More Fit Less Psoriasis
While some researchers focus their attention on coming up with new psoriasis treatments, others look at ways to avoid this skin disorder. One promising avenue of prevention centers on fitness.
Studies find that exercise, especially when itâs intense, might help reduce the chance of getting psoriasis. People who are less fit seem to have a higher risk for the disease. Although the link needs to be explored further, it may be about how exercise can lower chronic inflammation, a hallmark of psoriasis and many other conditions.
Ustekinumab Injection May Cause Side Effects Tell Your Doctor If Any Of These Symptoms Are Severe Or Do Not Go Away:
- headache
- swelling of the face, eyelids, tongue, or throat
- difficulty breathing
- tightness in the chest or throat
Ustekinumab injection may increase the risk that you will develop cancer. Talk to your doctor about the risks of using this medication.
Ustekinumab injection may cause other side effects. Call your doctor if you have any unusual problems while using this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administrations MedWatch Adverse Event Reporting program online or by phone .
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Barriers To Widespread Use
When biologics first came on the scene, guidelines called for starting with older and less-expensive disease-modifying drugs, such as methotrexate and cyclosporine, but now doctors are increasingly starting biologics earlier when and where they can.
The main impediment? Cost.
Access to biologics has been impeded by the high costs of these drugs. Some insurers require that you tryand failother therapies before starting on a biologic for your psoriasis. This is known as step therapy, and it is meant to rein in costs.
Access is not bad, says Dr. Strober. However, the prior authorization work needed to deliver the drugs and imposed on a busy practice is onerous.
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Otezla For Moderate To Severe Scalp Psoriasis
As you may already know, the scalp is one of the most commonly affected areas in plaque psoriasis, and can be hard to treat. Otezla is a systemic therapy, different from non-systemictopical treatments like creams or shampoos that are applied directly to the scalp. Thats because Otezla is a medication that treats beneath the skinits a pill for moderate to severe scalp psoriasis.
Review Of Key Questions
For all EPC reviews, key questions were reviewed and refined as needed by the EPC with input from Key Informants and the Technical Expert Panel to assure that the questions are specific and explicit about what information is being reviewed. In addition, for Comparative Effectiveness reviews, the key questions were posted for public comment and finalized by the EPC after review of the comments.
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Biologics Versus Older Psoriasis Medications
Biologics target specific parts of the immune system that cause inflammation.
Think of the immune system as a line of dominoes. The older drugs take no prisoners, knocking down the entire line. Biologics, on the other hand, start midway through the lineup, blocking inflammation only from that point on.
This is why biologics tend to cause fewer side effects than older drugs, Dr. Hwang explains.
Biologics have been game-changers for many people with psoriasis. Its now possible to achieve clear skinwith no plaquesin weeks. This is much faster than what has been seen with older disease-modifying psoriasis drugs, he says.
They also have a convenience edge.
You can give yourself injections at home in the fat layer under your skin, similar to insulin injections for people with diabetes, Dr. Hwang says.
But unlike insulin, these shots arent given daily. Some are only given every 12 weeks, he says. This is extremely convenient.
Your doctor will have to teach you or your caregiver how to self-inject these medications before giving you the green light to do so at home.
Best Buologic For Pustular Psoriasis
CLIENT: .Ehm..noits very sudden.
HYPNOTIST: Its very sudden?
CLIENT: Hm
HYPNOTIST: Alright. Now youre in the bath there, youve just become aware of this rash coming up. And youve discovered that Grandads got cancer. But youre only 7, so Im not quite sure whether that really is enough to worry you or not. But something is troubling you. Something perhaps just a day or two before this rash first appeared thats in your mind. And its a big worry, its a worry that youve carried for many years, even to adulthood.
So Im going to pick up your hand and drop it into your lap, and whatever that worry is will come very clearly in your mind, but youll still be in that bath in your mind. Stay relaxed, watch that happen. 1,2,3. Now what is it thats troubling you Helen?
CLIENT: They didnt tell me, I heard them.
HYPNOTIST: You heard them? Now who did you hear? Who did you hear? Thatsalright, you can let those feelings come out. Who did you hear then?
CLIENT: Mum and dad.
HYPNOTIST: And what did you hear them say?
CLIENT: That he was dying of cancer.
HYPNOTIST: Is that Grandad?
HYPNOTIST: So you knew that he was dying?
CLIENT: I dont think I was meant to know.
HYPNOTIST: No, but you overheard them?
CLIENT: Hm
HYPNOTIST: Alright. Obviously I can see that it worried you a lot because you knew what that meant didnt you?
CLIENT: Hm
CLIENT:.Yes.
HYPNOTIST: Did this rash just come along perhaps a day or two after you overheard mum and dad talking?
CLIENT: Mm
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Skyrizi Is A Biologic That Was Approved For The Treatment Of Moderate
What is Skyrizi?
Skyrizi was approved by the FDA in April 2019 for the treatment of moderate-to-severe plaque psoriasis in adults. Skyrizi was approved by the FDA in January 2022 for the treatment of active psoriatic arthritis in adults.
