A new drug for the treatment of severe chronic plaque psoriasis is to become available on the Pharmaceutical Benefits Scheme (PBS) soon, federal Health Minister Tony Abbott said.
The drug Raptiva will become available on April 1 for those patients who have exhausted other treatment options or had an inadequate response from them.
Mr Abbott said so-called refractory chronic plaque psoriasis is a disfiguring and disabling condition that affects about 17,000 Australians.
"It has a major impact on the quality of life, social relationships and participation in daily life of these patients," he said in a statement.
Mr Abbott said it was estimated about 6,000 people would start Raptiva in the first full financial year of listing.
He said the annual cost to the PBS for Raptiva would be about $12,700 per patient and its listing would add about $171 million to PBS expenditure between 2005-06 and 2008-09.
Tuesday, February 28, 2006
Friday, February 24, 2006
New Therapies May Offer Psoriasis Sufferers Some Relief
It’s a new era for patients covered in the itchy, scaly skin disease psoriasis. After years with few good treatments, doctors finally have a handful of therapies that promise to help control the incurable condition with fewer bad side effects.
What changed? Scientists learned that psoriasis isn’t just a skin-deep disorder but a dysfunction of the immune system, so the new therapies target the real culprit.
“Five to six years ago, I was telling my patients it was the wasteland,” says Dr. Craig Leonardi of St. Louis University Medical School, who participated in studies of the new treatments. “Now there’s this huge explosion of amazing drugs coming forward.”
The new options don’t help everyone, cautions Dr. Michael Tharp, dermatology chief at Chicago’s Rush University Medical Center. And they’re very expensive, costing $10,000 a year or more.
But, “it’s a great first step,” Tharp says. “Now we’ve got very directed molecules and know where they work and how they work. ... I hope it is just the beginning.”
Two unique psoriasis shots, Amevive and Raptiva, recently won Food and Drug Administration approval. Two drugs already sold to treat other conditions — Enbrel and Remicade — are used against psoriasis, too. A list of other potential treatments is under study.
Keeping symptoms at bayThe four newest options haven’t yet been compared to each other, but because each works somewhat differently, specialists expect hard-to-treat patients to find some relief among the bunch.
Some 4.5 million Americans have psoriasis. Of those, 1.5 million suffer moderate to severe symptoms — their skin covered in red or white scaly patches that burn and itch. It’s triggered when certain immune system cells, called memory effector T cells, run amok, causing skin cells to multiply faster than normal and become inflamed.
It can be life-altering.
“I wouldn’t wear anything but long-legged pants and long-sleeved shirts because I got so tired of people asking me questions,” says Lyle Newcomb, 60, of Milwaukie, Ore., who tried every treatment without success. “You don’t allow yourself to get real close to anybody because you don’t know how they’re going to accept it.”
Then Newcomb entered a study of Raptiva. “I had never been clear of psoriasis in my life, but I was totally clear in three weeks,” and, two years later, weekly shots keep symptoms at bay.
Ointments and light therapy — ultraviolet beams, sometimes with light-sensitizing drugs, a few times a week — are effective for milder psoriasis.
Until now, severely hit patients had two powerful options, each with serious side effects. The immune suppressor cyclosporine, commonly used to prevent rejection of transplanted organs, can destroy kidneys. Inflammation-suppressing methotrexate, also used for cancer and rheumatoid arthritis, can cause liver damage.
Fewer risks and side effectsThe new biologically engineered treatments promise more targeted therapy without those risks:
Amevive and Raptiva interfere with the harmful T cells, dramatically clearing psoriasis lesions in 20 percent to 40 percent of patients.
Amevive causes those T cells to die, explaining why some people’s symptoms don’t return for months after a three-month course of weekly shots. About 3,500 patients have begun Amevive since FDA approval in January, says maker Biogen Inc. The intramuscular shots are given in a doctor’s office.
In contrast, Raptiva keeps harmful immune cells from getting into and inflaming skin, so patients must take it indefinitely. Sales will begin by Thanksgiving, say makers Genentech Inc. and Xoma Ltd. Patients give themselves weekly under-the-skin shots.
That difference means more than convenience; some insurance pays for in-office therapy but not at-home drugs.
Instead of targeting T cells, Enbrel and Remicade inhibit a protein, TNF, that’s crucial to inflammation. FDA-approved for certain types of arthritis, some doctors already use the drugs for psoriasis’ skin lesions. The FDA now is evaluating Enbrel injections for that use; a final-stage study of intravenous Remicade is about to begin.
Specialists call the four new treatments largely safe but acknowledge that even mildly tinkering with the immune system for years might spur infections or cancer. “We’re crossing our fingers,” Tharp says.
That plus their huge cost means the new drugs are reserved for the worst patients. For less severe psoriasis sufferers, “we’re back in the stone ages,” Tharp says, urging companies to study better options for them, too.
What changed? Scientists learned that psoriasis isn’t just a skin-deep disorder but a dysfunction of the immune system, so the new therapies target the real culprit.
