Thursday, July 11, 2024

Scalp Psoriasis And Multiple Sclerosis

Treatment Of Psoriasis In Patients With Concomitant Multiple Sclerosis

Multiple sclerosis update Itchy Scalp Pain

As seen above, MS and PsO exhibit overlapping treatments including the use of fumarates , IFN-beta with MTX, and IL-17 inhibitors. MTX and CYA are both indicated for the treatment of PsO, and both also improve MS symptoms and reduce relapse rates. Dimethylfumarate works by downregulating Th1 and Th17 cells, which are upregulated in PsO and MS. This reduces the production of proinflammatory cytokines, including, but not limited to, IL-12, IL-17 and IL-23, which have been implicated in PsO and MS. In a small study, the addition of MTX to IFN-beta for the treatment of MS showed improvement of MS lesions. On the other hand, PsO outbreaks have been described with IFN-beta treatment for MS.

Secukinumab, an IL-17 inhibitor, is approved for use in PsO and PsA, and appears to be safe in patients with MS. As mentioned above, secukinumab causes significant reduction in MRI lesion activity in MS patients as well., The shared polymorphisms of the IL-23 receptor gene associated with MS and PsO may explain the efficacy of fumarates in both diseases, in addition to the successful use of IL-17A inhibitors in both conditions.,,

Ustekinumab is an IL-12/23p40 inhibitor approved for use in PsO and PsA. During a Phase II clinical trial, ustekinumab did not improve or worsen relapsing remitting MS, and there are no reports of worsening neurological disease with ustekinumab, allowing ustekinumab to remain as a treatment option in concomitant MS and PsO.,

What Psoriasis Treatments Are Available

Psoriasis is a chronic skin condition that may worsen and improve in cycles. Any approach to the treatment of this disease must be considered for the long term. Treatment regimens must be individualized according to age, sex, occupation, personal motivation, other health conditions, and available economic resources.

Disease severity is defined by the thickness and extent of plaques present as well as the patient’s perception and acceptance of the disease. Treatment must be designed with the patient’s specific expectations in mind, rather than focusing only on the extent of body surface area involved.

Many treatments exist for psoriasis. However, the construction of an effective therapeutic regimen is not necessarily complicated.

There are three basic types of treatments for psoriasis:

  • Laser therapy : A laser that produces UV-B light in the same wavelength as full body phototherapy units can target smaller areas of psoriasis without affecting the surrounding skin. Because the light treats only the psoriasis plaques, a strong dose of light can be used, which may be useful to treat a stubborn plaque of psoriasis, such as on the scalp, feet, or hands. This is an impractical treatment for psoriasis that covers a large area and, like other forms of phototherapy, requires regular visits over several months.
  • Psoriasis And Multiple Sclerosis

    Ive had psoriasis for at least five years, it affects my fingernails and nailbeds among other things so its tough to treat topically. Humira was very helpful but then I was diagnosed with MS so I had to stop. Fast forward, Im on Ocrevus for the MS, which is a powerful immunosuppressant. The psoriasis has gotten much worse. My question: is there anyone whos in a similar boat? A biologic would work for the psoriasis but Im not willing to be so at risk for serious infection by adding it to the Ocrevus. Theres no specific contraindications for Stelara or Cosentyx but the combination could really have an impact. My fingers look like hamburger and they hurt too. If you have MS and psoriasis Id love to hear about your drug cocktail. Thanks.

    Don’t Miss: Can Psoriasis Be In Only One Spot

    Ms Psoriasis Drugs And Deadly Brain Infections

    But experts say complication is rare, and no reason to stop medication

    HealthDay Reporter

    WEDNESDAY, April 8, 2015 — An active ingredient in some psoriasis and multiple sclerosis medications has been linked to two cases of a rare and sometimes lethal brain infection.

    The ingredient, dimethyl fumarate, appears to have contributed to the deaths of two European women. The women contracted progressive multifocal leukoencephalopathy, or PML, according to two letters published in the April 9 issue of the New England Journal of Medicine.

    One case involved a 54-year-old woman with multiple sclerosis. She died in October 2014 from complications related to PML and pneumonia, following 4.5 years of treatment with a time-delayed form of dimethyl fumarate carrying the brand name Tecfidera, researchers reported.

    The second case was a 64-year-old woman with psoriasis. She died in August 2014 from PML after being treated with a delayed-release dimethyl fumarate compound with the brand name Psorinovo for two years, according to the researchers.

    These cases follow reports linking other drugs containing dimethyl fumarate with PML, including Tysabri and Fumaderm, the researchers said.

    However, the latest case reports do not prove that dimethyl fumerate caused the PML infections.

    And outside experts said cases of PML occur rarely enough that dimethyl fumarate should remain on the market, as an option for people with MS or psoriasis.

    How Infusion Therapy For Psoriasis Works

    The connection between multiple sclerosis and psoriasis

    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.

    Also Check: Which Is Worse Psoriasis Or Eczema

    Multiple Sclerosis And The Nails: Causes And Treatment Medical News Today

    Nail problems are common, and they are not usually serious. If a person has multiple sclerosis , nail problems can cause pain or discomfort. While nail issues are not directly related to the disease, determining the cause may help prevent a person with MS from experiencing further discomfort.

    Multiple sclerosis causes the immune system to attack the myelin sheath, the protective covering around nerve cells. It can affect any part of a persons body.

