Smokers Experience More Severe Psoriasis Outbreaks

People with psoriasis who smoke tend to have more severe cases than nonsmokers, but it may be a consequence and not a cause of the skin condition, researchers said on Monday.
The condition, which afflicts up to 3 percent of the world's population and runs in families, varies in severity though heavy smoking was associated with more severe cases, said Italian researchers from Istituto di Ricovero e Cura a Carattere Scientifico in Rome.
"Specifically, patients who smoked more than a pack of cigarettes (more than 20 cigarettes) daily had twice the risk of more severe psoriasis compared with those who smoked 10 cigarettes or less per day," lead author Cristina Fortes wrote in this month's issue of the journal Archives of Dermatology.
The number of years spent smoking also was associated with more severe forms of the condition, which afflicts between 1 percent and 3 percent of the world's population and usually develops between the ages of 15 and 35.
However, an editorial in the journal said the study did not reveal whether smoking was a cause or a consequence of psoriasis, which most often appears in the scalp, knees, elbows and torso and frequently creates embarrassment.
A separate study in the same journal found a higher prevalence of obesity among psoriasis patients. The report by dermatologist Mark Herron of the Utah School of Medicine in Salt Lake City said smoking may have a role in causing psoriasis but obesity was definitely an outgrowth of having the condition.
Psoriasis, which appears to have a genetic component, is caused by an overactive immune system that causes skin cells to develop rapidly and rise to the skin surface where they are not shed rapidly enough and form itchy lesions, according to the National Psoriasis Foundation.
Outbreaks can be triggered by injuries such as scratches or sunburn and severe cases can affect the skin's ability to control body temperature and prevent infections.

treating Psoriasis And The Depression That May Accompany It

A drug used to treat psoriasis may also relieve the depression and fatigue associated with the condition, researchers report.
And it may one day offer a new avenue of treatment for depression itself, the scientists say.
Etanercept, which goes under the brand name Enbrel, works by blocking a protein called tumor necrosis factor-alpha, which is produced by the body and promotes inflammation. High concentrations of TNF-alpha have also been linked to major depression, the researchers says.
"When people get a cold, infections, psoriasis, arthritis, they tend to feel bad and have low energy, they want to sleep more, they are moody and depressed," says lead researcher Dr. Ranga Krishnan, chairman of Duke University's department of psychiatry. "It has been shown that this is due to the elevation of cytokines such as TNF-alpha," he adds.
The question that Krishnan and his colleagues wanted to answer was whether blocking TNF-alpha could improve the symptoms of depression and fatigue.
To test the theory, Krishnan's team assigned 618 psoriasis patients to receive injections of 50 milligrams of etanercept twice a week for 12 weeks, or a placebo. After this period, the patients were all given etanercept for an additional 84 weeks.
The researchers found that after 12 weeks, 47 percent of the patients receiving etanercept had a 75 percent or greater improvement in their psoriasis, compared with 5 percent of those receiving a placebo.
In addition, patients receiving etanercept had a significant improvement in guilt, irritability, interest, appearance, work, sleep and sexual symptoms, compared with those receiving a placebo.
Patients receiving the drug also showed lower levels of fatigue.
Improvement was strongly related to the improvements in joint and skin pain caused by psoriasis, the researchers report.
The researchers noted that the improvement in depression was not correlated with improvement in symptoms. However, the study was not designed to detect the effect of etanercept on primary depression.
The study findings were published Wednesday in an early online edition of The Lancet.
People shouldn't consider getting TNF-alpha injections to fight depression based on this study, Krishnan says. "The next question is, if we treat people with depression without psoriasis, would it be a benefit," he says. "If it does, it opens up a whole new avenue of treating depression."
One expert thinks that relieving the symptoms of psoriasis is the reason that patients felt less depressed and less tired.
"There has been some data that the drug gives an increased feeling of well-being," says Dr. Jeffrey M. Weinberg, director of the clinical research center in the department of dermatology at St. Luke's-Roosevelt Hospital Center, in New York City. "But I think any therapy that improves psoriasis is going to improve depression and fatigue."
Weinberg adds that he doesn't think his psoriasis patients are depressed at the start of therapy. "But my patients are very happy when they are doing better," he says. "Not only can we improve the disease, but the disease also has a social-psycho impact, and successful therapy can positively impact that."

New Treatment in The Psoriasis PIcture

An extract found in the cotton plant, gossypol, has shown the strongest anti-inflammatory actions yet seen in the scientific world. In the lab it completely knocks out dozens of different forms of skin inflammation and normalizes dilated, inflammed and hyper-reactive blood vessels. Gossypol's first indication is for the treatment of psoriasis because it also has a normalizing effect on keratinocytes.
Pharmaceutical companies are moving very fast on this substance and have already placed them in nanosomes for penetration into the skin and timed release. Two other skin disorders on their list are rosacea and atopic dermatitis.
Once again, the researchers have never seen an anti-inflammatory as potent, fast acting, and effective on dozens of different inflammatory responses. It out-performed a medium potency, prescription only steroid in a split-face study which is unheard of. Also, the nanosomes drop it off at several different levels in the dermis to treat multiple levels of blood vessels and inflammation. Anecdotally, many patients report diminished burning and stinging sensations within minutes of nanosome delivered gossypol.

Combination Therapy For Psoriasis

For people with mild psoriasis, one type of treatment is usually enough. But people with moderate or severe psoriasis often benefit from a combination of treatments. The best combinations are those in which the two therapies have complementary effects, so they can work together to create improved results. And since such combinations have better results, lowers doses of each treatment can be given, reducing the overall side effects.
A number of different regimens of pills, light therapy and topical agents can be used for combination therapy.
Here are the most common combinations:
Acriten plus light therapy: One popular regimen is acitretin, a retinoid taken as a pill, in combination with light therapy. While retinoids are only moderately effective on their own, they help light therapy work faster. So, skin clears with shorter treatments and fewer sessions, minimizing side effects from prolonged use of ultraviolet light. Adding light therapy also permits lower doses of acitretin to be used. Instead of taking 50 mg a day or more, people using combination therapy usually need only 10 or 25 mg a day. Researchers also suspect that acitretin may reduce the risk of skin cancer from light therapy, although this theory has yet to be proven.
Acitretin with ultraviolet B (UVB) is called reUVB, while acitretin with psoralen plus ultraviolet A (PUVA) is called rePUVA. The regimen requires the patient to begin taking acitretin about two weeks before adding light therapy.
Acitretin is relatively safe, but should not be taken by pregnant women because it can cause birth defects. Possible side effects include hair loss, cracking of the lips and high blood cholesterol.
UVB is also relatively safe; the most common side effects are burns. PUVA is more effective than UVB, but can lead to skin cancer if used too often. Cyclosporine and PUVA should not be combined because of the potential for cancer.
Methotrexate with UVB: Methotrexate pills and UVB is also a popular treatment combination. Methotrexate is very effective, but it has the potential to damage the liver and bone marrow. Combining this drug with UVB allows for lower, safer doses of methotrexate to be used. It also reduces the number and length of UVB treatments needed.
The combination usually involves several weeks of treatment with methotrexate before adding UVB treatments. The methotrexate dose is tapered and discontinued after the skin clears, and a maintenance regimen of UVB continues. The disadvantage of the regimen is that psoriasis may return after methotrexate is discontinued.
PUVA with UVB: A combination of PUVA and UVB appears to clear up skin more quickly than using either treatment alone. Another benefit to this combination is that overall exposure to ultraviolet radiation is reduced. The main drawback of this relatively new combination is that the long-term effects are unknown.
Methotrexate with cyclosporine: Methotrexate with cyclosporine, which is one of the most successful combinations used to treat psoriatic arthritis, also works well for psoriasis itself. It is especially effective in people who have pustules on their body. Low doses of methotrexate combined with low doses of cyclosporine clear skin better than either treatment alone and with fewer side effects. Cyclosporine is very effective against psoriasis, but it can cause kidney damage and elevated blood pressure.

Questions to ask your doctor:
Do you think I would benefit from combination therapy?
What type of combination therapy might be best for me?
What special precautions do I need to take with this treatment regimen?

Supported through an educational grant from Biogen Idec. For more information on psoriasis from Biogen Idec please click here.

Living With Psoriasis

PSORIASIS may not be as life threatening as heart disease, diabetes or cancer but its total impact can be just as debilitating. It is a chronic skin disease affecting 2 - 3% of the population. It is found in all age groups. Men and women are equally likely to get it. Although psoriasis may occur for the first time at any age, most people have the first symptoms between the ages of 20 to 30 years old. There are several types of psoriasis, ranging from mild forms on restricted skin areas to severe forms covering the entire skin surface. The disease often seriously compromises the quality of life of the affected persons.
Psoriasis is immunologically and genetically determined, with a multifactorial inheritance. It can be triggered in predisposed persons by a number of factors, including bacterial infections, trauma, psychological stress, certain drugs, certain diseases, alcohol and over-exposure to the sun.