“Five to six years ago, I was telling my patients it was the wasteland,” says Dr. Craig Leonardi of St. Louis University Medical School, who participated in studies of the new treatments. “Now there’s this huge explosion of amazing drugs coming forward.”
The new options don’t help everyone, cautions Dr. Michael Tharp, dermatology chief at Chicago’s Rush University Medical Center. And they’re very expensive, costing $10,000 a year or more.
But, “it’s a great first step,” Tharp says. “Now we’ve got very directed molecules and know where they work and how they work. ... I hope it is just the beginning.”
Two unique psoriasis shots, Amevive and Raptiva, recently won Food and Drug Administration approval. Two drugs already sold to treat other conditions — Enbrel and Remicade — are used against psoriasis, too. A list of other potential treatments is under study.
Keeping symptoms at bayThe four newest options haven’t yet been compared to each other, but because each works somewhat differently, specialists expect hard-to-treat patients to find some relief among the bunch.
Some 4.5 million Americans have psoriasis. Of those, 1.5 million suffer moderate to severe symptoms — their skin covered in red or white scaly patches that burn and itch. It’s triggered when certain immune system cells, called memory effector T cells, run amok, causing skin cells to multiply faster than normal and become inflamed.
It can be life-altering.
“I wouldn’t wear anything but long-legged pants and long-sleeved shirts because I got so tired of people asking me questions,” says Lyle Newcomb, 60, of Milwaukie, Ore., who tried every treatment without success. “You don’t allow yourself to get real close to anybody because you don’t know how they’re going to accept it.”
Then Newcomb entered a study of Raptiva. “I had never been clear of psoriasis in my life, but I was totally clear in three weeks,” and, two years later, weekly shots keep symptoms at bay.
Ointments and light therapy — ultraviolet beams, sometimes with light-sensitizing drugs, a few times a week — are effective for milder psoriasis.
Until now, severely hit patients had two powerful options, each with serious side effects. The immune suppressor cyclosporine, commonly used to prevent rejection of transplanted organs, can destroy kidneys. Inflammation-suppressing methotrexate, also used for cancer and rheumatoid arthritis, can cause liver damage.
Fewer risks and side effectsThe new biologically engineered treatments promise more targeted therapy without those risks:
Amevive and Raptiva interfere with the harmful T cells, dramatically clearing psoriasis lesions in 20 percent to 40 percent of patients.
Amevive causes those T cells to die, explaining why some people’s symptoms don’t return for months after a three-month course of weekly shots. About 3,500 patients have begun Amevive since FDA approval in January, says maker Biogen Inc. The intramuscular shots are given in a doctor’s office.
In contrast, Raptiva keeps harmful immune cells from getting into and inflaming skin, so patients must take it indefinitely. Sales will begin by Thanksgiving, say makers Genentech Inc. and Xoma Ltd. Patients give themselves weekly under-the-skin shots.
That difference means more than convenience; some insurance pays for in-office therapy but not at-home drugs.
Instead of targeting T cells, Enbrel and Remicade inhibit a protein, TNF, that’s crucial to inflammation. FDA-approved for certain types of arthritis, some doctors already use the drugs for psoriasis’ skin lesions. The FDA now is evaluating Enbrel injections for that use; a final-stage study of intravenous Remicade is about to begin.
Specialists call the four new treatments largely safe but acknowledge that even mildly tinkering with the immune system for years might spur infections or cancer. “We’re crossing our fingers,” Tharp says.
That plus their huge cost means the new drugs are reserved for the worst patients. For less severe psoriasis sufferers, “we’re back in the stone ages,” Tharp says, urging companies to study better options for them, too.
Wednesday, February 22, 2006
The Effects 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.
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.
Tuesday, February 14, 2006
Aging Population Drives Prescription Dermatological Growth
The aging of the worldwide population and a focus on lifestyle treatments that revitalize youthfulness and stave off skin damage are the driving forces behind a healthy prescription dermatological drug market, which should see sales jump to $11.1 billion by 2010, according to
a new study from the market research firm Kalorama Information, a division of MarketResearch.com, the leading provider of industry-specific market research reports.
With 2005 sales reaching $8.4 billion, The Worldwide Market for Prescription Dermatological Drugs predicts that sales in the antiaging, photodamage, hair treatment, psoriasis, and skin cancer segments will grow further at a rate of 5.7% over the next four years as consumer demand for newer and better derma drugs continues to increase as the aging population struggles to deal with a myriad of skin disorders and diseases.
While sales of prescription acne, Rosacea, dermatitis, seborrhea, and hyperpigmentation/melasma products have continued to perform well-although with slower growth rates during the last five years as many of these drugs are older or have lost patent protection-the overall market has been bolstered by recent trends in cosmeceuticals, a favorite among aging Baby Boomers.
