Smoking And Obesity Impact Psoriasis

Smoking and Obesity More Prevalent Among Psoriasis Patients
Researchers report that the prevalence of both smoking and obesity is higher among patients with psoriasis than in the general population.
Chicago, Ill. - infoZine - Mark D. Herron, M.D., now in private practice in Montgomery, Ala., and colleagues from the University of Utah School of Medicine, Salt Lake City, studied the impact of obesity and smoking on psoriasis. A case series of patients with psoriasis enrolled in the prospective Utah Psoriasis Initiative (UPI) was compared with three population databases: the Behavioral Risk Factor Surveillance System of the Utah population, the 1998 patient-member survey from the National Psoriasis Foundation, and 500 adult patients who attend the University of Utah Department of Dermatology clinics and do not have psoriasis."The prevalence of obesity in patients within the UPI population was higher than that in the general Utah population (34 percent vs. 18 percent) and higher than that in the non-psoriatic population attending our clinics," the authors write. "The prevalence of smoking in the UPI population was higher than in the general Utah population (37 percent vs. 13 percent) and higher than in the non-psoriatic population."
The authors found that obesity appears to be the consequence of psoriasis, and not a risk factor for onset of the disease. "Smoking appears to have a role in the onset of psoriasis, but obesity does not," they write."It seems certain that the cost of providing care for psoriasis - when coupled with the increased frequency of obesity and smoking in patients attending clinics such as ours - will continue to increase," the authors conclude. "An effort to control obesity and smoking in psoriasis patients and an increased appreciation of the effects of these comorbidities are clearly needed."JAMAEditor's Note: This study was supported by a grant from the Dermatology Foundation, Evanston, Ill., and by financial support from LineaGen Inc., Salt Lake City, Utah.
Editorial: Advances In PsoriasisIn an accompanying editorial, Mark G. Lebwohl, M.D., of Mount Sinai Medical Center, New York, examines recent advances in psoriasis treatment, and suggests that the impact of those treatments on all dermatologic disease has been profound.Summarizing the findings of Fortes and colleagues and Herron and colleagues, Dr. Lebwohl writes, "These studies do not answer the question, however, of whether psoriasis leads to smoking or smoking exacerbates psoriasis.""The current issue of the Archives demonstrates that psoriasis remains a therapeutically and intellectually challenging disease," he concludes. "As research and development continue, we undoubtedly will have better treatments. We can only hope that they will be treatments that patients can afford."JAMA Editor's Note: In the past year, members of Dr. Lebwohl's department have served as investigators for and received grants and honoraria from Abbott Laboratories, Allergan, Amgen, Astellas, Biogen Idec, Centocor, Connetics, Genentech, Novartis, and Warner Chilcott. Dr. Lebwohl is also a consultant (or has pending consulting agreements) for Abbott Laboratories, Amgen, Astellas, Biogen Idec, Centocor, Connetics, Genentech, Novartis, Pfizer, Warner Chilcott, and 3M. In addition, members of Mount Sinai's Department of Dermatology hold patents for short-contact tazarotene therapy, excimer laser treatment of vitiligo, and topical genistein. Finally, in the past year, Dr. Lebwohl has served as a speaker for Abbott Laboratories, Amgen, Astellas, Biogen Idec, Centocor, Connetics, Genentech, Novartis, Warner Chilcott, and 3M.