Prof Dr P.C.M. van de Kerkhof … ‘ Generally, it (psoriasis) has a greater impact on a patient’s psychosocial status compared to the impact on physical activity’“Patients with psoriasis are faced with numerous misconceptions and social prejudices. These misconceptions exclude psoriasis patients from public facilities such as receiving equal service or treatment in hair salons, public pools and health clubs,” explains Prof Dr P.C.M. van de Kerkhof.
This was one of the key findings of a study published in the British Journal of Dermatology 2004, shared by Prof Kerkhof in his lecture titled Psoriasis – State-of-the-Art in Management at the 7th Asian Congress of Dermatology held in Kuala Lumpur recently.
Prof Kerkhof, who is the Chief of the Department of Dermatology at the University Medical Centre of St Radboud in Nijmegen, The Netherlands, is also a much sought-after expert on skin disorders and studies particularly on psoriasis.
The quality of life of psoriasis patients is affected to a similar degree to that of patients with other diseases, such as migraine and mild rheumatoid arthritis, according to the findings by him.
Psoriasis can take on many forms. The most common is well-defined coin-shaped red, thick and scaly patches which when scraped or scratched, show bleeding points. It usually appears on the elbow, knees and scalp but may also affect the upper body, joints and nails.
There are a variety of types but no matter what form it takes, psoriasis patients can feel very uncomfortable, both because of the itch, the look and the stares from an innocent but uninformed public.
The negative impact psoriasis has on the physical dimension of quality of life includes burning sensations, joint pain, itching sensations and scaling skin. Those aspects will have a negative impact on the mental dimension of such patients, such as being stigmatised and a generally depressed attitude on life, especially one’s social life.
“Generally, it has a greater impact on patients’ psychosocial status in comparison with the impact on their physical activities, although both areas can be affected,” explains Prof Kherkhof.
“Severe chronic skin conditions such as psoriasis can be described as ‘life ruining’ although it is not ‘life-threatening’ compared to other man-killers like hypertension, diabetes and cancer,” he adds.
It has also been found that psoriasis has a significant impact on sexual relationships and sexual activity. It can also impair the quality of life of families. Treatment time, reluctance to leave home or avoidance of public places may interfere with family leisure time.
Quality of life can be adversely affected by treatments that require a great deal of time and/or effort to take/apply, are “messy” in nature, are slow acting, induce unpleasant side-effects, and/or do not produce a “satisfactory” degree of response in a patient.
Last year, another study commissioned by the National Psoriasis Foundation (of the United States) was published in the Journal of Investigative Dermatology. The study revealed that even a “small” amount of psoriasis can negatively impact daily life.

Psoriasis presents a unique challenge to patients, doctors and society as a whole.Closer to home, the first preliminary work on a National Psoriasis Registry only started in 1998. According to the statistics from the Registry, major aggravating factors are stress and exposure to strong sunlight over a period of time. Most patients suffer from plaque psoriasis (73.5%). Drugs such as traditional medication, body-building supplements, antibiotics and others also worsen the condition.
According to the National Psoriasis Registry, out of 25,717 patients who consulted the Dermatology Department of Kuala Lumpur Hospital from 1995 to 1999, psoriasis was the fourth most common skin problem with 5.2% (1,344 patients), after skin infection, eczema and acne.
Although Malaysia is only beginning to track and learn the dynamics of the condition, it is hoped that the knowledge and learning will help experts to provide better assistance to other and new psoriasis sufferers.

FDA Approval For Spray Clobex

Galderma Laboratories announced today that the U.S. Food and Drug Administration (FDA) has granted the company approval to market its CLOBEX® (clobetasol propionate) Spray, 0.05% for the treatment of moderate-to-severe plaque psoriasis. CLOBEX® Spray is the only available super-high potency corticosteroid formulation that provides the clinically proven strength of clobetasol in a non-aerosol spray formulation.

CLOBEX® Spray was demonstrated to be safe and effective in two multi-center, randomized, double-blind studies involving 209 patients with moderate-to-severe psoriasis. In the first clinical trial, 82% of patients became clear or almost clear after four weeks of treatment, with 47% of these subjects becoming clear or almost clear in as early as two weeks. In a second study, 78% of patients were clear or almost clear after four weeks.

CLOBEX® Spray reflects the proven and well-known clinical profiles of CLOBEX® Lotion and Shampoo. Available by prescription since September 2003 and June 2004 respectively, CLOBEX® Lotion and Shampoo are clinically proven to reduce and/or eliminate the signs and symptoms of moderate-to-severe psoriasis.

Lupin Begins Clinical Trial Phase For Desoris

Lupin has received approval for conducting phase II clinical trials of its Investigational New Drug candidate, the LLL-3348 (Desoris) from the Drug Controller General of India (DCGI).

Desoris is proposed for the treatment of moderate to severe chronic stable plaque-type psoriasis. Desoris is a herbal aqueous extract of a single plant that has a novel mechanism of action and effectively modulates the cellular function leading to marked psoriatic lesion improvement without any toxic effects.

About the commencement of clinical trials of the drug, Lupin Chairman DB Gupta said that there is an imperative need of effective and safe drugs to be made available in the global pharmaceutical market for psoriasis and the company is very excited that the regulatory authorities found its data promising enough to give the permission for further trials.

The candidate has been developed conforming to guidelines laid down by the US FDA for botanicals as well as DCGI guidelines on new drug development. The project is being developed in collaboration with the Centre for Scientific and Industrial Research (CSIR).

The most common form of psoriasis is plaque-psoriasis which is a chronic, immune-mediated disease. The disease manifests itself as lesions that are classically well circumscribed, circular, red papules or plaques with a grey or silvery-white, dry scale. Psoriasis can have a significant negative impact on the physical, emotional and psychosocial well-being of patients.

Currently, there are several treatment modalities available for psoriasis including phototherapy and systemic therapies. But most of these are associated with significant cutaneous and systemic adverse effects. The side effect profile of existing drug therapies itself leads to marked reduction in patient's compliance.

The approval comes on Lupin's successful completion of the therapeutic evaluation and safety profiling of Desoris in a phase I single and multiple dose study in healthy volunteers.

Managing Winter Pssoriasis

For some Americans, winter can bring a new set of challenges for their skin, hair and nail care. However, for individuals with psoriasis, this can be the most difficult season of all.
Environmental factors, such as cold winter weather and dry, indoor heat can rob the body of needed moisture and cause psoriasis symptoms to flare or worsen. The condition becomes even more severe when the stress of the holidays and winter illnesses combine and compromise the immune system.
“The physical and emotional discomfort felt by those with psoriasis can be challenging throughout the year,” says dermatologist Mark Lebwohl, M.D., professor and chairman, department of dermatology, the Mount Sinai School of Medicine in New York City. “Due to winter’s effect on the skin, patients should diligently monitor their condition carefully and consult with their dermatologist if they are concerned about changes on their skin during this time of year.”
Psoriasis affects 4.5 million Americans and is most commonly characterized by thick, red, white or scaly patches on the skin’s surface. Psoriasis is caused by the unusually rapid growth of skin cells that can build up on the skin’s surface -- usually around the knees, elbows, scalp, hands, feet or lower back -- and cause itching and severe discomfort.
Many treatments exist to help ease the emotional and physical discomfort for patients with psoriasis and can be prescribed by a dermatologist. Treatments are often selected based on the patient’s health, age, lifestyle and symptoms.
* Topical medications applied to the skin are used to treat mild to moderate psoriasis and are often prescribed by dermatologists at the first signs of the condition.
* Systemic medications treat the entire body and are often reserved for patients whose psoriasis is not responsive to topical medications or phototherapy.
* New biologic treatments, which target the precise immune responses involved in the development of psoriasis and psoriatic arthritis, are used to treat moderate to severe conditions forms of these conditions.
* Phototherapy, or ultraviolet light treatment, is reserved for moderate to severe cases of psoriasis that do not respond to topical therapy.
“Patients with psoriasis should review their treatment options with a dermatologist since many innovative treatments and therapies now exist that can greatly improve the quality of life for people with psoriasis,” adds Dr. Lebwohl.

Psoriasis Winter Fashion Picture For Women

What does winter fashion mean for women with psoriasis? Just like any other time of year, there's no reason you can't be comfortable and look great. Here are some highlights from this season's fashion-forward trends for any budget, age, and figure.
This winter, designers threw out the seasonal handbook. Instead, they turned to traditional springtime garb—skirts, feminine looks, dresses, and classic colors. The trend is casual-classy and always comfortable.
Layers are topsLayered tees and sweaters have a boyish bent—and a forgiving effect for any frame. Layers are a great way to keep from overheating. A soft, cotton shell is a perfect first layer to keep moisture away from your skin. So go nuts—it's almost impossible to make a mistake.
Featured look: Layer a denim jacket over a V-neck sweater, loose, button-down blouse with untucked hem, and cotton tee. Pair with jeans, skirts, khakis...anything.
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Basic black—and whiteWhether it's an oversized houndstooth check or a mod graphic look, black and white is a bold statement this season. However, many of the popular wintertime fabrics, like synthetics and scratchy wool, can be really irritating. So try adding a cotton layer next to your skin for maximum comfort.
Skirts or pants, it's your choiceMaybe you think the mini isn't for you, but here's some news that may make you rethink your hemline. Leg wear is back and bold—in bright, opaque colors and wonderful breathable cotton knits. Pair opaque tights with knee-high boots and you're only hinting at—instead of baring—skin.
But minis aren't your only skirt option. There are A-line and knee-length or mid-calf pencil skirts. One is sure to fit your comfort level and your frame.
Just not the skirt type? Cargos are still hot, and super skinny pants that are comfortable are a must-have. Both come in soft, natural fibers that are easily washable.
Cheap and easy chicTop-name retailers are catching on to our need for accessible fashion. So some of the hottest designers are now available at some of the hipper budget-friendly chains. Their prices make it a little easier to pick up a trendy item with a limited life span. So have fun. Attract some attention—and feel great about it!

Psoriasis Winter Fashion Picture For Men

Feel like you've got limited options when it comes to fashion and your skin? Does the idea of wearing winter wools and sweaty synthetics send a shiver down your spine? Don't let the cold turn you into a fashion disaster. We've asked around to find out what's hot this winter. And because we know that some clothes—regardless of the season—can be uncomfortable for people with psoriasis, we've also included some tips to help protect your skin.
PatternsSkip the worn-out, tone-on-tone look when putting on a suit and tie. Try mixing your patterns by accenting your suit with a striped shirt and solid tie. And as you may well know, lighter colors and patterns usually hide flakes better than dark solids.
Blended, natural fabrics that breathe can keep irritation to a minimum by reducing chafing. It's also a good idea to wear a cotton tee shirt under your dress shirt—or sweater or vest—to keep moisture away from your skin.
Hint: To make two different patterns work well together, make sure they're the same size (for example, big plaids with big stripes, small plaids with small stripes.) But if you're wearing two striped items, make sure the stripes are varied in size (some thick, some thicker).
Here's a fashion cheat sheet:
Bigger, bolder patterns make you look bigger.
Horizontal patterns make you look wider.
Vertical patterns make you look taller and thinner.
Trouser cuffs make short legs look shorter.
Mixing it upCombine your casual and dressy clothing this winter. Remember, layering in the winter helps you better regulate your body temperature and cut down on perspiration. This can help ease the irritation of psoriasis.
Try layering a single-breasted suit coat with a cool, casual, button-down shirt over a dark tee shirt (great for hiding stains from ointment). Then pull on your favorite older-looking jeans.
Or wear your suit trousers with a tee shirt, white button-down shirt, and a jean jacket. And by all means, leave the tie at home.
Remember, contrast makes this winter's look really work. Choosing what's comfortable can make fashion work for you. So get bold. There's no reason not to attract a little positive attention to yourself.
Special tips for men with psoriasis
Get loose. For example, boxers made of soft cotton or even natural silk are better than briefs to help maximize airflow and minimize perspiration.
Cotton liners inside gloves are a great extra barrier against chafing, cold, and perspiration. They can also help medications penetrate skin.