"The aging population is better educated and wants to see results-whether they have wrinkles, skin cancer, or psoriasis. Today's consumers are savvy to innovative dermatological treatments, derma drug delivery developments, and new prescription drug information which is widely available on the internet," notes Mary Anne Crandall, RN, the author of the final report. "This has changed the face of dermatology as cosmetic dermatology is now in vogue and manufacturers are racing to find new treatments to satiate public demand."
With 2005 sales reaching $8.4 billion, The Worldwide Market for Prescription Dermatological Drugs predicts that sales in the antiaging, photodamage, hair treatment, psoriasis, and skin cancer segments will grow further at a rate of 5.7% over the next four years as consumer demand for newer and better derma drugs continues to increase as the aging population struggles to deal with a myriad of skin disorders and diseases.
While sales of prescription acne, Rosacea, dermatitis, seborrhea, and hyperpigmentation/melasma products have continued to perform well-although with slower growth rates during the last five years as many of these drugs are older or have lost patent protection-the overall market has been bolstered by recent trends in cosmeceuticals, a favorite among aging Baby Boomers.
"The aging population is better educated and wants to see results-whether they have wrinkles, skin cancer, or psoriasis. Today's consumers are savvy to innovative dermatological treatments, derma drug delivery developments, and new prescription drug information which is widely available on the internet," notes Mary Anne Crandall, RN, the author of the final report. "This has changed the face of dermatology as cosmetic dermatology is now in vogue and manufacturers are racing to find new treatments to satiate public demand."
Tuesday, February 07, 2006
Options In Psoriasis Skin Care
Dermatitis-Ltd III. is a great option for individuals whose skin has been left sensitive and delicate by over-the-counter or prescription medications which often are messy, smelly, stain clothing, or thin the skin such as steroids. Skin appears more conditioned, even, elastic, and calm with Dermatitis-Ltd III. The ingredients of Dermatitis-Ltd are: zinc oxide, sodium chloride, magnesium stearate, polyethylene glycol, iron oxide, copper oxide, and sulfur. Zinc oxide is well known for its ability to protect and heal the skin.
Friday, February 03, 2006
Psoriasis Has Been Around For Thousands Of Years
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."
Wednesday, January 25, 2006
Understanding Psoriasis Flares
JERRY BAGEL, MD: The definition of a psoriasis flare is when a person with psoriasis gets worse. If a patient has localized psoriasis, and they move to moderate or severe psoriasis, that's clearly a flare. And at that point, different treatments need to be implemented.
When does psoriasis flare?JERRY BAGEL, MD: Psoriasis can flare independently of any known risk factors. But in general, people tend to get worse in the winter than they do in the summer. In the summer people with psoriasis can go outside and get extra exposure to ultraviolet light, which is helpful, whereas in the wintertime they tend to be inside. In addition, in the winter their skin tends to be drier. They can be more itchy, scratch more, and the trauma that occurs from scratching can result in exacerbating psoriasis.
PAUL YAMAUCHI, MD, PhD: A person on certain psoriasis medications can improve quite dramatically, but when you stop the medication, the psoriasis comes right back; it's sometimes rip-roaring and that can be very frustrating.
How often do flares occur?JERRY BAGEL, MD: The frequency of flares is dependent upon the individual. Some people can have low-grade psoriasis, and then it flares. If they treat it appropriately, they can do well for a few years. Other people are treated for a flare, go into remission, and flare again two to three months later because their psoriasis is that severe. But if you want an average, I think many people with severe psoriasis, who have it over 20 percent of their body, stay clear with good treatment for about six months, and then they flare again.
What is the pattern of flares for people with mild psoriasis?JERRY BAGEL, MD: The treatment of localized psoriasis is topical therapy. Topical steroids are pretty much the mainstay of topical therapy, but we have used vitamin D derivatives such as Dovonex (calcipotriene) for the past 15 years with lots of benefit.
In general, these treatments are suppressive, so they do not result in much remission. Some people might stay clear for a couple of weeks and others people might not respond to topicals at all.
How soon after phototherapy do people flare?JERRY BAGEL, MD: People who have more than 10 percent of their body surface area covered with psoriasis are candidates for phototherapy, which includes narrow band UVB and PUVA, as well as broadband UVB, but we're not using that as much now because narrow band works better. If patches are thin, people can come in three times a week for about 25 treatments and clear. If you pick your patients properly, you're probably going to get a six-month remission. But most people won't get six months' remission if they have real thick plaques. If you go with PUVA, where you have to take pills before you come in for ultraviolet light, one go-around would involve about 25 treatments. You can expect six months' remission, and many patients stay clear on PUVA for about a year.
Do people flare after taking the immunosupressant medications cyclosporin and methotrexate?JERRY BAGEL, MD: Cyclosporin and methotrexate are suppressive so when a patient is discontinued from both of those two medications, their psoriasis will recur in about six weeks and will be as bad as it was before they started their treatment.
How often do people flare on biologic treatments?JERRY BAGEL, MD: In the 40 percent of people who do very well with one 12-week course of Amevive (alefacept), they can stay very clear for six months. In fact, I've had some people stay clear for a year. And I see people continue to get better up to 12 to 24 weeks after they've discontinued the last dose, and when they start to flare, it's a very slow recurrence of their psoriasis, close to back to where it was in the beginning.