Study Indicates Psoriasis Drug Also Aids in Depression

LONDON (Reuters) - Amgen Inc.'s psoriasis drug Enbrel appears to reduce depression and fatigue, as well as improving symptoms of the chronic skin disease, researchers said on Thursday.
Psoriasis is characterized by inflamed, red, raised areas of skin that develop silvery scales. The condition can have a major psychological impact on patients.
A 618-patient trial of Enbrel, known generically as etanercept, found that those given the drug for 12 weeks had a 50 percent improvement in a commonly used rating scale for depression and suffered significantly less fatigue compared to those on placebo.
The clinical trial also reaffirmed the ability of Enbrel to fight psoriasis, with nearly half of patients taking it achieving a 75 percent or greater improvement in their psoriasis, compared with only 5 percent on placebo.
The findings by Ranga Krishnan of Duke University Medical Center, North Carolina, and colleagues were published online by the Lancet medical journal in Britain.
Enbrel works to treat a range of autoimmune diseases by blocking an inflammation-causing protein called tumor necrosis factor. These diseases, which include psoriasis and rheumatoid arthritis, occur when the body's immune system mistakenly attacks healthy tissue.
Rival drugs include Abbott Laboratories Inc.'s
Humira and Johnson & Johnson's Remicade.
The indictable medicines are expensive -- costing about 10,000 euros ($12,030) per patient a year in Europe -- but they are increasingly reimbursed through healthcare systems under strict conditions.
Enbrel was originally discovered by Immunex, now part of Amgen, and jointly developed with Wyeth, which markets the product outside North America.

Plant Extract May Prove Beneficial For Psoriasis

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.

Psoriasis Health Care Advocates

"Psoriasis Cure Now," a nonprofit patient group that works on behalf of the psoriasis community, today announced its 2005 "Health Care Advocates of the Year."

The recipients are Sen. Arlen Specter of Pennsylvania, Rep. Rosa DeLauro of Connecticut, and Rep. Ralph Regula of Ohio. These three lawmakers were instrumental in putting Congress on record in support of increased federal research for psoriasis and psoriatic arthritis. Psoriasis research funding has traditionally lagged behind other research areas, receiving just $6.5 million last year out of a federal medical research budget at the National Institutes of Health (NIH) approaching $30 billion.

"People with psoriasis have no Hollywood stars or other glitzy backers to call on for support or to bring attention to this incurable disease," said Michael Paranzino, president of Psoriasis Cure Now. "In fact, we have traditionally suffered in silence. Yet these leaders took up our cause without fanfare and recognized how research on psoriasis will help not just the millions of Americans with the disease, but may also help us better understand other challenging diseases. We are grateful for their service to their constituents."

"The National Institutes of Health plays an important role in medical discoveries that improve people's health and save lives," said Congressman Regula (Ohio-16). "I am pleased that, together with the support of my colleagues, we have been able to direct some of NIH's focus towards this disease which affects millions of Americans."

Psoriasis is an incurable, recurring disease of the immune system that can first strike at any age, causing dry, painful skin lesions that can crack, bleed and itch. Many people with psoriasis also have psoriatic arthritis, a chronic, progressive and debilitating inflammatory disease that often causes joint pain, stiffness and swelling, as well as bone damage. Studies this year found a higher incidence of autism in children of mothers with psoriasis, and a higher incidence of cardiovascular death among patients with severe psoriasis.

People with psoriasis also have higher rates of depression and suicidal ideation. "Congress really came together this year on behalf of psoriasis patients and their families," Paranzino added, "and Senator Specter, Congressman Regula and Congresswoman DeLauro led the way. A cure will come more quickly thanks to their efforts."

According to the NIH, there are as many as 7.5 million Americans with psoriasis, including an estimated 75,000 people with psoriasis in Connecticut; about 270,000 with psoriasis in Ohio; and about 285,000 with psoriasis in Pennsylvania. Each of these states also has important psoriasis research centers, including the University of Pennsylvania, Case Western Reserve University and Yale University.

"Cutting edge research like that being conducted at centers such as Yale University will help us find better treatments and ultimately a cure for psoriasis," said Congresswoman DeLauro (Conn.-3). "Federal funding for this research is critical, which is why I have fought in Congress to ensure psoriasis research continues. I am honored to be recognized by Psoriasis Cure Now for this work."

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.

Stress Induced Psoriasis

Although psoriasis is believed to be the result of an immune system malfunction, Lebwohl says there have also been a number of genes identified with this condition. And like most genetic conditions, he tells WebMD that there is also a unique, genetically determined time frame in which psoriasis is triggered into action, and it's different for everybody who has it. Still, he says, something does have to act as the initial trigger, and often, that "something" is stress.