The Molecular Picture of Psoriasis

Psoriasis is defined as an inherited skin disease. While we haven't isolated the gene yet, we have discovered that there is more than one gene coding it -- it has a different mutation in different families.
Like many diseases, once you start looking at the molecular biology, while the clinical picture of psoriasis can be fairly uniform, the genetic picture of psoriasis never is. Since the clinical picture of psoriasis is not by any means uniform, so this is really comes to no surprise.
The ultimate treatment of psoriasis will depend on the molecular biology.

A General Picture of Psoriasis

The psoriasis picture can vary in intensity from a very few spots, so mild that one may not even be aware of it; to a more chronic picture of psoriasis involvong open wounds and scaling skin.

Psoriasis may range from just a few spots anywhere on the body to large areas of involvement.

It is not contagious or spread able from one part of the body to another or from one person to another.

There is no blood test to diagnose psoriasis. The diagnosis is made by observation and examination of the skin. Sometimes microscopic examination of the skin (biopsy) is helpful where the changes are not typical or characteristic.

The exact cause of psoriasis is unknown, but hereditary and genetic factors are important. Psoriasis runs in families. This does not mean, however, that every child of a parent with psoriasis will develop psoriasis, but it is common that somewhere down the line psoriasis will appear in families.

Psoriasis is not caused by allergies, infections, dietary deficiencies or excesses, or nervous tension.

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THE ALTERNATIVE PSORIASIS TREATMENT PICTURE

The success rates of alternative psoriasis treatments are difficult to measure, as conclusive test results are not available. Psoriasis has traditionally been one of the skin conditions that has stumped researchers and has proven very difficult to cure. Unfortunately, many alternative treatment types available may not actually work, and many 'cures' play on the need of the patient and as merely a means to make money. There is not one treatment out there that is a miracle cure. If that was the case, the cure would widely be known and not be a secret, hidden cure.
However, there is no doubt that some alternative psoriasis treatment types do work, and some treatments may benefit one person and not another. Many natural treatments include Acupuncture, Ayurveda, Manipulation, Osteopathy, Climate, Diet, Dietary Supplements, Homeopathy, Water Therapy, Chinese Medicine, Meditation and Relaxation, Herbal therapies, Topical Moisturizing Products, and Magnets. Seeking consultation from a doctor is very important before trying any self-treatments.

Your Psoriasis Questions Answered

What is Psoriasis? Notice patches of raised red skin with a white flaky buildup? Read more about what psoriasis looks like, the different types and what causes it. Types, Triggers, Newly Diagnosed

Psoriasis Relief See your doctor for a diagnosis and learn more about the treatment options that are best for you.Biologics, Topicals, Systemics

Managing Psoriasis There are many actions you can take to manage psoriasis. It's time to learn more and regain control!Outlook, FAQ, Additional Resources

Galderma's "New" Psoriasis Treatment Is An Old Drug

Galderma Laboratories announced today that the U.S. Food and Drug Administration (FDA) has granted the company approval to market its CLOBEX(R) (clobetasol propionate) Spray, 0.05% for the treatment of moderate-to-severe plaque psoriasis. CLOBEX(R) Spray is the only available super-high potency corticosteroid formulation that couples the clinically proven strength of clobetasol in an advanced, highly-convenient, non-aerosol spray formulation.

CLOBEX(R) Spray was demonstrated to be safe and effective in two multi- center, randomized, double-blind studies involving 209 patients with moderate- to-severe psoriasis. In the first clinical trial, 82% of patients became clear or almost clear after four weeks of treatment, with 47% of these subjects becoming clear or almost clear in as early as two weeks. In a second study, 78% of patients were clear or almost clear after four weeks."CLOBEX(R) Spray will be a welcome option for the millions of psoriasis patients who struggle with their treatment regimen," said Albert Draaijer, President, Galderma Laboratories, L.P. "The product's vehicle has been specifically designed to efficiently deliver clobetasol propionate to the skin. Above and beyond its unsurpassed efficacy, the easy application of this advanced vehicle will allow even the most active psoriasis patients to remain compliant with their therapy."

In controlled clinical trials, the following adverse reactions have been reported: burning, pruritus, dryness, pain, hyperpigmentation around resolving plaque, irritation and atrophy. CLOBEX(R) Spray is not recommended for use on anyone younger than 18 years of age. The total dosage should not exceed 50 g (59 mL or 2 fl oz) per week.

Patients should use CLOBEX(R) Spray, 0.05% only for the minimum period necessary to achieve desired results.CLOBEX(R) Spray reflects the proven and well-known clinical profiles of CLOBEX(R) Lotion and Shampoo.

Available by prescription since September 2003 and June 2004 respectively, CLOBEX(R) Lotion and Shampoo are clinically proven to reduce and/or eliminate the signs and symptoms of moderate-to-severe psoriasis.Understanding the needs of psoriasis patients -- and providing products to address their special needs -- is a longstanding priority for Galderma. To better understand the impact of psoriasis on the lives of young adults, Galderma is partnering with the National Psoriasis Foundation (NPF) on a first-of-its-kind survey campaign directed to college-age individuals."College-age individuals seem to be affected by their psoriasis in ways that are perhaps different from than other patients," said Gail Zimmerman, Executive Director, NPF. "This new research will allow us to better understand this very unique patient population and introduce potential strategies to minimize their social and emotional impact." Results of the survey are expected for release in January.

The Factual Picture of Psoriasis

Psoriasis is a chronic skin condition affecting approximately 4.5 million people in the United States.

New skin cells grow too rapidly, resulting in inflamed, swollen, scaly patches of skin in areas where the old skin has not shed quickly enough.

Psoriasis can be limited to a few spots or can involve more extensive areas of the body, appearing most commonly on the scalp, knees, elbows and trunk.

Psoriasis is not a contagious disease. The cause of psoriasis is unknown, and there currently is no cure.

Psoriasis can strike people at any age, but the average age of onset is approximately 28 years. Likewise, it affects both men and women, with a slightly higher prevalence in women than in men.

Approximately 30 percent of people with psoriasis are estimated to have moderate-to-severe forms of the disease.

Psoriasis can be a physically and emotionally painful condition. It often results in physical limitations, disfiguration and a significant burden in managing the daily care of the disease.

Psoriasis sufferers may feel embarrassed, angry, frustrated, fearful, depressed and, in some cases, even suicidal.

The Pustular Psoriasis Picture

This type of psoriasis usually appears as a large red area covered with yellow-green pustules. They tend to be one to two millimeters in diameter and are quite tender. The yellow color is caused by masses of white blood cells (polymorph leucocytes), which flood into any part of the skin that is damaged or infected, in order to fight infection and aid recovery.After seven to 10 days, the pustules become dispersed and a brown scale appears. This scale will start to shed as new pustules develop in other areas, often in a continuous cycle. The most common type of pustular psoriasis affects the palms and soles. It isn't normally itchy however it can be sore or uncomfortable to use either your hands or feet, for example if you are writing or walking.

THE PICTURE OF GUTTATE PSORIASIS

Guttate psoriasis is characterized by small red dots (or drops) of psoriasis. Guttate is derived from the Latin word gutta meaning "drop." It often appears on the trunk, arms and legs. The lesions may have some scale. Guttate psoriasis frequently appears suddenly following a streptococcal infection or viral upper respiratory infections. There are also other events that can precipitate an attack of guttate psoriasis: tonsillitis, a cold, chicken pox, immunizations, physical trauma, psychological stress, illness, and the administration of anti-malarial drugs. Guttate psoriasis is many small patches of psoriasis, all over the body, and often happens after a throat infection. Guttate Psoriasis most often affects children and young adults. It appears as small, red bumps-the size of drops of water-on the skin. It usually appears suddenly, often several weeks after an infection such as strep throat.

Causes of Psoriasis

Researchers believe the immune system sends faulty signals that speed up the growth cycle in skin cells. Certain people carry genes that make them more likely to develop psoriasis, but not everyone with these genes develops psoriasis. Instead, a "trigger" makes the psoriasis appear in those who have these genes. Also, some triggers may work together to cause an outbreak of psoriasis; this makes it difficult to identify individual factors.Possible psoriasis triggers include: emotional stress; injury to the skin; some types of infection; reaction to certain drugs. Once the disease is triggered, the skin cells pile up on the surface of the body faster than normal. In people without psoriasis, skin cells mature and are shed about every 28 days. In psoriatic skin, the skin cells move rapidly up to the surface of the skin over three to six days. The body can't shed the skin cells fast enough and this process results in patches also called "lesions" forming on the skin's surface.

The Psoriatic Arthritis Picture

Psoriatic arthritis occurs in less than 10% of people with psoriasis. Its treatment often requires consultation with a rheumatologist in addition to treatment of the skin lesions by a dermatologist. It occurs most frequently in psoriasis patients whose disease is active, especially in persons with the pustular type of psoriasis. Occasionally it appears in a person who has no dermatologic signs or symptoms of psoriasis, in which case it must be diagnosed by its unique laboratory test results. Psoriasis of the fingernails and toenails is associated with a higher incidence of psoriatic arthritis. Symptoms of psoriatic arthritis resemble those of rheumatoid arthritis, although the diseases are otherwise quite different. Arthritis changes cause deterioration and pain in small joints of the hands and feet, large joints of the legs and spine, and tendons. Nonspecific foot pain or "tennis elbow" may be an early symptom to appear and may be overlooked if not associated with psoriatic skin or nail lesions.