PAUL YAMAUCHI, MD, PhD: There are biologics that must be given continuously. Raptiva (efalizumab), when abruptly stopped, can potentially result in a flare-up of the psoriasis. With Enbrel (etanercept), if a patient had to stop it, and the psoriasis did not flare up, patients can be in remission at least three months.
Does a flare during any type of treatment mean the therapy isn't working?JERRY BAGEL, MD: It takes time for most medications to help people with psoriasis. Depending upon the medication, it could take two weeks to eight weeks. So just because your psoriasis might be getting worse initially does not mean that the therapy's not working.
When should patients change therapies when flares occur?JERRY BAGEL, MD: Primary therapy does not necessarily have to be stopped if people are getting worse. It depends if the flare is significant. If it's the natural progression of the disease getting worse and hasn't responded to therapy yet, you just hang in there or add something else because it's not working quickly enough. But if you see someone who's doing well on therapy and then they get significantly worse, yes, then you should probably switch your therapy around.
When does psoriasis flare?JERRY BAGEL, MD: Psoriasis can flare independently of any known risk factors. But in general, people tend to get worse in the winter than they do in the summer. In the summer people with psoriasis can go outside and get extra exposure to ultraviolet light, which is helpful, whereas in the wintertime they tend to be inside. In addition, in the winter their skin tends to be drier. They can be more itchy, scratch more, and the trauma that occurs from scratching can result in exacerbating psoriasis.
PAUL YAMAUCHI, MD, PhD: A person on certain psoriasis medications can improve quite dramatically, but when you stop the medication, the psoriasis comes right back; it's sometimes rip-roaring and that can be very frustrating.
How often do flares occur?JERRY BAGEL, MD: The frequency of flares is dependent upon the individual. Some people can have low-grade psoriasis, and then it flares. If they treat it appropriately, they can do well for a few years. Other people are treated for a flare, go into remission, and flare again two to three months later because their psoriasis is that severe. But if you want an average, I think many people with severe psoriasis, who have it over 20 percent of their body, stay clear with good treatment for about six months, and then they flare again.
What is the pattern of flares for people with mild psoriasis?JERRY BAGEL, MD: The treatment of localized psoriasis is topical therapy. Topical steroids are pretty much the mainstay of topical therapy, but we have used vitamin D derivatives such as Dovonex (calcipotriene) for the past 15 years with lots of benefit.
In general, these treatments are suppressive, so they do not result in much remission. Some people might stay clear for a couple of weeks and others people might not respond to topicals at all.
How soon after phototherapy do people flare?JERRY BAGEL, MD: People who have more than 10 percent of their body surface area covered with psoriasis are candidates for phototherapy, which includes narrow band UVB and PUVA, as well as broadband UVB, but we're not using that as much now because narrow band works better. If patches are thin, people can come in three times a week for about 25 treatments and clear. If you pick your patients properly, you're probably going to get a six-month remission. But most people won't get six months' remission if they have real thick plaques. If you go with PUVA, where you have to take pills before you come in for ultraviolet light, one go-around would involve about 25 treatments. You can expect six months' remission, and many patients stay clear on PUVA for about a year.
Do people flare after taking the immunosupressant medications cyclosporin and methotrexate?JERRY BAGEL, MD: Cyclosporin and methotrexate are suppressive so when a patient is discontinued from both of those two medications, their psoriasis will recur in about six weeks and will be as bad as it was before they started their treatment.
How often do people flare on biologic treatments?JERRY BAGEL, MD: In the 40 percent of people who do very well with one 12-week course of Amevive (alefacept), they can stay very clear for six months. In fact, I've had some people stay clear for a year. And I see people continue to get better up to 12 to 24 weeks after they've discontinued the last dose, and when they start to flare, it's a very slow recurrence of their psoriasis, close to back to where it was in the beginning.
PAUL YAMAUCHI, MD, PhD: There are biologics that must be given continuously. Raptiva (efalizumab), when abruptly stopped, can potentially result in a flare-up of the psoriasis. With Enbrel (etanercept), if a patient had to stop it, and the psoriasis did not flare up, patients can be in remission at least three months.
Does a flare during any type of treatment mean the therapy isn't working?JERRY BAGEL, MD: It takes time for most medications to help people with psoriasis. Depending upon the medication, it could take two weeks to eight weeks. So just because your psoriasis might be getting worse initially does not mean that the therapy's not working.
When should patients change therapies when flares occur?JERRY BAGEL, MD: Primary therapy does not necessarily have to be stopped if people are getting worse. It depends if the flare is significant. If it's the natural progression of the disease getting worse and hasn't responded to therapy yet, you just hang in there or add something else because it's not working quickly enough. But if you see someone who's doing well on therapy and then they get significantly worse, yes, then you should probably switch your therapy around.