Indeed, in a study published in the Journal of the American Academy of Dermatology in 1988, doctors from the Baylor College of Medicine concluded that stress can not only trigger a psoriasis flare-up, but in some instances it may also play a significant role in the initial onset of the condition.

Since the fall season frequently kicks off an activity-packed school year -- stressful for parents as well as students -- it's not hard to see why this time of year can make psoriasis worse. Toss in a stress-filled holiday season, and some psoriasis patients can suffer well into the New Year.

But doctors say you can head off the effects of stress by engaging in some form of relaxation beginning at the start of the fall season. The Baylor research notes that several studies found hypnosis and biofeedback are effective stress reducers in some people with psoriasis.

And in at least one study published in a Swedish dermatology journal, doctors from McGill University in Quebec found that both meditation and guided imagery were effective relaxation methods in reducing psoriasis symptoms. Lebwohl reports that in another study, patients undergoing UV light therapy who practiced guided imagery -- imagining their psoriasis being healed -- experienced a quicker remission than those undergoing UV therapy alone.

Indeed, Moore tells WebMD that anything that helps you relax -- including meditative yoga, vigorous exercise, acupuncture, or even just taking time out of your day to listen to a favorite CD or drift away with a great novel -- can help keep your psoriasis under control, particularly during a stressful season. Remember that these techniques work best with traditional medical therapy instead of alone.

Vitae Enters Phase II Clinical Trials

Vitae Pharmaceuticals, Inc.announced today that it has initiated Phase II clinical studies with VTP-201227 for the treatment of psoriasis and VTP-195183 to enhance immune celllevels in specific cancer treatments. "Within the last 18 months, Vitae has progressed multiple products intoPhase II trials, created a significant partnership with GlaxoSmithKline, andexpanded our robust pipeline of discovery projects," said Jeffrey Hatfield,CEO of Vitae Pharmaceuticals. "We now have significant development efforts inthree major disease areas, including oncology, dermatology and hypertension.The speed of our progress demonstrates the ability of our team, our uniqueapproach and the strength of our drug discovery capabilities and proprietarytechnologies." The first Phase II clinical compound, VTP-201227, has a novel mechanism ofaction and is being developed at Vitae Pharmaceuticals as a topical agent forthe treatment of psoriasis with potential extensions into other dermatologicalindications. The Phase II trial is designed to include 128 psoriasis patientsat 16 study sites in the U.S. The first psoriasis patient was enrolled anddosed in the study this month. VTP-201227 is a potent, selective inhibitor of two specific enzymes thatare active in the skin. Therapeutic targeting of these enzymes by VTP-201227promotes naturally-occurring healing processes within the skin. The compoundhas been designed to be rapidly inactivated in systemic circulation and thushas the potential to have a more favorable safety profile. In preclinicalanimal models, VTP-201227 was shown to exhibit a superior therapeutic indexcompared to other topical dermatology drugs. The second Phase II clinical compound, VTP-195183, is being studied incombination with other therapies for its potential to boost the levels ofinfection-fighting white blood cells in certain oncologic conditions. Vitaeadvanced the clinical program for this compound and initiated a Phase IIclinical trial in October. The Phase II trial is designed as a proof-of-biology study to determine the effectiveness of VTP-195183 in combination withGranulocyte Colony Stimulating Factor (G-CSF) to enhance mobilization ofperipheral blood progenitor cells in patients for whom high-dose chemotherapyis planned. VTP-195183 is a novel subtype-specific nuclear receptor agonistthat has been shown to be generally safe and well tolerated in cancer patientsin Phase I studies. The Phase II clinical trial of VTP-195183 is beingconducted outside of the U.S.

Understanding Scalp Psoriasis

Psoriasis is a common skin condition affecting 2-3% of the population of the United Kingdom and Ireland.
Psoriasis is in simple terms only a vast acceleration of the usual replacement processes of the skin. It appears as raised red patches of skin covered with silvery scales.

