Psoriasis Doesn’t Have To Be A Life
Peter Amento avoided shorts and short sleeves for most of his life, no matter how warm the weather. When he did wear them, People would comment: What have you got? Poison ivy? Thats how bad my psoriasis would look, says the 61-year-old husband and father of three from Hamden.
Weve worked together to find the best treatment for his condition. Its a great partnership.Keith Choate, MD, PhD
The skin disorder appeared when Amento was 15, and over the years he tried everything to make it go away. I started with sunlamps, which was the way to go back then, he says. It didnt do much. He moved on to ointments, slathering them on the red patches on his arms, legs and torso, then covering the areas with plastic wrap to help the medication seep in. Theyd go away for a couple of weeks, then youd have to repeat the whole process.
Later, he would fly to Florida and sunbathe on the beach until his skin was crisp. The sunburn killed me for a couple of days, but it got rid of the psoriasis for a month, he says.
Amento assumed he would struggle with the condition for the rest of his life. Then his local dermatologist referred him to Yale Medicine, where physicians had a new approach.
Therapy Of Chronic Plaque Psoriasis
Psoriasis shows a chronic-relapsing course and requires longterm management. Treatments available for psoriasis are various and they can be topical and systemic . Topical therapies include keratolitics, corticosteroids, Vitamin D analogs, retinoids, and topical calcineurin inhibitors, which are reserved for mild forms. Phototherapy, which includes either narrow-band ultraviolet B light and photochemotherapy , and conventional systemic agents such as cyclosporine , methotrexate , and acitretin are reserved for moderate to severe cases. In the event of intolerance, inefficacy, or contraindication to phototherapy or conventional systemic treatments, patients are eligible for biological agents, which include TNF- antagonists , or the anti-IL12/23 monoclonal antibody ustekinumab.
Treatments of chronic plaque psoriasis.
Although criteria for selection of a systemic treatment are well established, the undertreatment in moderate to severe psoriasis is still an open issue. A recent population-based, multinational survey of 3426 patients from 139,948 screened households in North America and Europe found that only 11% of patients with affected BSA > 10% were receiving a systemic agent for psoriasis 52% were receiving topical treatment alone and 37% were untreated.
Lifestyle Changes And Home Remedies
The most important lifestyle change that people with psoriasis can make is to avoid triggers, which might include cold weather, stress, or smoking.
People may also wish to try the following home remedies. While they will not cure psoriasis, they may reduce itching, dryness, and other types of discomfort:
- applying aloe vera gel to reduce redness and itching
- avoiding alcohol and tobacco
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Psoriasis Remission: How It Can Happen
No medicine will keep symptoms away forever. Recent advances have been made in the quest to isolate the part of the immune system response that causes psoriasis, resulting in an explosion of new and effective remedies. With the right treatment, you may enter psoriasis remission and have no visible symptoms for a period of time.
But the reality is that even if symptoms go away, theyre likely to come back. And when they do, you have to be ready to squelch them before your skin flares up too badly.
How Can I Stop Psoriasis From Spreading
Psoriasis is a chronic skin condition in which your skin may get red patches covered with silver and white scales. The skin may become inflamed and itchy.
Psoriasis is an autoimmune disorder where the immune cells target healthy skin. It causes scaly eruptions on the skin. Stress can trigger your psoriasis condition and makes the symptoms worse.
Symptoms of psoriasis:
With psoriasis, you get red, inflamed patches. They can cause severe itching, which leads to bleeding. At times, it can burn as well. Most of the time, it comes and goes with the change of season. In one season, your skin could be completely clear, and in another season, it may relapse.
Types of psoriasis:
Plaque psoriasis: You will find thick red patches on skin with a silver or white scaly layer. Mostly, the patches are on the elbows, knees, lower back, and scalp.
Guttate Psoriasis: You will find separated drop-shaped spots. These eruptions are not very thick. Medications, infections, and injuries can trigger it.
Inverse Psoriasis: You will find rashes on skinfolds, mainly under the breasts or in the armpits or groin area.
Pustular Psoriasis: You will find pus around the patches. It is one of the severe types of psoriasis.
Erythrodermic Psoriasis: You will find exfoliating patches with the patient complaining of a burning sensation. As the patches may develop very fast, you should seek medical help.
Other common types of psoriasis are scalp psoriasis, nail psoriasis, and psoriatic arthritis
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Video: Certain Factors Affect Patients’ Perception Of Psoriasis Remission
Gondo G, et al. Demographic and Clinical Factors Associated with Patient-Reported Remission in Psoriasis. Presented at: AAD VMX 2021 April 23-25, 2021 .
Disclosures: We were unable to process your request. Please try again later. If you continue to have this issue please contact .
New data presented at AAD VMX 2021 suggest that certain clinical and demographic factors may affect patient-perceived remission of psoriasis.
In this video, of the Keck School of Medicine at the University of Southern California, Los Angeles, discusses some of these factors, such as Dermatology Life Quality Index score, body surface area, use of biologics and more.
She noted that these findings are important because they offer insight into how patients may define remission.