Thursday, January 19, 2006
Psoriasis Treatment: One Patients Journey
Treatment for intense psoriasis icky, effective
Editor's note: Over several weeks, reporter Jessi De La Cruz is detailing the intensive treatment she is being given for psoriasis through a special program at the University of Michigan.
Sunlight, moisturizer and rest.
Those are the key ingredients in confronting the skin disease of psoriasis and putting it into remission.
I learned these basic yet not-so-simple rules during my first week at the Dermatology Treatment Center at the University of Michigan Medical Center in Ann Arbor. After one week of intensive, outpatient treatment, my psoriasis was dramatically less painful and less visible.
Psoriasis is a noncontagious, autoimmune disease for which there is no cure. A person with psoriasis produces new skin cells four to six times faster than a healthy person. They build up into inflammed lesions -- or plaques -- which can be itchy, painful and unsightly. Some people also develop arthritis from their skin cells gone amuck, but that hasn't happened to me so far.
The UM Dermatology Treatment Center is one of about a dozen such facilities in the U.S. designed to intensively treat psoriasis and other skin diseases without hospitalization.
When I arrived at the hospital Jan. 9, my first task was to fill out paperwork, change into dark brown, hospital-issued pajamas and get a quick tour of the center. The tour consisted of being shown the locker room, the photolight beds, an activity room stocked with magazines, a TV and a DVD player, and a quiet room where someone was sleeping under a towel. I nodded, tried to smile and felt like running from the room in my hospital-issued booties.
Instead, I stayed and met the doctor and other patients. I was given the combination to a locker that would be mine for the duration of my treatment, a bar of Dove soap and a stout jar of heavy body cream.
When I was called for my intial treatment, I tentatively entered a room with lots of towels and jars of ointments. The nurse coated my body from head to toe with a steroid cream, wet my pajamas (which I put back on) with warm water and gave me a jogging suit to put over my pajamas. The suit would keep moisture in and speed up the cream's effectiveness, she said.
My time in the sauna suit lasted three days, two applications daily. I also was introduced to photolight therapy which is used to slow the growth of skin cells. In between, my body was slathered in coal tar to increase my skin's ability to absorb the light. And to top it off, literally, I had oil and steroids on my scalp and then had my head wrapped in plastic wrap and taped over to fight the psoriasis on my scalp.
I spent the week cold, squishy, slimy, damp and itchy. Toward the end of the week, I also found myself nursing a sunburn. The nurses like it if you're pink from the light because it means your skin cells are halting production. I was more a shade of magenta bordering on red by Wednesday -- so I didn't get light treatment again until Saturday.
After treatment on Saturdays, we are given a one-day reprieve from the goops, gels, oils, light and hospital food -- all starting again on Mondays at 7:30 a.m. sharp.
Although it sounds (and often feels) terrible, this treatment is working. My skin has not felt softer nor looked better in years. And I can commiserate with others who share this disease.
I'm becoming a master at Tetris, daytime TV and napping. I'm also learning how to manage a disease I will never be rid of but, hopefully, don't have to live with in the same way for the rest of my life.
Editor's note: Over several weeks, reporter Jessi De La Cruz is detailing the intensive treatment she is being given for psoriasis through a special program at the University of Michigan.
Sunlight, moisturizer and rest.
Those are the key ingredients in confronting the skin disease of psoriasis and putting it into remission.
I learned these basic yet not-so-simple rules during my first week at the Dermatology Treatment Center at the University of Michigan Medical Center in Ann Arbor. After one week of intensive, outpatient treatment, my psoriasis was dramatically less painful and less visible.
Psoriasis is a noncontagious, autoimmune disease for which there is no cure. A person with psoriasis produces new skin cells four to six times faster than a healthy person. They build up into inflammed lesions -- or plaques -- which can be itchy, painful and unsightly. Some people also develop arthritis from their skin cells gone amuck, but that hasn't happened to me so far.
The UM Dermatology Treatment Center is one of about a dozen such facilities in the U.S. designed to intensively treat psoriasis and other skin diseases without hospitalization.
When I arrived at the hospital Jan. 9, my first task was to fill out paperwork, change into dark brown, hospital-issued pajamas and get a quick tour of the center. The tour consisted of being shown the locker room, the photolight beds, an activity room stocked with magazines, a TV and a DVD player, and a quiet room where someone was sleeping under a towel. I nodded, tried to smile and felt like running from the room in my hospital-issued booties.
Instead, I stayed and met the doctor and other patients. I was given the combination to a locker that would be mine for the duration of my treatment, a bar of Dove soap and a stout jar of heavy body cream.
When I was called for my intial treatment, I tentatively entered a room with lots of towels and jars of ointments. The nurse coated my body from head to toe with a steroid cream, wet my pajamas (which I put back on) with warm water and gave me a jogging suit to put over my pajamas. The suit would keep moisture in and speed up the cream's effectiveness, she said.