For both plaque psoriasis and PsA, Skyrizi is given by injection under the skin at week 0 and week 4, and then every 12 weeks afterwards.
To learn more, please visit the Skyrizi website.
How Infusion Therapy For Psoriasis Works
Infusion therapy also known as IV therapy works by administering biologic medications into your body through a slow-drip IV infusion. Medications for psoriasis are administered via IV infusion into the patients arms, abdomen, or legs. Since infusion therapy delivers the medication directly into the patients bloodstream, many patients experience results more quickly than with other medications, usually within a week or two.
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B Searching For The Evidence
A systematic literature search using the strategy detailed in Appendix A will be conducted in MEDLINE® and the Cochrane Central Register of Controlled Trials. Language restrictions will not be applied. A manual search of references from included clinical trials and systematic reviews will be conducted. A grey literature search for meeting abstracts will be conducted in Web of Science, limiting search results to meeting proceedings. For agents with an FDA-approved indication for the treatment of psoriasis, a search for completed trials with posted results will be conducted on ClinicalTrials.gov and a search of FDA regulatory documents will be conducted. Data from these two sources will be used to supplement published manuscripts when the trials can be matched. The Scientific Resource Center of the Agency for Healthcare Research and Quality Effective Health Care Program will contact the manufacturers of identified interventions and comparators for scientific information packets. The same inclusion/exclusion criteria previously described will be applied to packets that are received. The literature search will be updated concurrently with the peer review process, and the same inclusion and exclusion criteria will be applied as described previously. Relevant literature will be incorporated into the review.
The Link Between Psoriasis And The Immune System
No one ever really considered that the immune system had any real role in psoriasis, or its painful outbreaks. Not until a new drug Cyclosporine was offered to arthritis patients. What happened next was both surprising and unexpected. Patients who were prescribed the immune suppressing drug for their arthritis symptoms , began to report a decrease in their skin attacks. Without warning, researchers were faced with the theory that the immune system could be causing psoriasis.
It didnt take long before researchers began to figure out the mystery of psoriasis in regards to how the immune system can impact it.
The Role of the Immune System on the Skin
The immune system is responsible for standing guard and attacking any invaders which penetrate the body. Since the skins main job is to act as the bodys first defense mechanism against invasion, it is no wonder that the immune system works in close connection with each layer of the skin. Heres how it all works:
1. Immune cells patrol the entire body for dangers. Best Biologic for Scalp Psoriasis
2. When an invader is detected, these immune send out chemical and nervous system messages to the immune system to ready itself for an attack
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What Steps Should Someone Take If A Biologic Is Ineffective Or Stops Working
Many people experience benefits from biologics for several years. But in some cases, the response lessens over time.
This may result from the persons body developing antibodies against the medication, neutralizing its effect. In some cases, a particular class of biologics may not be effective at all.
While psoriasis on any two people may look the same, various genetic mutations can cause the condition. Depending on the particular type of mutation, or genotype, a person may respond better to a certain class of biologic.
Currently, medical professionals have yet to identify all of the genetic mutations that cause psoriasis, and they have no way of predicting which drug will lead to the best response.
However, many of these medications have been evaluated both in people new to biologics and those who have previously used other types. So, we do have some guidance when making decisions for our patients.
If an individual does not respond to a biologic after several weeks of continuous use, or if someone is no longer responding to one, the dermatologist may change the medication to another in the same class or to one in a different class.
Over Time A Biologics Effectiveness Might Diminish
After months or years of taking a certain biologic, it may become less effective for you. Thats because your immune system may develop antibodies to the drug, particularly if you missed any doses. If this happens, you might notice plaques gradually coming back, and your doctor may recommend switching to another biologic.
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What Are The Side Effects Of Taking A Biologic
Each PsA biologic is different. Each has its own potential side effects.
However, there are also similarities in this class of drugs. The most common side effect for all biologics is an increased risk of unusual, or opportunistic, infections.
In addition, TNF-alpha inhibitors may cause new or worsening heart failure.
If you and your doctor decide to try this course of treatment with a biologic, you may experience flu-like symptoms or respiratory infections.
Since biologics are given by injection or via an intravenous solution, you may also experience discomfort where the needle pokes your skin.
Biologics may lead to more serious side effects, such as blood disorders or cancer.
For these reasons, its a good idea to maintain a strong relationship with your doctor that focuses on open communication.
Together, you can talk about and decide on whether a biologic is the right treatment for your psoriatic arthritis.
Biologics are recommended for those living with moderate to severe PsA. But some people arent candidates for biologics.
Thats because the drugs side effects may do more harm than good.
People with compromised immune systems or active infections shouldnt take biologics for their PsA. These drugs suppress the immune system and can be unsafe if yours is already compromised in some way.
The cost and out-of-pocket expenses for biologics can also be a barrier for some people.
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Is Hair Loss Due To Dandruff Temporary Or Permanent
Hair loss due to dandruff is not permanent. Once you treat the dandruff, your hair follicles are restored and hair grows back.