When we think about whether patients feel like theyre in remission that is, if they feel that their psoriasis is under very good control such that they dont feel it at all we know that oftentimes it has to do with how they really feel in terms of their quality of life, as measured by DLQI or Global Assessment of their psoriasis-related quality of life scores, she said.
How I Got To Psoriasis Remission
Psoriasis affects your body, mind, and spirit. Theres no cure, but healing and even remission is possible. The road to remission can be rocky with lots of stops and starts along the way. Its a journey. And like any other, theres more than one route to get there.
Heres how three women have made peace with their disease and themselves.
Nadine FerrantiTeacherDallas
In 2008, I had a flaky scalp that I thought was just dandruff. After about a year, it started to spread, and I was diagnosed with psoriasis.
At its worst, my body was completely covered. My face, ears, legs, back no place was spared. I itched horribly, and when I scratched my skin, it bled.
For 10 years, I tried all different kinds of shampoos and skin creams. While living in Singapore, I visited the National Skin Clinic and started UVB treatments, which helped a lot. The problem is, as soon as I stopped going, my psoriasis came back.
When it was time to start a family, I wanted to avoid strong medications while pregnant. I just dealt with it the way I could.
We moved to New York, and I went to see a dermatologist to find relief. Eventually, I found Dr. Saakshi Khattri at Mount Sinai Hospital, who also diagnosed me with psoriatic arthritis. I thought I had just normal aches and pain from walking around and chasing after the kids. But Dr. Khattri said that if inflammation is this bad on your skin, its probably worse on the inside.
The treatment has been life-changing.
Irene Prantalos
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Strategies That Can Help You Increase The Length Of Time You Spend Without Symptoms
Psoriasis is a chronic inflammatory skin disorder that can wax and wane over time. It may affect the skin in different ways, causing pain, itchiness, and red, scaly patches. Psoriasis can take some time to get under controlso once you do, you want to do everything you can to keep it that way.
While psoriasis flares may still happen unexpectedly, you can increase the length of time you spend being without symptomswhich is called remissionby avoiding your triggers and sticking with a treatment plan.
Avoiding psoriasis triggers Many different things can trigger psoriasis, and individual triggers can vary for everyone. But here are some of the common culprits, along with ways to manage or avoid them:
In addition, stress can be a major trigger for psoriasis.
Sticking with your treatment plan Finding the right treatment plan for psoriasis can take some trial and error. Once youve established the right combination of treatments with your dermatologist and your psoriasis is in remission, heres what you can do to help keep it that way:
While managing psoriasis can take a lot of work, with the right treatment, the right healthcare providers, and strategies like the ones described above, many people are able to achieve remission.
Get Some Sun But Not Too Much
The ultraviolet rays in sunlight slow the growth of skin cells, so getting moderate doses of sun is good. But make it brief — about 20 minutes or so at a time. And use sunscreen. Sunburn can trigger psoriasis, and it raises your risk of skin cancer. Some medications can make your skin more sensitive to ultraviolet rays, so talk to your doctor first. Read more on the risks and benefits of sunlight for psoriasis.
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Exercise Eat Right And Maintain A Healthy Weight
Although no studies have shown a link between diet and psoriasis, experts recommend that people with the condition eat a well-balanced diet that’s high in fruits and vegetables. Some people say their symptoms improve when they remove dairy or gluten. Exercise may also help. Some studies show excess weight can trigger flares, so stay at a healthy weight.
Avoid Medications That Cause Flare
Let your doctor know about all the medications you take, even over-the-counter ones. Ask if they could affect your psoriasis. Drugs that are known to make things worse include:
- Lithium, used to treat psychiatric disorders
- Propranololand possibly other beta-blockers, which are prescribed for heart conditions
- Quinidine, medication for irregular heart beat
If you’re using any of these medications, ask your doctor about substitutes. Know about these and other drugs that can trigger psoriasis flares.
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What Does Psoriasis Remission Mean For Treatment
Once you reach near or full skin clearance, you may want to stop some or all psoriasis treatments. Depending on your health status, psoriasis history, and treatment plan, however, your dermatologist may recommend continuing therapy unchanged. The doctor may also suggest modifying dosages, or they may suggest stopping particular medications. According to the American Academy of Dermatology, one of three things may happen if psoriasis treatment is stopped:
In general, dermatologists do not recommend stopping biologic therapy. Long-term, continuous therapy is ideal for maintaining remission. Once you reach remission, you should discuss a maintenance plan with your dermatologist. You may need close monitoring and regular adjustments to your treatment plan to help keep your psoriasis under control.
Psoriasis And Oral Medications
Psoriasis is a common autoimmune disorder that causes red, thick, inflamed patches of skin. The patches are often covered in whitish silvery scales called plaques. In some cases, the affected skin will crack, bleed, or ooze. Many people feel burning, pain, and tenderness around the affected skin.
Psoriasis is a chronic condition. Even with treatment, psoriasis will never fully go away. Therefore, treatment aims to reduce symptoms and to help the disease enter remission. Remission is a period of little to no disease activity. This means there are fewer symptoms.