My time in the sauna suit lasted three days, two applications daily. I also was introduced to photolight therapy which is used to slow the growth of skin cells. In between, my body was slathered in coal tar to increase my skin's ability to absorb the light. And to top it off, literally, I had oil and steroids on my scalp and then had my head wrapped in plastic wrap and taped over to fight the psoriasis on my scalp.
I spent the week cold, squishy, slimy, damp and itchy. Toward the end of the week, I also found myself nursing a sunburn. The nurses like it if you're pink from the light because it means your skin cells are halting production. I was more a shade of magenta bordering on red by Wednesday -- so I didn't get light treatment again until Saturday.
After treatment on Saturdays, we are given a one-day reprieve from the goops, gels, oils, light and hospital food -- all starting again on Mondays at 7:30 a.m. sharp.
Although it sounds (and often feels) terrible, this treatment is working. My skin has not felt softer nor looked better in years. And I can commiserate with others who share this disease.
I'm becoming a master at Tetris, daytime TV and napping. I'm also learning how to manage a disease I will never be rid of but, hopefully, don't have to live with in the same way for the rest of my life.
Friday, January 13, 2006
National Psoriasis Foundation
The National Psoriasis Foundation is the leading patient-driven, nonprofitorganization dedicated to improving the quality of life of more than 5 millionAmericans diagnosed with psoriasis and/or psoriatic arthritis and theirfamilies. We focus on education, advocacy and research toward bettertreatments and a cure.
For more information, please call the PsoriasisFoundation, headquartered in Portland, Ore., at 800.723.9166 or visithttp://www.psoriasis.org
For more information, please call the PsoriasisFoundation, headquartered in Portland, Ore., at 800.723.9166 or visithttp://www.psoriasis.org
Tuesday, January 10, 2006
New Component In Psoriasis Research
An immune molecule that normally assists in cell “suicide” may be an important trigger in the development of the common skin disease psoriasis, according to scientists from the Technion-Israel Institute of Technology and State University of New York, Stony Brook.
The culprit, a molecule called Fas, acts as a middleman between activated immune cells and a handful of inflammatory hormones involved in psoriasis flare-ups, say Technion researcher Dr. Amos Gilhar and colleagues. The study appears in the January, 10 2006 American Journal of Pathology.
Psoriasis is a non-contagious, lifelong skin disease that usually appears as scaly and inflamed patches of skin, although it can take several different forms. In patients with psoriasis, the white blood cells that make up the body’s immune defense system go into overdrive, triggering other immune responses that pile up skin cells at an abnormal rate.
Current treatments for psoriasis such as the drug Enbrel focus on these inflammatory hormones, but the researchers were able to stop the development of psoriasis in mice long before these hormones came into play by injecting an Fas-blocking antibody.
“The finding that antibodies to Fas can prevent psoriasis further demonstrates the complexity of the disease and its numerous molecular pathways,” Gilhar says.
Dr. Alice Gottlieb, chair of the Clinical Research Center at the Robert Wood Johnson Medical School in New Jersey agrees. “This research shows that activation of the Fas pathway is important in starting the ball rolling in psoriasis,” comments Gottlieb (who was not involved with this study). “These findings could have implications for other immune diseases such as rheumatoid arthritis and Crohn's disease,”
The researchers suspected that the Fas molecule was in the middle of this process, since it is found at high levels in psoriatic skin and leads an intriguing dual life. Most of the time, Fas guides the normal process of cell suicide called apoptosis. But in cells where apoptosis is blocked by other molecules, as it is in psoriatic cells, Fas switches roles and encourages the production of common inflammatory hormones instead.
To figure out exactly where Fas stood in the development of psoriasis, Gilhar and colleagues transferred grafts of clear, non-involved skin from human psoriasis patients to mice. They injected the mice with white blood cells bearing the Fas molecule on their surfaces to jump-start the formation of psoriatic skin lesions.
By blocking Fas action with a special antibody, the researchers were able to show that Fas actually is the key middleman in psoriasis formation. Without Fas, the natural killer cells were unable to trigger the production of the inflammatory hormones that lead to the characteristic skin thickening and other signs of psoriasis.
There is some evidence that Fas is involved in other skin conditions such as eczema, so future treatments targeting the Fas pathway may prove useful for a variety of diseases, suggests Dr. Richard Kalish, Gilhar’s collaborator from SUNY Stony Brook. However, researchers need to develop a human antibody to Fas before the technique could be tested in people.
“The current study is one of the many wonderful papers that have come out of this very productive collaboration across many miles between Dr. Gilhar and Dr. Kalish,” says Gottlieb.
According to the National Psoriasis Foundation in the United States, 1-3 percent of the world’s population suffers from psoriasis. About 30 percent of people with psoriasis have severe cases, where the affected skin covers more than 3 percent of their body. In some people, the disease is associated with a form of arthritis.