With scalp psoriasis there is thick scale and redness that is also evident around the scalp margins. Many patients experience severe itching and a feeling of tightness and some report soreness. One patient has described the build-up of scales as being like 'a mountain on my head'.

For those with scalp patches which flare up from time to time it is possible to manage at home. Shampoo treatments are improving all the time and can be bought over the counter. Your pharmacist should be able to advise. However if your scalp is covered with thick scale or it does not clear up do consult your GP who may arrange referral to a Dermatologist.

There is a range of treatments which can be prescribed including coal tar, dithranol, salicylic acid, cortico-steroids and Vitamin D derivatives to bring the flare-up to a manageable level.

The method of applying the treatment is most important. It involves parting the hair in sections and rubbing the treatment along the exposed area. It is best to do this in a sequential fashion working your way around the hair. You may need someone to help you in order to see the top of your head properly.

Providing care is taken to avoid scratching the scalp, combing and brushing to remove scaling is not only good but necessary.

Scalp psoriasis should not prevent any cosmetic procedures. Having a perm or colouring the hair can have a positive effect on your self esteem. Hair dyes are gentler than they used to be but it would be best to seek advice from a hairdresser who should have up to date information about possible options rather than colour or tint your hair at home. It is also a good idea to make sure that there are no scratches on the scalp when the hair is treated as the chemicals concerned can cause irritation on the broken skin.

A good hairdresser should be able to help you manage your hair and scalp. Telephone in advance and speak to a stylist to explain the situation or try to find a hairdresser who will visit you in your home.

Some people with severe psoriasis suffer temporary thinning of the hair. This can be very distressing but the hair will grow again once the flare up has subsided.

Psoriasis is known as the waxing and waning condition, and it can and does go away. Some people may be lucky enough not to suffer a further flare up, others may experience long remissions. It is unusual for anyone to suffer extensive scalp psoriasis for a long time, provided they seek medical help and use treatments as directed.

Children Suffer From Psoriatic Arthritis Also

Juvenile psoriatic arthritis can be tricky to diagnose. While psoriasis is a common skin condition, associated primarily with a chronic rash all over the, only about 12 to 14 percent of people with psoriasis will develop related arthritis.CausesGenetic and environmental factors play a strong role in the development of psoriatic arthritis. A family history of psoriasis is linked to many children with juvenile psoriatic arthritis, as well as a family history of other forms of spondyloarthropathy. There is little relationship between the severity of a rash and the risk of getting juvenile psoriatic arthritis, however.NOTE: In some people with juvenile psoriatic arthritis, the arthritis shows up before the rash. In these cases, diagnosis can be so difficult that it may take up to 10 years to be certain of a definite diagnosis.Signs and Symptoms
Pitting or thickening and yellowing of the fingernails and toenails
A small round scaly patch on the scalp, belly button or buttocks
Joint problems in large joints, such as the hip and sacroiliac joints
Joint problems can occur on just one side or in the same joints on both sides of the body
Swelling of entire fingers or toes, making them resemble sausages (dactylitis)
Eye inflammation occurs in 10 to 20 percent of children
NOTE: Children with juvenile psoriatic arthritis should be examined by an eye specialist (ophthalmologist) annually to check for eye problems.Long-term Concerns
Damage to the eyes or other eye problems
Decreased range of motion of a joint
Shortening or lengthening of a limb or digit
Damaged cartilage and/or enlargement of a joint
NOTE: Many children have no long-term consequences of having juvenile psoriatic arthritis. Your child may have none, one or several of the concerns listed above, but you should be on the lookout for any or all of them.