The Picture of Scalp Psoriasis

Scalp psoriasis occurs in at least half of all people with psoriasis. It can range from very mild with fine scaling to very severe with thick, crusted plaques. Scalp psoriasis may appear as lesions that extend from the hairline onto the forehead and the nape of the neck. It is common for the psoriasis to appear behind the ears. Scalp psoriasis usually accompanies plaques in other areas of the body. Scalp psoriasis scales appear powdery with a silvery sheen. Possible causes of scalp psoriasis include: scalp treatments and severe psoriasis can both cause temporary hair loss; itching, picking and scratching lesions can worsen the psoriasis by causing a Koebner phenomenon (psoriasis appearing on the site of skin injuries).

The Historical Picture of Psoriasis

Psoriasis has been around since the days of Greek mythology, more than 2,500 years ago. It was considered a curse from the gods.

The Bible refers to psoriasis but mistakenly calls it leprosy. For hundreds of years, people with the disease were ostracized and forced to wander as homeless beggars. Some had to wear warning bells so others could avoid their paths. Some suffered the same fate as lepers, who were burned at the stake in the 14th century."

Amazingly, psoriasis was a disease that had been misunderstood for more than 2,000 years before it was clearly defined (in the early 1800s) and named what we know it as today."

Understanding Psoriasis

Psoriasis is a common immune-mediated chronic skin disease that comes in different forms and varying levels of severity. Most researchers now conclude that it is related to the immune system (psoriasis is often called an "immune-mediated" disorder).It is not contagious. In general, it is a condition that is frequently found on the knees, elbows, scalp, hands, feet or lower back. Many treatments are available to help manage its symptoms. More than 4.5 million adults in the United States have it. Between 10 percent and 30 percent of people with psoriasis also develop a related form of arthritis, called psoriatic arthritis.

The Symptomatic Picture of Psoriasis

Individuals with psoriasis experience symptoms such as itching, cracking, stinging, burning, or bleeding. Lack of sunlight and low indoor humidity in the winter months can cause the psoriasis symptoms to worsen. The skin is most likely to crack at the joints where the body bends, or in areas where the individual scratches. Scratching should be strictly avoided, because it can cause bleeding and infection. Psoriasis has also been known to cause pits or dents to form in fingernails and toenails. There is also the possibility that the soft tissue inside the mouth and genitalia can be affected. In some cases, psoriasis will cause joint inflammation that produces arthritis symptoms. This condition is called psoriatic arthritis.People with psoriasis may notice that there are times when their skin worsens, then improves. Conditions that may cause flare-ups include changes in climate, infections, stress, and dry skin. Also, certain medicines, most notably beta-blockers, which are used in the treatment of high blood pressure, and lithium or drugs used in the treatment of depression, may cause an outbreak or worsening of the disease.

A Factual Picture of Psoriasis

Psoriasis is a chronic skin condition affecting approximately 4.5 million people in the United States.
New skin cells grow too rapidly, resulting in inflamed, swollen, scaly patches of skin in areas where the old skin has not shed quickly enough.
Psoriasis can be limited to a few spots or can involve more extensive areas of the body, appearing most commonly on the scalp, knees, elbows and trunk.
Psoriasis is not a contagious disease. The cause of psoriasis is unknown, and there currently is no cure.
Psoriasis can strike people at any age, but the average age of onset is approximately 28 years. Likewise, it affects both men and women, with a slightly higher prevalence in women than in men.
Approximately 30 percent of people with psoriasis are estimated to have moderate-to-severe forms of the disease.Psoriasis can be a physically and emotionally painful condition. It often results in physical limitations, disfiguration and a significant burden in managing the daily care of the disease.
Psoriasis sufferers may feel embarrassed, angry, frustrated, fearful, depressed and, in some cases, even suicidal.

Treating Psoriasis With Cotton Extracts

A substance found in the cotton plant could help treat the common skin disease psoriasis, according to new research from the Pharmacy School at Sunderland University to be launched today (Tuesday 27 September 2005) at the British Pharmaceutical Conference in Manchester.
Gossypol is a natural toxin that is thought to protect the cotton plant from insect damage. In the past it has been investigated as a male contraceptive but no product was ever marketed. Dr Kalliopi Dodou from Sunderland University reports that, since discovery of gossypol's antifertility activity in the 1960s, studies had indicated that it might also have anti-proliferative and anti-inflammatory activity.
"Such activity suggested possible therapeutic use in psoriasis, since the disease is associated with skin inflammation and hyper-proliferation of cells (keratinocytes) in the outer skin layers," she says. "It is this hyper-proliferation that leads to the characteristic scaly skin patches in patients with psoriasis."
Dr Dodou tested the efficacy of gossypol and synthetic derivatives in treating the human papillomavirus (HPV). HPV infection is associated with benign hyper-proliferation. The tested compounds were found to inhibit keratinocyte proliferation, with gossypol itself being the most active.
In further studies gossypol was also shown to have anti-oxidant activity. Dr Dodou explains that this is also potentially useful in treating psoriasis: "One of the theories of the pathogenesis of psoriasis is that the condition is related to imbalance in the body's anti-oxidant system. Some studies have shown people with psoriasis to have high levels of oxidative metabolites. Gossypol might therefore stop oxidation of the fatty acids in the skin."
Dr Dodou is to tell the conference that gossypol appears to dampen down inflammation and hyper-proliferation and is a good candidate for the topical treatment of psoriasis. She said that subsequent work showed that formulating gossypol into a cream would be feasible.

The Picture of Psoriasis Management

Psoriasis is a chronic skin condition in which new skin cells grow too fast. This causes thick, dry, scaly patches of skin to form in areas where the old skin hasn't shed quickly enough.
If you've been diagnosed with psoriasis, there are several things you can do to help manage flare-ups.
Health Canada suggests you:
Keep your skin moist.
Apply creams and ointments slowly and gradually in the direction of your hair's growth.
Avoid using very hot water when bathing or showering.
Use mild soaps and deodorants.
Use brushes with soft bristles. Wash your hair gently and let it dry naturally whenever possible.
Avoid picking or scratching skin and skin injuries. An injury to the skin can cause psoriasis patches to form at the site.

Clinical Trials on Possible New Psoriasis Treatment

Isotechnika said data from a Canadian Phase III trial for its immunosuppressive drug, ISA247 met all primary and secondary effectiveness endpoints at 12 weeks with minimal side effects.
The trial of 453 patients with stable moderate to severe plaque psoriasis was conducted at 32 sites over a 24 week period using orally administered ISA247 in psoriasis patients.
"Our goal was to create a drug with a superior safety and efficacy profile compared to other medications used to treat psoriasis," Isotechnika president and chief operating officer Randall Yatscoff said in a release.
"We are pleased to have achieved these goals in the interim data analysis which indicates the presence of a therapeutic window. It is very encouraging to see that our 24-week endpoints were achieved at the 12 week point of the trial."

Phase One Clinical Trials for Psoriasis Treatment

Celera Genomics has chosen Christchurch for phase one clinical tests of its Cathepsin S inhibitor, CRA-028129, and will dose about 70 volunteers with either CRA-028129 or a placebo. The subjects will not know which one they have been given,
Cathepsin S is an enzyme responsible for the breakdown of other natural proteins, but in some cases of autoimmune diseases it has been found to be poorly regulated by the body. Researchers propose that in those cases, controlling the enzyme could control psoriasis.
Celera said in a statement that it had the approval of New Zealand's director general of health for the tests, a committee of the Health Research Council, and a council ethics committee.
James Yee, head of development at Celera Genomics said the quality of clinical science and operations at the Christchurch trust meant that results from the study would be considered a valid basis to judge the suitability of CRA-028129 for further tests on people suffering from psoriasis.
Psoriasis is a genetic condition that causes the over-production of skin cells, leading to a thickening of the skin, resulting in raised red, scaly patches.
It is estimated to affect 1-3 per cent of the population worldwide, with two to three million of these patients suffering a moderate or severe form of the disease.
The most common form, plaque psoriasis, accounted for approximately 85 per cent of all cases, and caused raised, red patches covered with a silvery white buildup of dead skin cells,.
Dr Yee said there was considerable evidence that the immune system was involved in the disease, and there was evidence that inhibiting the production of Cathepsin S by some skin cells might reduce the immune reaction.
The company had identified two genetic markers in humans which it would use to check the behaviour of the compound in the volunteers. It expected that the medication would also be useful against other autoimmune diseases. Other researchers have proposed targeting Cathepsin S in treatments for the incurable diseases rheumatoid arthritis and multiple sclerosis.