The Technion-Israel Institute of Technology is Israel's leading science and technology university. Home to the country’s winners of the Nobel Prize in science, it commands a worldwide reputation for its pioneering work in nanotechnology, computer science, biotechnology, water-resource management, materials engineering, aerospace and medicine. The majority of the founders and managers of Israel's high-tech companies are alumni. Based in New York City, the American Technion Society is the leading American organization supporting higher education in Israel, with 17 offices around the country.
The culprit, a molecule called Fas, acts as a middleman between activated immune cells and a handful of inflammatory hormones involved in psoriasis flare-ups, say Technion researcher Dr. Amos Gilhar and colleagues. The study appears in the January, 10 2006 American Journal of Pathology.
Psoriasis is a non-contagious, lifelong skin disease that usually appears as scaly and inflamed patches of skin, although it can take several different forms. In patients with psoriasis, the white blood cells that make up the body’s immune defense system go into overdrive, triggering other immune responses that pile up skin cells at an abnormal rate.
Current treatments for psoriasis such as the drug Enbrel focus on these inflammatory hormones, but the researchers were able to stop the development of psoriasis in mice long before these hormones came into play by injecting an Fas-blocking antibody.
“The finding that antibodies to Fas can prevent psoriasis further demonstrates the complexity of the disease and its numerous molecular pathways,” Gilhar says.
Dr. Alice Gottlieb, chair of the Clinical Research Center at the Robert Wood Johnson Medical School in New Jersey agrees. “This research shows that activation of the Fas pathway is important in starting the ball rolling in psoriasis,” comments Gottlieb (who was not involved with this study). “These findings could have implications for other immune diseases such as rheumatoid arthritis and Crohn's disease,”
The researchers suspected that the Fas molecule was in the middle of this process, since it is found at high levels in psoriatic skin and leads an intriguing dual life. Most of the time, Fas guides the normal process of cell suicide called apoptosis. But in cells where apoptosis is blocked by other molecules, as it is in psoriatic cells, Fas switches roles and encourages the production of common inflammatory hormones instead.
To figure out exactly where Fas stood in the development of psoriasis, Gilhar and colleagues transferred grafts of clear, non-involved skin from human psoriasis patients to mice. They injected the mice with white blood cells bearing the Fas molecule on their surfaces to jump-start the formation of psoriatic skin lesions.
By blocking Fas action with a special antibody, the researchers were able to show that Fas actually is the key middleman in psoriasis formation. Without Fas, the natural killer cells were unable to trigger the production of the inflammatory hormones that lead to the characteristic skin thickening and other signs of psoriasis.
There is some evidence that Fas is involved in other skin conditions such as eczema, so future treatments targeting the Fas pathway may prove useful for a variety of diseases, suggests Dr. Richard Kalish, Gilhar’s collaborator from SUNY Stony Brook. However, researchers need to develop a human antibody to Fas before the technique could be tested in people.
“The current study is one of the many wonderful papers that have come out of this very productive collaboration across many miles between Dr. Gilhar and Dr. Kalish,” says Gottlieb.
According to the National Psoriasis Foundation in the United States, 1-3 percent of the world’s population suffers from psoriasis. About 30 percent of people with psoriasis have severe cases, where the affected skin covers more than 3 percent of their body. In some people, the disease is associated with a form of arthritis.
The Technion-Israel Institute of Technology is Israel's leading science and technology university. Home to the country’s winners of the Nobel Prize in science, it commands a worldwide reputation for its pioneering work in nanotechnology, computer science, biotechnology, water-resource management, materials engineering, aerospace and medicine. The majority of the founders and managers of Israel's high-tech companies are alumni. Based in New York City, the American Technion Society is the leading American organization supporting higher education in Israel, with 17 offices around the country.
Wednesday, January 04, 2006
Winter Psoriasis
Asking people with psoriasis whether their psoriasis acts up in the winter or summer quickly reveals one of the mysteries of the disease: it can be different for everyone. Some people experience flares in the winter, others in the summer, and some both or neither.
Tips for inclement weather:
Wear gloves while you wash dishes or clean inside, and when you're outside in the cold or driving.
Place a bowl of water or damp towel on the radiator, which will put water back in the air. Take care to redampen the towel.
Apply moisturizer while your skin is still wet from bathing or showering, which traps water in the skin. Avoid prolonged hot baths or showers.
Drink plenty of water. If the body doesn't get enough water, your skin's water reservoir can become depleted.
Minimize the use of soaps. They dry out the skin.
Turn off the heat at night, and keep it low during the day. Cool air is less drying.
Anecdotal reports suggest it is more common for psoriasis to become agitated or flare during the winter, but some people do suffer more during the summer.
Conversely, during a hot and humid summer, when the air contains more water vapor, the saturated air keeps us from sweating as we normally would, which essentially locks water in. This is perhaps why some people fare better with their psoriasis during humid summers.
A small percentage of people have psoriasis that flares when they are exposed to sunlight. Intensive exposure to sunlight, salty sea water or some other environmental factor also may play a role in why a person's psoriasis appears worse in the summer.