Psoriasis Cover ups

People are curious when they see something different, especially on your skin. You have many choices about how to react to their curiosity. You may choose to ignore their attention, or you can explain that psoriasis is a skin disease that is not contagious. Educating people about psoriasis is very valuable because it helps them to accept people who live with skin that is different.
But when you wish to go out in public without addressing your skin condition, certain techniques can help you cope. Wearing long sleeves, pants, turtlenecks, hats or scarves, for example, can make coping in public a lot easier on days when you don't have the emotional energy to accept the stares and questions.
Cosmetic cover-up products can help for those times when clothing won't do. Masking psoriasis lesions and camouflaging redness can make it easier to feel confident in social situations. Dermablend is one brand name of a body makeup that some people use. It can be found in major department stores.
Caution: Never apply cosmetic cover-up to open skin lesions, unhealed cuts or raw or irritated skin. Avoid using cosmetics if skin allergies are present. If you're ever in doubt about applying a cover-up, seek the advice of your physician.
Note: Not all types of psoriasis can be camouflaged. Masking pustular or erythrodermic psoriasis is not a good idea, because minor irritants in cosmetics can produce stinging and redness, and this skin is already inflamed.
What can I do to make my psoriasis less noticeable?Using moisturizers regularly can help improve the redness and scaling of psoriasis lesions. Also, remove as much scale as possible if you are going to use a cosmetic cover-up. There are two ways you can get rid of psoriasis scale on your own:
Occlusion: You can coat each plaque with a thick layer of heavy, over-the-counter emollient cream and then cover it overnight with a plastic wrap. In the morning, wash away the scales in the shower. Note: never occlude a prescription drug without first consulting your doctor.
Hydration: After soaking for 10 to 15 minutes in warm water and bath oil, gently rub your skin with a towel to remove the scales

THE FACTS ON PSORIATIC ARTHRITIS

Psoriatic arthritis is a genetically determined autoimmune disease that occurs in less than 10 percent of persons with psoriasis. Its treatment often requires consultation with a rheumatologist in addition to treatment of the skin lesions by a dermatologist. Psoriatic arthritis is classified with the disease grouping called seronegative spondyloarthropathies which also includes ankylosing spondylitis, enteropathic arthritis, and Reiter’s Syndrome. 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.
Confirmation of a diagnosis of psoriatic arthritis requires specific blood and serum tests to differentiate it from conditions such as rheumatoid arthritis and other autoimmune diseases.
Please see the National Psoriasis Foundation for information on the treatment of psoriatic arthritis.
A pediatric form of psoriatic arthritis may appear as early as age 2 to 4 years in girls. A peak period of pediatric onset is age 11 to 12 in both girls and boys. In children the arthritis may appear several years prior to the onset of psoriatic skin lesions; this may pose a problem in recognizing the nature of the underlying disease, especially if there is no known family history of psoriasis.
Although psoriatic arthritis and psoriasis occasionally occur in the absence of a history of psoriasis in the family, a genetic predisposition for psoriasis is considered to be a necessary condition for development of psoriatic arthritis. The evidence for inheritability is well established.
As in the case of psoriasis, an environmental "trigger" may initiate the development of psoriatic arthritis in a genetically predisposed person.

Nail Psoriasis

About 50 percent of persons with active psoriasis have psoriatic changes in fingernails and/or toenails. In some instances psoriasis may occur only in the nails and nowhere else on the body. Psoriatic changes in nails range from mild to severe, generally reflecting the extent of psoriatic involvement of the nail plate, nail matrix (tissue from which the nail grows), nail bed (tissue under the nail), and skin at the base of the nail. Damage to the nail bed by the pustular psoriasis can result in loss of the nail.

Nail changes in psoriasis fall into general categories that may occur singly or all together:
The nail plate is deeply pitted, probably due to defects in nail growth caused by psoriasis.
The nail has a yellow to yellow-pink discoloration, probably due to psoriatic involvement of the nail bed.

White areas appear under the nail plate. These are air bubbles marking spots where the nail plate is becoming detached from the nail bed (onycholysis). There may be reddened skin around the nail.

The nail plate crumbles in yellowish patches (onychodystrophy), probably due to psoriatic involvement in the nail matrix.

Psoriasis of the nails can resemble other conditions such as chronic infection or inflammation of the nail bed or nail fold. Psoriasis of the toenails can resemble chronic fungal infection of the nails.

A person with psoriatic nails should avoid any injury - bumps, scrapes, etc. - that may trigger a worsening of psoriasis (Koebner’s phenomenon). Nail psoriasis is treated by the dermatologist as part of the overall treatment of the disease.

