guide covers the descriptive pharmacological action of the therapeutics, its complete research and development history and latest news and press releases.

The Psoriasis (Immunology) pipeline guide also reviews of key players involved in therapeutic development for Psoriasis and features dormant and discontinued projects. The guide covers therapeutics under Development by Companies /Universities /Institutes, the molecules developed by Companies in Pre-Registration, Filing rejected/Withdrawn, Phase III, Phase II, Phase I, IND/CTA Filed, Preclinical, Discovery and Unknown stages are 14, 1, 21, 44, 42, 1, 103, 32 and 9 respectively. Similarly, the Universities portfolio in Preclinical and Discovery stages comprises 8 and 6 molecules, respectively.

Psoriasis (Immunology) pipeline guide helps in identifying and tracking emerging players in the market and their portfolios, enhances decision making capabilities and helps to create effective counter strategies to gain competitive advantage.

Key Topics Covered:

For more information about this report visit http://www.researchandmarkets.com/research/4kcrcl/psoriasis

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Global Psoriasis Therapeutics Pipeline Review, H1 2017 - Research and Markets - Business Wire (press release)

May 04, 2017

For 18 years, the patient applied Clobetasol Propionate 0.05% daily on several areas of his body

This article is written live from the American Association of Clinical Endocrinologists (AACE) 2017 Annual Meeting in Austin, TX. MPR will be reporting news on the latest findings from leading experts in endocrinology. Check back for more news from AACE 2017.

At the AACE 2017 Annual Meeting, lead study author Kaitlyn Steffensmeier, MS III, of the Dayton Veterans Affairs (VA) Medical Center, Dayton, OH, presented a case study describing a patient who developed secondary adrenal insufficiency secondary to long-term topical steroid use and who with decreased topical steroid use recovered.

The patient was a 63-year-old white male with a 23-year history of psoriasis. For 18 years, the patient had been applying Clobetasol Propionate 0.05% topically on several areas of his body every day. Upon presentation to the endocrine clinic for evaluation of his low serum cortisol, the patient complained of a 24-pound weight gain over a 2-year period, feeling fatigued, as well as facial puffiness.

Laboratory analysis found that the patient's random serum cortisol and ACTH levels were low (0.2g/dL and <1.1pg/mL, respectively). According to the study authors, the labs were indicative of secondary adrenal insufficiency. Additionally, a pituitary MRI showed a 2mm hypoenhancing lesion within the midline of the pituitary gland consistent with Rathke's cleft cyst versus pituitary microadenoma.

The patient was initiated on 10mg of hydrocortisone in the morning and 5mg in the evening and was instructed to decrease the use of his topical steroid to one time per month. For the treatment of his psoriasis, the patient was started on apremilast, a phosphodiesterase-4 enzyme (PDE4) inhibitor, and phototherapy.

After 2.5 years, the patient had a subnormal response to the cosyntropin stimulation test. However, after 3 years, a normal response with an increase in serum cortisol to 18.7g/dL at 60 minutes was obtained; the patient was then discontinued on hydrocortisone. Additionally, a stable pituitary tumor was shown via a repeat pituitary MRI.

The study authors explained that, although secondary adrenal insufficiency is not commonly reported, one study showed 40% of patients with abnormal cortisol response to exogenous ACTH after two weeks of topical glucocorticoids usage. Another meta-analysis of 15 studies (n=320) revealed 4.7% of patients developing adrenal insufficiency after using topical steroids. Because of this, clinicians need to be aware of potential side effects of prolong topical steroid use, added the study authors.

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Topical Steroid Use in Psoriasis Patient Leads to Severe Adrenal Insufficiency - Monthly Prescribing Reference (registration)