There are a range of treatment options available for psoriasis, including oral medications. Oral drugs are a form of systemic treatment, which means they affect your whole body. These drugs can be very strong, so doctors typically only prescribe them for severe psoriasis. In many cases, these drugs are reserved for people who havent had much success with other psoriasis treatments. Unfortunately, they can cause a variety of side effects and issues.
Read on to learn more about the most common oral medications and their side effects and risks.
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The Right Treatments Could Lead To Some Much Needed Relief
If you have psoriatic arthritis , you might worry that your painful, swollen joints will never be normal again. But the good news is, with the right treatment many people with PsA can achieve remission. One study showed that nearly two-thirds of subjects had minimal symptoms with 12 months.
What is remission? Remission means the disease is controlled says rheumatologist Paula Rackoff, MD, associate professor of clinical medicine at NYU School of Medicine. Patients in remission have minimal joint pain and stiffness. Theyre able to do all their daily activities with minimal symptoms and minimal morning stiffness.
Dr. Rackoff says that most people achieve remission from PsA within about six months. Once remission is achieved, Rackoff says that doctors usually try and see the least amount of medications that control the symptoms.Corticosteroids and disease-modifying antirheumatic drugs are most often prescribed by doctors to control symptoms.
Between 5 and 10 percent of people can come off medication entirely, according to Rackoff, and she adds that doctors generally wont start tapering medication until after about a year.
We always encourage people to exercise and strengthen the muscles around the joints that are affected, says Rackoff. The stronger the muscles are around a joint, the less the joint has to do.
Are Blood Tests For Psoriasis Necessary
It is estimated that 85 percent of people who suffer from psoriasis deal with humiliation or discrimination in some form. It seems people have to deal with a lot because of this condition. On top of all this, most people with this condition feel like they are not getting proper care. This is the reason why some might wonder does psoriasis go away on its own?
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Treatment For Psoriatic Arthritis
Treatment for psoriatic arthritis aims to:
- relieve symptoms
- slow the condition’s progression
- improve quality of life
This usually involves trying a number of different medicines, some of which can also treat the psoriasis. If possible, you should take 1 medicine to treat both your psoriasis and psoriatic arthritis.
The main medicines used to treat psoriatic arthritis are:
- non-steroidal anti-inflammatory drugs
- biological therapies
More Than Skin Troubles
A 2017 study from the Journal of the American Academy of Dermatology found that people with psoriasis that covers 10% of their body or more are 64% more likely than those without psoriasis to develop type 2 diabetes. “About 30% of people with psoriasis also might develop psoriatic arthritis, which causes destructive inflammation in your joints,” says dermatologist Dr. Gideon Smith. Psoriasis also may signal a higher risk for fatty liver disease and heart attacks.
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How Can I Achieve Or Stay In Remission
Remission may be followed by periods of severe psoriasis flare-ups. However, close monitoring by a dermatologist as well as an effective treatment plan can help people achieve and better sustain remission. Combination therapy with phototherapy, topical corticosteroids, and systemic medications such as methotrexate or biologics can help improve skin clearance. Newer medications that target the immune system, such as the cytokine inhibitors etanercept, infliximab, and adalimumab, may also increase the likelihood of remission.
The treatment of psoriasis is a complex process. Over time, you may need different medications or therapy options to keep your psoriasis in check. Avoiding triggers such as stress, skin injury, extreme weather, infection, and smoking can help keep the skin clear of psoriasis lesions.
However, it is impossible to predict who will reach remission and how long remission will last. You and your doctor should also weigh potential medication side effects against potential remission benefits. Regular follow-up with your dermatologist may also help you manage psoriasis more effectively. The National Psoriasis Foundation recommends working with your health care provider to find the right combination of psoriasis treatments that can reduce or eliminate symptoms.
Possible Causes For Psoriasis Remission
The goal of psoriasis treatment is to reduce the symptoms and hopefully end the flare. If treatments are successful, psoriasis may go into remission.
Even without treatment, psoriasis may disappear. Spontaneous remission, or remission that occurs without treatment, is also possible. In that case, its likely your immune system turned off its attack on your body. This allows the symptoms to fade.
This doesnt mean that you wont ever have another flare. Watch for symptoms of psoriasis so that you can begin treating them if they reappear.
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There Are Ways To Shorten Flare
Psoriasis is a big star on TV drug ads, but this autoimmune skin disease is something most people try to keep well hidden.
“Psoriasis is among the most common skin conditions, affecting about 2% of the U.S. population, and while the condition doesn’t affect everyone the same way, the approach to treatment and prevention is often similar,” says Dr. Gideon Smith, an assistant professor of dermatology at Harvard-affiliated Massachusetts General Hospital.
Your Nails Look Better
For some people, changes to their nails are the first sign a flare-up is occurring. You may notice your finger and toenails are pitted, discolored, or growing abnormally. Psoriasis can also cause your nails to become loose and break. If your psoriasis is going into remission, you may notice your nails returning to a normal color and becoming stronger, with less pits present.
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