Nail psoriasis is frequently associated with psoriatic arthritis

Psoriasis Sufferers Face Increased Risks From Heart Disease

People severely afflicted by psoriasis have a significantly increased risk of dying from heart disease, new research shows.
A Swedish study found that patients hospitalised with the skin disorder were 50% more likely to die from a heart condition than expected.
The extra risk increased sharply as patients got younger, rising to 162% for those admitted under the age of 40.
For severe psoriasis sufferers aged 40-59 when they were hospitalised, the risk was 91% higher than in the average population.
However the same trend was not seen in less seriously affected individuals who were not admitted to hospital.
The findings emerge from a Swedish study of almost 9,000 psoriasis patients admitted to dermatology wards and more than 19,000 outpatients.
They suggest a genetic defect linking the skin condition and heart problems.
Serious psoriasis sufferers are known to have raised levels of blood cholesterol, which is a chief indicator of heart and artery disease.
Previously this was blamed on the age of older patients or the long term effect of drugs used to treat the disorder.
But the Swedish researchers found high cholesterol levels in a group of 600 newly diagnosed patients who had been suffering from psoriasis for less than a year.

Thymodepressin Now in Clinical Development In US

Few diseases cause more misery than psoriasis, a condition that occurs when a person's immune system overreacts and begins to attack the skin. Psoriasis is a non-contagious skin disorder which most commonly appears as inflamed, fluid-filled skin lesions covered with a silvery white scale. In its more severe phase, the scaly, red blotches can become itchy or painful and cover large areas of skin.
Approximately 2% of the population suffers from this often painful inflammatory condition. In the United States alone, this translates to about 5.5 million patients, many of whom are suffering from a reduced quality of life, and its effect can be as bad as or worse than many other well known diseases or conditions.
GenaDerm, a specialty dermatological company, is in the race to provide better therapies for more effective treatment of psoriasis. GenaDerm is a subsidiary of Bioaccelerate Holdings Inc. (OTCBB:BACL). The privately held company is co-developing with Immunotech Developments Inc., for Thymodepressin(r) the first synthetic peptide developed for the treatment of autoimmune diseases including psoriasis. Immunotech is a biotechnology-focused firm that works to develop novel therapeutic peptides for the treatment of large market diseases.
Now in clinical development and testing in North America, Thymodepressin(r) has already proved to be an effective treatment for psoriasis in Russia, where the drug was invented and is currently sold.
Professor Vladislav Deigin, Chief Executive Officer and President of Immunotech and inventor of Thymodepressin(r) said, "Immunotech was established to pursue the development and commercialization opportunities presented by a scientific platform for the identification and production of peptides. We are delighted that this has been the basis of developing an effective treatment for such a chronic and debilitating condition. Key therapeutic goals in the treatment of psoriasis are alleviation of the condition, and sustainability of the relief provided by treatment. After successfully treating many psoriasis patients in Russia we are optimistic that clinical trials will confirm this efficacy in other countries."
Christopher O'Toole, Head of Specialty Pharmaceuticals for Bioaccelerate said, "In the United States alone, 30% of psoriasis sufferers or 1.5 million patients are seeking treatment. Of these, roughly one third have moderate to severe psoriasis. We are confident that Thymodepressin(r) will demonstrate similar clinical efficacy for this group of patients as it progresses through its planned clinical trial program, and thus provide more treatment options in the future."