Psoriasis Advocacy Group Approaches The FDA

“Psoriasis Cure Now,” a nonprofit patient advocacy group, today urged the Food and Drug Administration's Arthritis Drugs Advisory Committee to support approval of abatacept for use by rheumatoid arthritis (RA) patients. The biologic drug would be marketed by Bristol-Myers Squibb (BMS) under the brand name Orencia. “As we have seen repeatedly in the past, many of the same medications that help RA patients also bring relief to people with psoriasis or psoriatic arthritis, and vice versa,” said Michael Paranzino, president of Psoriasis Cure Now. “We would like abatacept available not just to help RA patients, but because it may provide the psoriasis community with an additional treatment option.” Biologics for the treatment of psoriasis and psoriatic arthritis are already bringing relief to tens of thousands of Americans with these painful, debilitating and incurable diseases. But no psoriasis treatment works for everyone; each treatment works better for some patients than for others; and in some cases, patients find their treatment loses effectiveness for them over time. Additional options, then, provide patients with more opportunities to find a treatment that will work for them. “We do have a concern that post-Vioxx skittishness may lead some to try to slow down the approval of promising new treatment options,” added Paranzino, himself a psoriasis patient. “But that would be a mistake. We patients need relief, and we need it now. The FDA should continue to approve these promising new treatments, while also strengthening their post-approval monitoring of any adverse events that may emerge once large populations are using a particular drug.” Paranzino is scheduled to appear before the Advisory Committee in its afternoon session. His written statement to the Committee is available here: psorcurenow.org/abatacept.php

The Theroetical Picture on The Cause of Psoriasis

Normally, skin cells are constantly being formed, then pushed up to the surface where they eventually die and flake off, revealing new skin cells. In people with psoriasis, however, the skin cells grow too quickly, causing layers of skin to build up, forming a whitish, flaky crust. Blood vessels increase flow in an attempt to nourish this skin, causing reddened inflammation. Thus the hallmark symptoms of psoriasis are reddened, inflamed skin with a whitish, flaky layer of dead cells on top.
Although psoriasis usually appears as a skin condition, recent discoveries show that its real cause is a problem with the immune system.
Your body naturally fights infections and heals injuries with special cells -- called white blood cells -- that are designed to battle viruses or bacteria. Normally these cells go to the site of infection or injury and release antibodies and other chemicals to repair wounds, clot blood and prevent infection. One byproduct of this normal process is inflammation (redness and swelling).
For reasons that doctors don't yet understand, the immune systems of people with psoriasis malfunction. One type of white blood cell - the B-cell - begins creating antibodies that destroy normal skin cells. Another type of white blood cell - the T-cell - begins overproducing a substance called cytokines. This overproduction turns off a signal that regulates skin cell grow.
That's why psoriasis is considered an autoimmune disease - the immune system malfunctions and turns on normal body tissues. Other autoimmune diseases include lupus and rheumatoid arthritis.
Psoriasis of the skin or nails may look like a rash or fungus, but you can't catch psoriasis from another person and you can't give it to anyone else. You also can't spread it from one part of your body to another by touch. Experts now know that a susceptibility to getting psoriasis can be inherited. If it runs in your family, your chances of developing psoriasis are higher.

The Progressive Picture of Psoriasis

Psoriasis doesn't have any set way of progressing -- it develops differently depending on the person. While some people may only have occasional and minor symptoms for their entire lives, others may have to cope with severe symptoms on a regular basis.
In most people, the symptoms come and go. Flare-ups might be brought on by some of the conditions mentioned above, such as dry weather or stress.
Untreated, extremely severe psoriasis can be dangerous. Although it happens very rarely, if lesions cover enough of the body, it's possible for the immune system to become overwhelmed trying to fight off infections. This increases your risk of developing serious bacterial infections. Be sure to see your doctor immediately if your psoriasis spreads to cover large parts of your body or if you show signs of infection, such as fever.
Coping with psoriasis can be exhausting and frustrating. It's important to try to stay emotionally and physically healthy during treatment.

The Changing Picture of Psoriasis

While most people develop one type of psoriasis and have flare-ups and clearings from that type for life, this is not always the case. It is possible to experience only one outbreak. A child can experience one outbreak of guttate psoriasis and never have another psoriasis outbreak.
It is also possible for two types of psoriasis at the same time. A person with plaque psoriasis can develop a second type of psoriasis. Pustules could develop within or around the plaques. If this occurs, the person has both plaque psoriasis and pustular psoriasis.
Have psoriasis that begins as one type and transforms into another type. Plaque psoriasis can develop into guttate or erythrodermic psoriasis. Abruptly stopping a psoriasis medication, such as cyclosporine or methotrexate, is one such trigger that may cause this transformation

The Erythrodermic or Exfoliative Psoriasis Picture

In the overall picture of psoriasis, one cannot forget the least known type of psoriasis. Erythrodermic Psoriasis also known as “exfoliative” psoriasis, this is the least common type. It occurs in about 1% or 2% of people who develop psoriasis. Erythrodermic psoriasis can be life-threatening because the skin loses its protective functions. The skin may not be able to safeguard against heat and fluid loss nor prevent harmful bacteria and other substances from entering the body. Patients are usually hospitalized and given intravenous fluids. Body temperature regulation may be required.
Erythrodermic psoriasis may occur suddenly in a person who has never had psoriasis or evolve from plaque psoriasis. Triggers include infection, emotional stress, alcoholism, and certain medications such as lithium, anti-malarial drugs, and a strong coal tar preparation. It also may be triggered by excessive use of potent corticosteroids, which is why it is important to use corticosteroids as instructed. Suddenly stopping a psoriasis medication, such as cyclosporine or methotrexate, also can trigger erythrodermic psoriasis.How to recognize erythrodermic psoriasis:
Severe redness and shedding of the skin that covers a large portion of the body.
Skin looks as if it has been burned.
Fluctuating body temperature, especially on very hot or cold days.
Accelerated heart rate due to increased blood flow to the skin — can complicate heart disease and cause heart failure.
Severe itching and pain.

THE GUTTATE PSORIASIS PICTURE

Although not as common as plaque psoriasis; about 10% of people who get psoriasis develop guttate psoriasis, making this the second most common type. Guttate psoriasis most frequently develops in children and young adults who have a history of streptococcal (strep) infections. A mild case of guttate psoriasis may disappear without treatment, and the person may never have another outbreak of psoriasis. Some children experience flare-ups for a number of years. It also is possible for the psoriasis to appear later in life as plaque psoriasis. In some cases, guttate psoriasis is severe and disabling, and treatment may require oral medication or injections.

Recognizing guttate psoriasis:
Drop-sized, red dots form — usually on the trunk, arms, and legs. Lesions occasionally form on the scalp, face, and ears.
Lesions widespread.
Appears quickly, usually a few days after a strep throat or other trigger, such as a cold, tonsillitis, chicken pox, skin injury, or taking certain medications.
Can first appear as another form of psoriasis, such as plaque psoriasis, and turn into guttate psoriasis.

A Clinical Picture of Plaque Psoriasis

About 80% of people living with psoriasis have plaque psoriasis, which also is called “psoriasis vulgaris.” “Vulgaris” means “common.” How to recognize plaque psoriasis:
Raised and thickened patches of reddish skin, called “plaques,” which are covered by silvery-white scales.
Plaques most often appear on the elbows, knees, scalp, chest, and lower back. However, they can appear anywhere on the body, including the genitals.
Plaques vary in size and can appear as distinct patches or join together to cover a large area.
In the early stages, the psoriasis may be unnoticeable. The skin may itch and/or a burning sensation may be present.
Plaque psoriasis usually first appears as small red bumps. Bumps gradually enlarge, and scales form. While the top scales flake off easily and often, scales below the surface stick together. The small red bumps develop into plaques (reddish areas of raised and thickened skin).
Skin discomfort. The skin is dry and may be painful. Skin can itch, burn, bleed, and crack. In severe cases, the discomfort can make it difficult to sleep and focus on everyday activities.

The Inverse Psoriasis Picture

Inverse or Flexural psoriasis is localized in the flexural surfaces of the skin, e.g., armpit, groin, under the breast, and other skin folds. Typically, it appears as smooth inflamed lesions without scaling and is particularly subject to irritation due to rubbing and sweating. This type of psoriasis is often white in color, appears softened as if soaked by water, and may resemble a fungal infection. There is very little scaling, although the patches are inflamed and can be very sore. Appearing as it does in the folds of the skin, it is moister than other forms of psoriasis, and can be more uncomfortable physically. Flexural psoriasis rarely occurs by itself. It is more likely to accompany common plaque psoriasis. Psoriasis sufferers in their middle years or old age are more susceptible to this type of psoriasis as are people who are overweight and have more folds of skin.

Psoriasis Phototherapy

Phototherapy involves the use of light to treat a medical condition. Ultraviolet light therapy improves psoriasis symptoms in some people. Phototherapy may only use ultraviolet light, or may combine the use of ultraviolet light with psoralen, a drug that increases light sensitivity. While ultraviolet rays occur naturally in sunlight, excessive sun exposure causes sunburn, which can make symptoms worsen. Phototherapy uses carefully measured amounts of ultraviolet light; a safety measure that cannot be duplicated by simple exposure to the sun. A side effect of this is photo damage or increased risk of skin cancers.

Natural sunlight contains ultraviolet (UV) light. UV light kills T cells in skin, reducing redness and slowing the overproduction of skin cells that causes scaling. This is why brief, regular periods of sun exposure can help to clear psoriasis. Exposing the skin to UV light in carefully controlled doses is called phototherapy. Sunlight contains two kinds of UV light, known as UVA and UVB. Both can be used to treat psoriasis. In phototherapy, the affected person sits or lies inside a "light box," a booth fitted with special light-emitting tubes. Usually, people go to a doctor's office to receive phototherapy. Sometimes a light box can be purchased with a doctor's prescription for use at home.

UVB therapy: Treatment with UVB light is the safest form of phototherapy for widespread psoriasis or psoriasis that has not responded to medications applied to the skin. Usually 3 to 5 treatments a week are recommended, with a gradual increase in UV exposure depending on skin type. Significant clearing of psoriasis can be expected in 1 to 3 months. Exposure to UVB light must be carefully monitored to prevent sunburn. During treatment, the eyes must be shielded with goggles to guard against the possible formation of cataracts. Skin aging may be a side effect of UVB treatment. Large long-term studies have found no evidence of an increase in the risk of skin cancer as a result of UVB treatment. UVB phototherapy may be combined with tar, anthralin, topical steroids, or other medications applied to the skin. The Goeckerman regimen, developed at the Mayo Clinic, uses crude coal tar, tar baths, and UVB treatment to treat widespread psoriasis. The Ingram regimen uses coal tar baths, anthralin paste, and UVB therapy.

PUVA: This treatment combines a medication called psoralen with exposure to UVA light. (PUVA stands for Psoralen with UVA.) Psoralen may be taken by mouth or applied to the skin. It makes the skin more sensitive to light. Treatment is given 2 or 3 times a week, with a gradual increase in UV exposure depending on skin type. As with UVB therapy, significant clearing of psoriasis can be expected in 1 to 3 months. Compared with UVB therapy, PUVA clears skin more consistently with fewer treatments. However, PUVA has more short-term side effects, such as nausea, headache, fatigue, burning, and itching. When psoralen is taken by mouth, nausea may be avoided by taking food at the same time. As with UVB therapy, the eyes must be shielded with goggles during UVA exposure to guard against the formation of cataracts. Psoralen can be applied to the skin in the form of a cream, lotion, gel, or solution. After the paint, soak, or bath routine, the person is exposed to UVA light in a light box. UVA light is the same kind used in commercial tanning salons. Treating psoriasis in tanning salons is not recommended because attendants are untrained and the dose of UVA is not controlled. UVA therapy must be given in carefully controlled doses and supervised by a doctor. PUVA is recommended for people with moderate to severe psoriasis or who have not improved with other treatments. Long-term use of PUVA increases the risk of developing certain types of skin cancer. Regular medical examinations are advised to check for signs of skin cancer.