Wrapping Up
Numerous scalp conditions can be mistaken for dandruff. Though not a direct cause for hair fall, dandruff can accelerate hair fall. If you have extreme scalp itching or hair that falls out in clumps, consult your dermatologist without a delay. Most importantly, love yourself despite all the physical issues.
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What Are Office Treatments For Scalp Psoriasis
Rarely, it may be of benefit to inject triamcinolone acetonide directly into psoriatic plaques. Aside from the pain involved, the benefit only lasts about six weeks at best. Ultraviolet light in wavelengths near 313 nm is effective in psoriasis. The hair, however, can pose a barrier to effective administration unless it is removed or sparse. The excimer laser produces out laser light in these UV wavelengths also and can be of benefit if the amount of scalp involvement is limited.
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Getting Social With Scalp Psoriasis
Remember, youre not alone! Here are some social media communities for people like us living with scalp psoriasis. Join in on these online conversations and find out how others manage their scalp psoriasis. Here are some of my favorite Instagram blogs: , , .
In the meantime, tell me what products you use to treat your scalp psoriasis. You can DM me .
Featured Image via
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How Is Pustular Psoriasis Different
Pustular psoriasis looks different to plaque psoriasis, although plaque and pustular psoriasis can coexist or one may follow the other. The main distinguishing feature of pustular psoriasis is the appearance of pus spots surrounded by or on top of areas of red skin. This does not mean there is infection present. The spots simply show that the skin has been invaded by white blood cells. The person is not infected and neither are they contagious in any way.
Pustular psoriasis flare-ups can be triggered by some medicines, irritating substances on the skin, ultraviolet light overdoses, pregnancy, systemic steroids , infections or emotional stress.
Theyre Considered Safe But Do Have Potential Side Effects
The most common side effects of biologics are pain and skin reactions at the site of the injection. Its also possible to have an allergic reaction that leads to a rash, itchiness, shortness of breath, or dizziness.
Since biologics work by suppressing your immune system, they increase your susceptibility to infections, such as bacterial and fungal infections, and may increase your risk of tuberculosis and lymphoma. Before starting a biologic, your doctor will run tests to make sure the drug is safe for you to take.
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What Should People Know About Self
A person can self-inject nearly every biologic on the market in the comfort of their own home. Many companies also provide nursing support, which involves a nurse visiting the persons home to teach them to self-administer injections.
Most of the medications are administered through auto-injector pens, rather than traditional syringes, to ease the process. In some cases, people can still go to their doctors office for the injections, if they are not comfortable administering them at home.
The first step is to thoroughly clean the hands and the site of the injection. An injection should only take place in an area that is not affected by psoriasis.
Place the auto-injector flush to the skin, then press the releaser to deliver the medication. Do not lift the auto-injector from the skin until the dose has been fully administered.
Then, clean the skin again if there is a drop of blood, and apply an adhesive bandage.
Certain Biologic Treatments May Be Safer For Patients With Psoriasis
The study focused on the comparative risk of infection across 7 systemic biologics.
A new study conducted by researchers from Beth Israel Deaconess Medical Center has found a decreased risk of infection in patients with psoriasis using newer, more targeted medications compared to those taking methotrexate, a drug widely used since the 1960s as a first-line treatment for moderate-to-severe psoriasis. The findings were presented at the Society for Investigative Dermatology meeting in Chicago.
This retroactive observational comparative cohort study, the largest of its kind, focused on the comparative risk of infection across 7 systemic biologics, new medications that inhibit the overactive immune system by targeting specific inflammatory pathways.
According to the study, the investigators used 2 large insurance claims databases of approximately 250 million patients in the United States. They then tracked the incidence of serious infection in approximately 107,000 patients with psoriasis who had a prescription for 1 of 7 systemic medications FDA-approved for the treatment of moderate-to-severe psoriasis including older systemic medications , biologics , and a small-molecule inhibitor .
These findings suggest that biologics more specifically targeted to inflammatory pathways in psoriasis may be both more effective and safer when it comes to risk of infection, the investigators noted.
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Which Biologic Do You Think Is Best For Me And Why
There are currently more than a dozen different biologic drugs that treat psoriasis. Each one blocks a specific part of the immune response that triggers psoriasis flares. Thats great because you have a lot of options, but it can also feel a little daunting.
Its important to note that the first biologic you take may not be the one,Matthew Keller, MD, director of the Jefferson Psoriasis Center, tells SELF. Here is where the trial-and-error part comes in, as everyone responds differently to these medications. One big thing your doctor might keep in mind, when starting you on a biologic for the first time, is if you have other medical conditions to consider when choosing your medication. For instance, if you have psoriatic arthritis, and about 30% of people with psoriasis do, there is a certain class of biologics your doctor might recommend first because theyre shown to be most effective for both psoriasis and psoriatic arthritis, Dr. Keller says. On the other hand, your doctor might avoid this class of drugs if you have other immune-related diseases like lupus or multiple sclerosis because it could flare up these conditions.
Your personal preference is also important. If youre not a fan of injections, you might prefer certain classes of biologics that only require injection four to six times a year instead of weekly, according to a 2019 study published in the journal Frontiers in Pharmacology.2