In a study published in the January 2001 issue of Archives of Dermatology, researchers measured and compared the impact of psychological stress on the skin in students without psoriasis during three different stress level periods: after winter vacation, during final exams and after spring break. The researchers measured water loss in the students skin during these periods and found that during periods of stress, the skin's ability to maintain a normal permeability barrier and retain water appears to be reduced.
A person's legs and arms have fewer oil glands than elsewhere in the body, which already causes them to be drier. Our skin also has what doctors call a "permeability barrier"-an ability to prevent the passage of substances through it. In people with psoriasis, the level of water that passes through this barrier is increased-the skin loses its ability to hold water, which contributes to the formation of dry, scaly lesions. During the cold winter, when the air contains less moisture, even more water is stripped from the skin, which may contribute to a flare.
Winter, according to researchers, is just a more stressful time. Researchers studying weekly and seasonal variations in heart attacks, which are also stress related, have found that Mondays during the winter months, especially January, have the highest rates of heart attacks.
In the homeThe dehumidified air in most people's homes during the winter, whether from electric or forced air heat, fires or woodburning stoves, also strips the skin of natural moisture. More water escapes from skin at low humidity. Normal skin achieves a balanced level of water loss when humidity is at 60 percent. In most homes during the winter, the humidity is much lower.
Experiencing one heating environment at the office and another at home, with short, cold, "uncontrolled" moments in between, can also further dry out the skin and potentially make psoriasis worse.
Not everyone experiences changes in their psoriasis brought on by changes in the weather. Climate also may play a role. Someone who lives in dry, desert heat may find relief during the summer, but flare when they are experiencing a humid summer.
There is no firm scientific proof that winter or summer directly cause a person's psoriasis to worsen. Nonetheless, to the people it happens to it is pretty obvious.
Tips for inclement weather:
Wear gloves while you wash dishes or clean inside, and when you're outside in the cold or driving.
Place a bowl of water or damp towel on the radiator, which will put water back in the air. Take care to redampen the towel.
Apply moisturizer while your skin is still wet from bathing or showering, which traps water in the skin. Avoid prolonged hot baths or showers.
Drink plenty of water. If the body doesn't get enough water, your skin's water reservoir can become depleted.
Minimize the use of soaps. They dry out the skin.
Turn off the heat at night, and keep it low during the day. Cool air is less drying.
Anecdotal reports suggest it is more common for psoriasis to become agitated or flare during the winter, but some people do suffer more during the summer.
Conversely, during a hot and humid summer, when the air contains more water vapor, the saturated air keeps us from sweating as we normally would, which essentially locks water in. This is perhaps why some people fare better with their psoriasis during humid summers.
A small percentage of people have psoriasis that flares when they are exposed to sunlight. Intensive exposure to sunlight, salty sea water or some other environmental factor also may play a role in why a person's psoriasis appears worse in the summer.
In a study published in the January 2001 issue of Archives of Dermatology, researchers measured and compared the impact of psychological stress on the skin in students without psoriasis during three different stress level periods: after winter vacation, during final exams and after spring break. The researchers measured water loss in the students skin during these periods and found that during periods of stress, the skin's ability to maintain a normal permeability barrier and retain water appears to be reduced.
A person's legs and arms have fewer oil glands than elsewhere in the body, which already causes them to be drier. Our skin also has what doctors call a "permeability barrier"-an ability to prevent the passage of substances through it. In people with psoriasis, the level of water that passes through this barrier is increased-the skin loses its ability to hold water, which contributes to the formation of dry, scaly lesions. During the cold winter, when the air contains less moisture, even more water is stripped from the skin, which may contribute to a flare.
Winter, according to researchers, is just a more stressful time. Researchers studying weekly and seasonal variations in heart attacks, which are also stress related, have found that Mondays during the winter months, especially January, have the highest rates of heart attacks.
In the homeThe dehumidified air in most people's homes during the winter, whether from electric or forced air heat, fires or woodburning stoves, also strips the skin of natural moisture. More water escapes from skin at low humidity. Normal skin achieves a balanced level of water loss when humidity is at 60 percent. In most homes during the winter, the humidity is much lower.
Experiencing one heating environment at the office and another at home, with short, cold, "uncontrolled" moments in between, can also further dry out the skin and potentially make psoriasis worse.
Not everyone experiences changes in their psoriasis brought on by changes in the weather. Climate also may play a role. Someone who lives in dry, desert heat may find relief during the summer, but flare when they are experiencing a humid summer.
There is no firm scientific proof that winter or summer directly cause a person's psoriasis to worsen. Nonetheless, to the people it happens to it is pretty obvious.
Tuesday, December 20, 2005
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.
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.
Friday, December 16, 2005
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.
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.
Wednesday, December 14, 2005
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.
Tuesday, December 13, 2005
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."
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."
Monday, December 05, 2005
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.
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.
Thursday, December 01, 2005
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.
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.
Tuesday, November 29, 2005
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.
Friday, November 18, 2005
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.
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.
Tuesday, November 15, 2005
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.
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.
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