The Scalp Psoriasis Picture

Psoriasis that affects the scalp is also called seborrheic psoriasis. The scalp may be the first site to be affected by psoriasis. The condition may resemble severe dandruff. Patches of thick, flaky skin may extend to the forehead below the hairline. Scales may build up in the outer ear. Other than the forehead and the ears, the face is usually spared. However, some people may have patches of inflamed skin that resemble seborrheic dermatitis a type of dandruff eczema that affects the scalp and face.

Psoriasis on the scalp is common and, in many cases, it is the only area affected. It usually consists of red, scaly patches that are sometimes lumpy. The edge of the patch tends to be well defined. This type of psoriasis can extend beyond the hairline, onto the forehead. Psoriasis of the scalp does not damage the hair follicle and is not associated with alopecia (hair loss), but if the scale is thick and forms hard lumps, it can lead to temporary hair thinning. However, this is not permanent and will grow back again after the psoriasis clears.

This form of psoriasis can be extremely uncomfortable. It is often very itchy, and the psoriatic patches that are inflamed and sore can start to bleed if they are scratched or picked. The condition is not caused by poor hygiene or hair care. Scalp psoriasis can be demoralizing, as the look of dead skin cells on clothing can be embarrassing, and it is not always easy to brush them off inconspicuously. Itchiness is another big problem, not only because of the social implication but also because it inflames the condition and makes it worse. Forehead along the hairline is a common site as is the temples, nape of the neck, around the ears, as well as the hair parting. Massaging a little warm baby/olive/coconut oil gently into the scalp, preferably before going to bed to allow plenty of time to soak (bind up the head in an old towel) will help. Wash out with cream shampoo (i.e. Dry Hair Products), add a little lemon juice to the final rinse to get rid of excess grease. Only shampoo three times a week, more than this and the natural oils may be washed out. Always treat the head as gently as possible, do not comb or brush harshly. Perms and colorants can be used as long as the skin is not broken. Shampoo the hair and scalp with a tar-based shampoo that can be purchased over-the-counter or by prescription. Shampoos, scalp steroid lotions, vitamin D analogues and some tar preparations such as tar pomade may be used on the scalp.

Psoriasis Scalp Treatment

Scalp psoriasis requires slightly different regimes from psoriasis affecting the skin elsewhere. This is due to hair, which makes application of many topical products difficult and protects the scalp from the effects of ultraviolet light. Unfortunately, many scalp treatments for scalp psoriasis are messy and smelly. Most treatments will need to be used regularly for several weeks before a benefit is seen.
Special medicated shampoos can be purchased from the chemist.
Coal tar shampoos are suitable for most patients with scalp psoriasis
Ketoconazole shampoo is effective for dandruff, seborrhoeic dermatitis and sebopsoriasis
The shampoos work best if rubbed into the scalp well, and left in for 5 or 10 minutes and then reapplied. They are safe for daily use but may irritate if applied more than twice weekly. If you dislike the smell of coal tar, try shampooing again with a favourite brand, and use a conditioner.
More severe cases require leave-on scalp applications.
Alcohol-based topical steroid and calcipotriol lotions can reduce itch but don't lift scale very well. Use topical steroids intermittently; overuse results in more extensive and severe psoriasis.
Salicylic acid and coal tar creams work much better, but are messy. Coconut compound ointment is a combination of coal tar, salicylic acid and sulphur and seems particularly effective. Leave on for at least an hour and shampoo off later. Most people rub the cream into the plaques at night and wash it off in the morning.
Use the scalp preparation daily at first then as the condition improves, reduce the frequency. Unfortunately in many cases the scale soon builds up again, so the creams may have to be applied regularly to keep the scalp clear.
Cutting hair short helps control scalp psoriasis, probably by making the treatments easier to apply, but is not appealing to everyone.

Pustular Psoriasis

In visualizing a picture of pustualr psoriasis; picture a large red area covered with yellow-green pustules. The pustules tend to be one to two millimeters in diameter and are quite tender. The yellow color is caused by masses of white blood cells (polymorph leucocytes), which flood into any part of the skin that is damaged or infected, in order to fight infection and aid recovery.

After seven to 10 days, the pustules become dispersed and a brown scale appears. This scale will start to shed as new pustules develop in other areas, often in a continuous cycle.The most common type of pustular psoriasis affects the palms and soles. It isn't normally itchy however it can be sore or uncomfortable to use either your hands or feet, for example if you are writing or walking.

Generalized pustular psoriasis is marked by a general reddening and inflammation of the skin with sheets of small pustules merging into larger sheets. This is a serious and potentially life-threatening illness that can severely disrupt the skin’s function.

Generalized pustular psoriasis which is spread over wide areas of the body is also called von Zumbusch pustular psoriasis, named after the physician who first described it in the early 1900s. In this relatively rare form of the disease, widespread areas of reddened skin (erythema) develop, and the skin becomes acutely painful and tender. Pustules—blisters of non-infectious pus—may appear on the skin, dry, then reappear in repeated cycles lasting several days.

Some Thoughts on the Cause of Psoriasis

Researchers believe the immune system sends faulty signals that speed up the growth cycle in skin cells. Certain people carry genes that make them more likely to develop psoriasis, but not everyone with these genes develops psoriasis. Instead, a "trigger" makes the psoriasis appear in those who have these genes. Also, some triggers may work together to cause an outbreak of psoriasis; this makes it difficult to identify individual factors.Possible psoriasis triggers include: emotional stress; injury to the skin; some types of infection; reaction to certain drugs. Once the disease is triggered, the skin cells pile up on the surface of the body faster than normal. In people without psoriasis, skin cells mature and are shed about every 28 days. In psoriatic skin, the skin cells move rapidly up to the surface of the skin over three to six days. The body can't shed the skin cells fast enough and this process results in patches also called "lesions" forming on the skin's surface.

What is Psoriasis?

Psoriasis is a chronic scaling skin. It may range from just a few spots anywhere on the body to large areas of involvement. It is not contagious or spread able from one part of the body to another or from one person to another. There is no blood test to diagnose psoriasis. The diagnosis is made by observation and examination of the skin. Sometimes microscopic examination of the skin (biopsy) is helpful where the changes are not typical or characteristic. The exact cause of psoriasis is unknown, but hereditary and genetic factors are important. Psoriasis runs in families. This does not mean, however, that every child of a parent with psoriasis will develop psoriasis, but it is common that somewhere down the line psoriasis will appear in families. Psoriasis is not caused by allergies, infections, dietary deficiencies or excesses, or nervous tension.

The Psoriasis Lifestyle Control Picture

It is important to treat psoriasis in as many ways as possible: those who modify their lifestyles, eating habits and reduce their level of stress often experience a much greater degree of psoriasis clearing. While you try to treat the symptoms of the skin (psoriasis) that are most visible and distressing, you should try treating the cause! If we find and treat the cause, then maybe all the symptoms of psoriasis need not occur! Good health for your skin as well as your entire body may require a permanent lifestyle change that will reward you with a longer life and more beautiful skin to wear during those extra years.

The Occurrence of Inverse Psoriasis

Inverse psoriasis is characterized by smooth inflamed lesions in the body folds -- armpits, under the breast, skin folds of the groin, buttocks, and genitals. Large, dry, smooth, vividly red plaques occur in the folds of the skin near the genitals, under the breasts, or in the armpits. Inverse psoriasis is related to increased sensitivity to friction and sweating and may be painful or itchy.

The Guttate Psoriasis Picture

Guttate psoriasis is characterized by small dot-like lesions. It is most common in children and young adults who have a prior history of upper respiratory infection, pharyngitis, or tonsillitis (Camisa 64). The lesions are not as scaly as plaque-type psoriasis and are likely to be found on the trunk and involve the face (Camisa 64).

The Lifelong Picture of Psoriasis

Because psoriasis is a lifelong condition, the levels of its severity and improvement can fluctuate over time. Psoriasis is not a contagious skin condition. An individual instead, has a genetic predisposition for psoriasis, which can be activated by certain environmental factors or emotional stress. Individuals with psoriasis may find that their condition tends to flare up due to stress, certain medications, winter weather, and infections (ICN Pharmaceuticals, Inc.). Most often psoriasis affects the scalp, knees, elbows, hands, and feet (National Psoriasis Foundation).

The Psoriasis T-Cell Connection

There are many beliefs as to what causes psoriasis. Although no one knows for sure, many scientists believe that a biochemical stimulus triggers the abnormally high skin growth which in turn causes the skin lesions (National Psoriasis Foundation). Heredity also plays a role in the development of psoriasis. Individuals who have a family member with a severe case of psoriasis tend to experience early onset of the disease (Camisa 55). Recent research studies indicate that psoriasis may be a disorder of the immune system. The T cell, a white blood cell, normally works to fight off infection and disease. Scientists believe that having an abnormal immune system causes abnormal activity by T cells in the skin. These abnormally active T cells cause skin inflammation and increased cell production. Diet and vitamin influences have also been thought to play a role in psoriasis development and progression (Kligman 729).

A General Picture of Psoriasis Facts and Figures

Psoriasis is a chronic skin condition affecting approximately 4.5 million people in the United States.New skin cells grow too rapidly, resulting in inflamed, swollen, scaly patches of skin in areas where the old skin has not shed quickly enough.Psoriasis can be limited to a few spots or can involve more extensive areas of the body, appearing most commonly on the scalp, knees, elbows and trunk.Psoriasis is not a contagious disease. The cause of psoriasis is unknown, and there currently is no cure.Psoriasis can strike people at any age, but the average age of onset is approximately 28 years. Likewise, it affects both men and women, with a slightly higher prevalence in women than in men.Approximately 30 percent of people with psoriasis are estimated to have moderate-to-severe forms of the disease.Psoriasis can be a physically and emotionally painful condition. It often results in physical limitations, disfiguration and a significant burden in managing the daily care of the disease.Psoriasis sufferers may feel embarrassed, angry, frustrated, fearful, depressed and, in some cases, even suicidal.