Psoriasis And The Social Connection

People with psoriasis perceive they have less social support, have difficulty expressing their feelings and have more trouble with social relationships than others, a new study shows.
Newswise — The study says these life stresses may make them more prone to outbreaks of their psoriasis.
Researchers led by Angelo Picardi, M.D., suggest in the November-December issue of Psychomatics that “psychological interventions aimed at increasing emotional awareness, fostering the security felt in close interpersonal relationships and increasing social support might help reduce” outbreaks or at least lessen their severity.
The scientists from La Sapienza University in Rome studied 33 patients with psoriasis who had a recent worsening of their symptoms and 73 patients who had other minor skin conditions. Both groups were asked about stressful events over the past year, specifically about their social and emotional lives.
Psoriasis is an inflammatory skin condition that affects about 7 million Americans. The study participants had plaque psoriasis, the most common form, which appears as patches of raised, reddish skin covered by silvery-white scales and forms most commonly on the elbows, knees and lower back.
The researchers found that, in comparison with the group that had minor conditions, the patients with a recent psoriasis outbreak had lower perceived social support, more characteristics of bottled-up emotions and higher “attachment-related anxiety.” There were no differences in their scores, however, on measures that tested experiences in close relationships.
People who are high in attachment-related anxiety tend to worry about whether their partners really love them and often fear rejection. In addition, some people are more avoidant that others. People who are high in attachment-related avoidance are less comfortable depending on and opening up to others and are reluctant to ask their partners for comfort or support.
Age, gender, education, marital status and alcohol consumption were taken into consideration when assessing patient outcomes.
“Theoretical models emphasize that these persons tend to rely more on cognition and cognitive information than on feelings and emotional information,” Picardi said. “Clearly, self-regulation is compromised both internally and externally, which may increase susceptibility to disease.
“Perceived social support is a subjective measure, but when the level is higher, it is associated with better health,” Picardi added. “Immunological processes play a major role in the pathophysiology of psoriasis.” He said that prior research has shown that stress has particular effects on the skin, including slower wound healing, greater susceptibility of skin cells and a higher propensity for inflammation.
Picardi A, et al. Stress, social support, emotional regulation, and exacerbation of diffuse plaque psoriasis. Psychomatics 46(6), 2005.

Living With Psoriasis

"People judge us on the basis of our skin — our whole culture is based on cosmetics, lotions, creams and all that," said Finkelstein, of Oakland, Calif. "With (psoriasis), there's a whole layer of psychosocial problems, feelings of embarrassment, of shame, of ultimately feeling isolated."
But these days, Finkelstein, a filmmaker, has cast off the shy persona and is sharing his story with a new documentary, "My Skin's on Fire: Living With Psoriasis." DVDs of the film can be ordered for free at www.beyondpsoriasis.com.
He said now is an ideal time to shed light on the skin disease that affects more than 5 million people because, thanks to new medications, it's no longer a disease that needs to remain hopelessly hidden.
Rather than treating the disease topically, a new class of drugs known as "biologics" and "immuno-supressants" target the internal cause — an immune system on overdrive, which leads to the visible pile-up of inflamed skin cells. Inflammation normally protects the body, but too much of it is harmful.
"Here, really in the last 2 to 3 years, they've changed the disease of psoriasis. For many years it was considered an inflammatory skin disease. Now it's known as an 'immune-mediated disease,'" he says. "They've been able to pinpoint some of the mechanisms that misfire in the immune system."
But as Finkelstein's film shows, living with psoriasis is often far more than just a bothersome condition. Its obvious symptoms — flaky, red skin — can be a tremendous mental burden as well.
In the film, Finkelstein follows the typical trajectory of dealing with psoriasis. First, small patches of flaky skin crop up, usually when a person is a young adult. Then comes the diagnosis of psoriasis. The person may feel confused, wondering where they got such a disease, but a bit of questioning often reveals that it runs in the family — a trait kept hidden from most family members. Then, the person goes through a long trial of different treatments, many of which don't work.
Thankfully, that last step has been shortened by the advent of biologic drugs, said Dr. Alan Menter, a clinical professor of dermatology at the University of Texas Southwestern Medical School in Dallas and founder of the International Psoriasis Council.
Menter, who was interviewed for Finkelstein's film, said it accurately portrays the emotional burden of the disease.
For example, when patients first come to him for medical help, they often are overweight and depressed, Menter said. Most newly-diagnosed patients are young adults.
"For example, you take a 25-year-old, standing in the mirror seeing these crusted patches all over his or her body. They're trying to go out and get a date and it's crushing. They can hide it with clothing but that can't hide it from themselves or when they relationship starts becoming intimate," he said.
But Menter and Finkelstein are both optimistic that this will be less of a problem in the coming years, as more people are treated with medicines that truly help quell the disease.
"Right now I think there are something like 40 new drugs," Finkelstein said. "The future looks very bright for all of us who have suffered for so many years. I think it's a very good time to be talking about psoriasis."

What is 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.

Psoriasis and the T-Cell Connection

Scientists believe that certain white blood cells called T lymphocytes (T cells) play an important role in psoriasis. "And the disease has a genetic component," says Lindstrom. In about one-third of psoriasis cases, there is a family history of the disease.
T cells circulate throughout the body, orchestrating the immune system's response to foreign invaders like bacteria or viruses. In people with psoriasis, the defective T cells are overactive and migrate to the skin as if to heal a wound or ward off an infection. This process leads to the rapid growth of skin cells, triggering inflammation and the development of lesions.
Both the environment and genetics may play a role in the development of psoriasis. "In genetically predisposed children, psoriasis can be triggered by a strep or other infection," says Lindstrom. That's what happened to author John Updike. After an attack of measles at the age of 6, Updike developed psoriasis "in all its flaming scabbiness from head to toe," as he later described it in his memoir, Self-Consciousness.

PSORIASIS: CURE OR REMISSION

While the disease never goes away, the symptoms of psoriasis subside for a while (remission) and then return (flare-up, or reactivation). Remission can last for years in some people; in others, flare-ups occur every few weeks. Certain triggers, such as stress and seasonal changes, can reactivate psoriasis. "Certain drugs may also exacerbate it," says Lindstrom, including lithium, prescribed for bipolar disorder (also called manic-depressive illness), beta-blockers used to treat high blood pressure, and antimalarial drugs.

Arthritis Drug Treats Psoriasis

A drug for rheumatoid arthritis can relieve the suffering of patients with moderate to severe psoriasis for a year, researchers said on Friday.
They found that infliximab, which is marketed under the name Remicade by Johnson & Johnson in the United States and by Schering-Plough Corp in other markets, improved symptoms of the chronic skin condition that affects 2 percent of the population in western countries.
"This is the first study to show that the very rapid and dramatic improvement that you see with psoriasis can, in the majority of patients, be maintained over at least the medium term -- over the course of a year," said Professor Christopher Griffiths, of the University of Manchester in England.
Previous trials have only looked into the impact of the drug on psoriasis over a short period of about 12 weeks.
The study published in The Lancet medical journal also showed patients saw a significant improvement in one of the most disturbing features of psoriasis: nail disease.
"Up until now it has been extremely difficult to treat," Griffiths told Reuters.
He and his colleagues compared the effects of the intravenous treatment to a placebo, or dummy drug, on 378 patients with the illness.
Each patient was given three intravenous infusions of the drug or a placebo over six weeks and then every 8 weeks for nearly a year. After less than 3 months on the treatment, 80 percent of the patients showed at least a 75 percent improvement, compared to 3 percent in the placebo group.
By the end of the trial, the drug completely cleared the skin condition in a quarter of patients but no one in the placebo group had the same result.
"Some of the patients were improved to the extent that they had no psoriasis and there was no impairment of their quality of life. So this is the best result you could possibly aim for with a treatment for psoriasis," said Griffiths.
"Compared with the other available treatments, it does work extremely effectively and extremely quickly."
The scientists said none of the patients given the drug had any serious side effects. But they stressed that the treatment is not a cure. It is likely patients would have to be on a long-term maintenance programme.
Psoriasis, an immune mediated disease, can develop at any age but it occurs most commonly before the age of 40. Psoriasis patches can also show up on the fingernails and toenails. About 15 percent of patients also suffer from arthritis linked to the condition.
European regulators recently approved infliximab for the treatment of psoriasis but the drug has not yet been approved for the skin condition in the United States.
The drug is also used as a treatment for Crohn's disease, an inflammatory bowel condition.