The Signs And Symptoms of Psoriatic Arthritis

When psoriasis and arthritis occur together, it is known as psoriatic arthritis. (Arthritis is not a single disorder but rather the name for joint disease from a number of causes. Arthritic disease causes painful inflammation of one or several joints, with the inflammation destroying the cartilage in the joints.) The most easily recognizable form of psoriatic arthritis affects the joints of the fingers and toes. Psoriatic arthritis is usually less painful than rheumatoid arthritis. It also usually causes less disability.Psoriatic arthritis generally affects the fingers and toes, but it can involve the wrists, lower back, knees and ankles. Psoriatic arthritis can be a serious disease, with a large percentage of patients reporting that their symptoms limit their work or home activities.Psoriatic arthritis usually appears between the ages of 30 and 50. Its symptoms usually include at least one of the following:
Pain in one or more joints
Movement that is restricted by pain in the joint or surrounding areas
Morning stiffness
Eye pain or redness
Because there is no laboratory test for psoriatic arthritis, people with psoriasis and joint pain may want to consult a specialist in joint diseases, called a rheumatologist, to evaluate their symptoms. Other joint diseases such as rheumatoid arthritis, gout, and Reiter’s syndrome all may be confused with psoriatic arthritis.

The Broader Picture of Psoriasis

It is currently believed (although not statistically proven) that Psoriasis affects around 2 percent of the worlds population. In the United States it is estimated that around 7 million people suffer from one form or another of Psoriasis. In the United Kingdom, it is believed that around 1.2 million people suffer from this depressive and resistant disease. This figure is similarly reflected in many countries around the world.With all forms of Psoriasis there appears to be a significant link between the disease and the sufferers mental wellness. Due to the nature of the disease and how it acts, sufferers often experience an elelment of depression, increased anxiety and stress levels. This in turn then causes the Psoriasis to increase, thus increasing the levels of stress and anxiety which in turn then may make the Psoriasis even worse. In this way the Psoriasis can caused tremendous continued emotional upset for the sufferer.Thankfully the issue of mental health of the sufferer is beginning to be addressed by the medical professions around the world.

Historical References to Psoriasis

Psoriasis has been around since the days of Greek mythology, more than 2,500 years ago. It was considered a curse from the gods.The Bible refers to psoriasis but mistakenly calls it leprosy. For hundreds of years, people with the disease were ostracized and forced to wander as homeless beggars. Some had to wear warning bells so others could avoid their paths. Some suffered the same fate as lepers, who were burned at the stake in the 14th century."Amazingly, psoriasis was a disease that had been misunderstood for more than 2,000 years before it was clearly defined (in the early 1800s) and named what we know it as today."

Other Psoriasis Blogs of Interest

Other blogs of interest concerning psoriasis and the treatment of psoriasis can be found at:
The Psoriasis Page: http://psoriasispage.blogspot.com/
Psoriasis is a chronic, genetic, noncontagious skin disorder that appears in many different forms and can affect any part of the body, including the nails and scalp. Psoriasis is categorized as mild, moderate, or severe, depending on the percentage of body surface involved and the impact on the sufferer's quality of life.


PSORIASIS TREATMENT : http://psoriasistreatment.blogspot.com/
Psoriasis is a chronic skin disorder that affects over 6 million people in the United States. Psoriasis is caused by a hyper proliferation of the epidermis, concomitant inflammation, and vascular changes, which occur based on combined genetic and environmental factors. Psoriasis occurs equally in men and women and is rarely life threatening.

Psoriasis Can Improve During Pregnancy

For women with psoriasis, high levels of estrogen during pregnancy seem to improve their skin condition, a study suggests.
Dr. Gerald D. Weinstein, of the University of California, Irvine, and colleagues studied fluctuations in psoriasis during pregnancy and the post-partum period. The researchers assessed the body surface area affected by psoriasis in 47 pregnant women and 27 non-pregnant, menstruating women. In addition, levels of progesterone and estrogens were measured.
Overall, 55 percent of the pregnant women patients reported improvements in psoriasis, 21 percent reported no change, and 23 percent reported worsening, according to the researchers' article in the Archives of Dermatology.
In the post-partum period, 9 percent of patients reported improvement, 26 percent no change, and 65 percent reported worsening.
Significant decreases in the body surface area affected by psoriasis were observed from 10 to 20 weeks into pregnancy compared with the non-pregnant group, but the situation reversed by 6 weeks post-partum, Weinstein's team found.
The improvement in body surface area correlated with levels of estrogens and the estrogen-progesterone ratio.
The investigators say it would be worthwhile to look into how estrogen improves psoriasis, and whether the hormone might prevent worsening of psoriasis after menopause.
SOURCE: Archives of Dermatology, May 2005.

Psoriasis Scams

This is a critical review of psoriasis treatments promoted on the net. Many of these are scams. Some are just deceptive misinformation, others are potentially dangerous. Secrets are revealed wherever possible to spoil the marketing game. It's a shame that these hucksters prey on people desperately looking for a safe and effective treatment.
Skip to: FDA Steroids Skin-Cap SkinZinc Miralex Exorex Zinc Miracure Kessler Psoriasis.COM Lupicare Itchstopper Psorigon Emu Oil Neem Oil Ewell CureBook GilTeva Amjo D.P.Ray silver PsoriasiCure feedback
Why is this page needed?
Quackery is everywhere. With a few notable exceptions, commercial sites selling psoriasis treatments emphasize only the claimed benefits of their products and provide no support for those claims. They rarely mention risks, side effects, or offer an accurate list of ingredients so that consumers can make their own informed choice. The only public place to find this information has been in the psoriasis newsgroup, and the postings don't stay around long enough for newcomers to see them. By putting this information here on the web, the reviews will hopefully be as visible to the world as the commercial sites are now.
One universal trait of the Hall of Pshame sites is that they raise unrealistic hopes of miracle cures and rapid clearing. Most psoriatics have become hardened to these tactics, but sometimes the sales pitch can be very convincing. "What have you got to lose?" is a common question. The fact is, that besides the money lost, the time wasted on an ineffective treatment could have been used to try something more realistic. The greatest loss is when a desperate person gets fooled again, and loses hope of ever finding something that works.
Please distinguish between the treatments being offered and the methods used to promote them. The intent here is not to invalidate anyone's personal success with a treatment, but to show how the claims are deceptive and misleading. The promoters of the secret cures no doubt got benefit with their regimen, but it is a serious mistake to assume that their experience will be universal. Psoriasis covers a wide range of symptoms that can be triggered by many different causes. What has been discovered repeatedly in the open forum discussions is this: What works for one person does nothing for the next.

Understanding Psoriasis

People with psoriasis may notice that there are times when their skin worsens, then improves. Conditions that may cause flareups include changes in climate, infections, stress, and dry skin. Also, certain medicines, most notably beta-blockers, which are used in the treatment of high blood pressure, and lithium or drugs used in the treatment of depression, may cause an outbreak or worsening of the disease.
More information on psoriasis can be found at:
http://www.dermatitis-ltd.com/aboutpso.php3

What is Flexural Psoriasis?

Inverse or Flexural psoriasis is localized in the flexural surfaces of the skin, e.g., armpit, groin, under the breast, and other skin folds. Typically, it appears as smooth inflamed lesions without scaling and is particularly subject to irritation due to rubbing and sweating. This type of psoriasis is often white in color, appears softened as if soaked by water, and may resemble a fungal infection. There is very little scaling, although the patches are inflamed and can be very sore. Appearing as it does in the folds of the skin, it is moister than other forms of psoriasis, and can be more uncomfortable physically. Flexural psoriasis rarely occurs by itself. It is more likely to accompany common plaque psoriasis. Psoriasis sufferers in their middle years or old age are more susceptible to this type of psoriasis as are people who are overweight and have more folds of skin.

Psoriasis Can Affect The Ears

Psoriasis is commonly found in the ears too. In this case it can appear as dry scales in the ear canal. It also occurs behind the ear so this area has to be checked to look for the plaques if the diagnosis of psoriasis is considered. The image shows some dryness of the skin in the ear, with some scaling, which is characteristic of psoriasis.

Guttate Psoriasis Can Affect Children Too

Guttate psoriasis is characterized by small red dots (or drops) of psoriasis. Guttate is derived from the Latin word gutta meaning "drop." It often appears on the trunk, arms and legs. The lesions may have some scale. Guttate psoriasis frequently appears suddenly following a streptococcal infection or viral upper respiratory infections. There are also other events that can precipitate an attack of guttate psoriasis: tonsillitis, a cold, chicken pox, immunizations, physical trauma, psychological stress, illness, and the administration of anti-malarial drugs. Guttate psoriasis is many small patches of psoriasis, all over the body, and often happens after a throat infection. Guttate Psoriasis most often affects children and young adults. It appears as small, red bumps-the size of drops of water-on the skin. It usually appears suddenly, often several weeks after an infection such as strep throat.

Facts on Psoriasis

Psoriasis is a chronic skin condition affecting approximately 4.5 million people in the United States.
New skin cells grow too rapidly, resulting in inflamed, swollen, scaly patches of skin in areas where the old skin has not shed quickly enough.
Psoriasis can be limited to a few spots or can involve more extensive areas of the body, appearing most commonly on the scalp, knees, elbows and trunk.
Psoriasis is not a contagious disease. The cause of psoriasis is unknown, and there currently is no cure.
Psoriasis can strike people at any age, but the average age of onset is approximately 28 years. Likewise, it affects both men and women, with a slightly higher prevalence in women than in men.
Approximately 30 percent of people with psoriasis are estimated to have moderate-to-severe forms of the disease.
Psoriasis can be a physically and emotionally painful condition.
It often results in physical limitations, disfiguration and a significant burden in managing the daily care of the disease.
Psoriasis sufferers may feel embarrassed, angry, frustrated, fearful, depressed and, in some cases, even suicidal.

Five Types of Psoriasis

There are five different types of psoriasis. The most common form of psoriasis is called "plaque psoriasis," which is characterized by well-defined patches of red, raised skin. About 80 percent of people with psoriasis have this type. Plaque psoriasis can appear on any skin surface, although the knees, elbows, scalp, trunk and nails are the most common locations. The other types of psoriasis are: Guttate described as small, red, individual drops on the skin. Inverse psoriasis is smooth, dry areas of skin, often in folds or creases, that are red and inflamed but do not have scaling Erythrodermic psoriasis is characterized as periodic, widespread, fiery redness of the skin. Pustular psoriasis which involves either generalized, widespread areas of reddened skin, or localized areas, particularly the hands and feet (palmo-plantar pustular psoriasis).Typically, people have only one form of psoriasis at a time. Sometimes two different types can occur together, one type may change to another type, or one type may become more severe. For example, a trigger may convert plaque psoriasis to pustular.

Pustular Psoriasis

This type of psoriasis usually appears as a large red area covered with yellow-green pustules. They tend to be one to two millimeters in diameter and are quite tender. The yellow color is caused by masses of white blood cells (polymorph leucocytes), which flood into any part of the skin that is damaged or infected, in order to fight infection and aid recovery.After seven to 10 days, the pustules become dispersed and a brown scale appears. This scale will start to shed as new pustules develop in other areas, often in a continuous cycle.The most common type of pustular psoriasis affects the palms and soles. It isn't normally itchy however it can be sore or uncomfortable to use either your hands or feet, for example if you are writing or walking.

Learn more about this type of psoriasis at:
http://www.internationaleczema-psoriasisfoundation.org/pustular_psoriasis.php4

PSORIASIS: TYPES AND SYMPTOMS

Individuals with psoriasis experience symptoms such as itching, cracking, stinging, burning, or bleeding. Lack of sunlight and low indoor humidity in the winter months can cause the psoriasis symptoms to worsen. The skin is most likely to crack at the joints where the body bends, or in areas where the individual scratches. Scratching should be strictly avoided, because it can cause bleeding and infection. Psoriasis has also been known to cause pits or dents to form in fingernails and toenails. There is also the possibility that the soft tissue inside the mouth and genitalia can be affected. In some cases, psoriasis will cause joint inflammation that produces arthritis symptoms. This condition is called psoriatic arthritis.People with psoriasis may notice that there are times when their skin worsens, then improves. Conditions that may cause flare-ups include changes in climate, infections, stress, and dry skin. Also, certain medicines, most notably beta-blockers, which are used in the treatment of high blood pressure, and lithium or drugs used in the treatment of depression, may cause an outbreak or worsening of the disease

The Treatment of Psoriasis

In the treatment of psoriasis, it is important to treat psoriasis in as many ways as possible. Those who modify their lifestyles, eating habits and reduce their level of stress often experience a much greater degree of psoriasis cure. The most visible and distressing symptoms receive treatment, but more can be accomplished by treatment of the cause!

Erthrodermic Psoriasis

Erythrodermic psoriasis appears on the skin as a widespread reddening and exfoliation of fine scales, often accompanied by severe itching and pain. Swelling may also develop. This is a rare condition in which the rash is spread over large sections of the body. The skin is very inflamed which affects its ability to function properly. It does not retain fluid as normal, which results in the patient feeling constantly thirsty and being dehydrated. It also impairs the skin's performance in maintaining body temperature control so the sufferer may lose heat more easily and be more susceptible to hypothermia. This is also a more serious form of the condition and one that needs expert medical management.Erythrodermic psoriasis is a particularly inflammatory form of psoriasis that often affects most of the body surface. It is the least common form of the disease. It most commonly appears on people who have unstable plaque psoriasis, where lesions are not clearly defined

Inverse Psoriasis

Inverse or Flexural psoriasis is localized in the flexural surfaces of the skin, e.g., armpit, groin, under the breast, and other skin folds. Typically, it appears as smooth inflamed lesions without scaling and is particularly subject to irritation due to rubbing and sweating. This type of psoriasis is often white in color, appears softened as if soaked by water, and may resemble a fungal infection. There is very little scaling, although the patches are inflamed and can be very sore. Appearing as it does in the folds of the skin, it is moister than other forms of psoriasis, and can be more uncomfortable physically. Flexural psoriasis rarely occurs by itself. It is more likely to accompany common plaque psoriasis. Psoriasis sufferers in their middle years or old age are more susceptible to this type of psoriasis as are people who are overweight and have more folds of skin.

For more information on the types of psoriasis visit :
http://www.internationaleczema-psoriasisfoundation.org/psoriasis.php4

Guttate Psoriasis

Guttate psoriasis is characterized by small red dots (or drops) of psoriasis. Guttate is derived from the Latin word gutta meaning "drop." It often appears on the lower half of the body. The lesions may have some scale. Guttate psoriasis is many small patches of psoriasis, all over the body, and often happens after a throat infection. Guttate Psoriasis most often affects children and young adults. It appears as small, red bumps-the size of drops of water-on the skin. It usually appears suddenly, often several weeks after an infection such as strep throat. Antibiotics may be used to treat guttate psoriasis that is triggered by an infection. Guttate psoriasis usually responds to treatment and may gradually go away on its own. Many people who have an episode of guttate psoriasis may not have another one for many years.

What is Palmoplantar Psoriasis?

Psoriasis that affects the palms of the hands and the soles of the feet is called palmoplantar psoriasis. It may appear as chronic flaky patches that crack and bleed. The nails may be affected as well. In severe cases the condition can be disabling. Palmar-plantar psoriasis: Psoriasis of the palms, of the hands and the soles of the feet, characterized by erythema, thickening and peeling of the skin, blistering is often present. It may prevent patient from opening and closing hands thus leading to a disability. The palms and soles can also be affected by pustular psoriasis. In this condition small, deep, pus-filled blisters appear on the palms and soles. They may have a copper-colored hue on a background of red, flaky skin. This condition may also be called palmoplantar pustulosis or acropustulosis.Red, scaling plaques with small pustules that develop on the palms and the soles of the feet are called palmolatar psoriasis. The pustules are 1–10mm (pin- to dime-sized) in diameter and are often painful, interfering with daily functioning. It predominately affects women.This condition looks very different from common plaque psoriasis and flexural psoriasis, and usually only appears on the soles of the feet and palms of the hands. Instead of inflamed and scaly patches, there are weeping, cracked lesions that can look like masses of tiny yellow blisters. These can be quite painful and look infected, even though there is no infection present. Over a period of days, the pustules turn a brownish color and fall off, often only to be quickly replaced. The production of new pustules to replace the ones that have been shed can go on over a period of years. Psoriasis can affect the feet causing thick scaling and redness. The feet can occasionally be the only area to be affected by psoriasis with no rash elsewhere on the body. When psoriasis is found elsewhere on the body, the feet can also be the area involved with thick scaling, redness and sometimes pustules. The pustules are known as sterile pustules as they do not have infection within them.

Getting the Facts on Psoriasis

Psoriasis is a chronic skin condition affecting approximately 4.5 million people in the United States.

New skin cells grow too rapidly, resulting in inflamed, swollen, scaly patches of skin in areas where the old skin has not shed quickly enough.

Psoriasis can be limited to a few spots or can involve more extensive areas of the body, appearing most commonly on the scalp, knees, elbows and trunk.

Psoriasis is not a contagious disease.

The cause of psoriasis is unknown, and there currently is no cure.

Psoriasis can strike people at any age, but the average age of onset is approximately 28 years.

Likewise, it affects both men and women, with a slightly higher prevalence in women than in men.

Approximately 30 percent of people with psoriasis are estimated to have moderate-to-severe forms of the disease.

Psoriasis can be a physically and emotionally painful condition. It often results in physical limitations, disfiguration and a significant burden in managing the daily care of the disease.

Psoriasis sufferers may feel embarrassed, angry, frustrated, fearful, depressed and, in some cases, even suicidal.

Types of Psoriasis

Plaque-type psoriasis is the most common form of the disease and is commonly referred to as psoriasis vulgaris (Camisa 56). Plaque-type psoriasis is characterized by inflamed skin lesions topped with silvery white scales. This type of psoriasis can assume many different appearances based on its location, the activity of the disease, and the treatment being administered. Plaque-type psoriasis is most commonly found on the elbows, knees, scalp, sacrum, umbilicus, intergluteal cleft, and genitalia (Camisa 56).
Guttate psoriasis is characterized by small dot-like lesions. Guttate psoriasis is the most common cause of psoriasis in children and young adults who have a prior history of upper respiratory infection, pharyngitis, or tonsillitis (Camisa 64). The lesions are not as scaly as plaque-type psoriasis and are likely to be found on the trunk and involve the face (Camisa 64).
Pustular psoriasis is characterized by pustules, which are blister-like lesions of non-infectious fluid, and cause intense scaling. Individuals with pustular psoriasis are often among the most seriously ill and may have to be hospitalized (Camisa 67).
Erythrodermic psoriasis is the rarest form of psoriasis and is characterized by intense redness and swelling, exfoliation of dead skin, and pain. Erythrodermic psoriasis usually develops during the course of chronic psoriasis. However, in some cases erythrodermic psoriasis is the first manifestation of psoriasis, even in children (Camisa 74). Individuals with this type of psoriasis may experience chills and low grade fever, and may be rather uncomfortable (Camisa 75).
Inverse psoriasis is characterized by smooth inflamed lesions in the body folds -- armpits, under the breast, skin folds of the groin, buttocks, and genitals.
Koebner's Phenomenon psoriasis are psoriatic lesions which appear at the site of injury, infection or other skin psoriasis, or may be a new lesion in an existing case.
The degree of psoriasis can also vary from individual to individual. It ranges in severity from mild (affects less than 2% of body) to moderate (affects 2-10% of body) to severe (affects greater than 10% of the body). Skin injury and irritation, sun exposure, diet, stress and anxiety, medications, and infections have been known to make psoriasis worse.