    There is no clear link between MS and issues with the nails. If a person notices changes in their nails, it may be due to the nail itself or the skin underneath it. Changes in the nails may be due to environmental factors that affect the wider population in the same way, including trauma or prolonged exposure to dyes, such as nail polish.

    Nail issues could also be a marker for an underlying systemic disease, such as chronic obstructive pulmonary disease , so a person should contact a doctor if they feel concerned.

    In this article, we look at the possible causes of various nail changes and how to treat them.

    Learn how to identify nail diseases using our illustrated chart here.

    MS is an autoimmune disease that causes the immune system to attack healthy cells.

    MS can cause weakness and paresthesia. Paresthesia causes unusual sensations that can affect any part of the body, usually on one side or limb. However, it often affects the extremities, such as hands, legs, or feet.

    Learn how MS can affect the body here.

    See the rest here:

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    Also Check: Best Treatment For Psoriasis And Psoriatic Arthritis

    What Are The Types Of Psoriasis

    Occasionally psoriasis of one clinical type may evolve into another such as pustular psoriasis, erythrodermic psoriasis, or guttate psoriasis. Clinical types of psoriasis include the following:

    • In pustular psoriasis, the red areas on the skin contain small blisters filled with pus.
    • Pustular psoriasis. Image courtesy of Hon Pak, MD.

    • In erythrodermic psoriasis, very extensive and diffuse areas of red and scaling skin are present.
    • In guttate psoriasis, there are many isolated small scaling bumps.

    Are There Alternative Therapies For Psoriasis

    Healed from Multiple Sclerosis and psoriasis!

    Conventional therapy is one that has been tested with clinical trials or has other evidence of clinical effectiveness. The FDA has approved several drugs for the treatment of psoriasis as described above. Some patients look to alternative therapy, diet changes, supplements, or stress-reducing techniques to help reduce symptoms. For the most part, alternative therapies have not been tested with clinical trials, and the FDA has not approved dietary supplements for treatment of psoriasis. There are no specific foods to eat or to avoid for patients with psoriasis. However, some other therapies can be found on the National Psoriasis Foundation web site. Individuals should check with their doctors before starting any therapy.

    Read Also: Over The Counter Products For Scalp Psoriasis

    Psoriasis Complications To Watch For After A Diagnosis

    Being diagnosed with a chronic condition like psoriasis may feel overwhelming. Theres no cure for psoriasiswhich causes inflammation as well as itchy, scaly patches known as plaques1 to develop on various parts of the bodybut there are treatments that can help you keep your symptoms under control. Sometimes that can be challenging and finding the best medication for you may take a bit of trial-and-error.

    With that, people with psoriasis also have to contend with the fact that they have a higher risk for a whole host of other health conditions. While people might think of these conditions as psoriasis complications, they are actually considered related conditions in the medical community.Weve done lots of studies2 now to show that a person with moderate to severe psoriasismeaning more than 10% of their body surface area is affected with psoriasisdoes have a higher risk of comorbidities, Alan Menter3, M.D., chairman of the division of dermatology program at Baylor University Medical Center in Dallas, tells SELF.

    Understanding the specific conditions that you may be at most at-risk for developing can help both you and your care team stay on top of monitoring your overall health. Here are some of the most common conditions you may want to watch for.

    Untreated psoriasis| Psoriasis treatment | Autoimmune diseases | Psoriatic arthritis | Cardiovascular disease | Depression | Anxiety | Parkinsons disease | Metabolic syndrome | Eye diseases | Type 2 diabetes

    Psoriasis: Top Treatment Options For Flare

    Psoriasis is an inflammatory skin disease. Characterized by circular, red patches covered with silvery scales, it can most commonly be found on the scalp, outside of the elbow and knee joints, lower back, buttocks, and genitals.

    While no one knows exactly what causes psoriasis, multiple risk factors such as genetics, viral and bacterial infections, stress, obesity, and smoking contribute to its development. In addition to excessive alcohol consumption, skin injury, cold/dry weather, and certain medications, some of the risk factors listed above trigger psoriasis flare-ups.

    This article will concentrate on the top treatment options for psoriasis. This includes topical treatments, light therapy, biologics, systemic treatments, and natural treatments.

    Don’t Miss: What Are Symptoms Of Plaque Psoriasis

    Studies Suggesting No Correlation

    In contrast, there have been several studies to suggest no association between PsO and MS. For example, a prospective study of patients diagnosed with MS in England did not detect an association with PsO. In this study, comorbidities of 658 consecutive patients attending a large MS specialty clinic in Nottingham were recorded during 20022003. There were 454 females and 204 males that participated in the study. The prevalence of PsO in MS patients compared to the general population did not differ significantly.

    Similarly, one of the largest published multicenter studies evaluated autoimmune disease risk in MS patients as well as their families, comparing rates of occurrence to their first-degree relatives, as well as in their unrelated spouses. In this study, 5031 MS patients along with 30,529 of their first-degree relatives and spouses were analyzed. The frequency of PsO in MS patients was found to be no different than for their spousal controls . No significant difference in genders or in first-degree relatives of MS patients compared to controls was found.

    Finally, a comorbidity survey conducted by the National Psoriasis Foundation which spanned from 2003 to 2011 did not show an increased incidence of MS in patients with PsO.

    Demyelinating Disorders Associated With Anti

    Account Suspended

    Another link between MS and PsO is illustrated with the use of anti-TNF-alpha therapy. TNF-alpha inhibitors are a well-known treatment option for PsO. However, a potential link between TNF-alpha inhibitors and demyelinating disease has been suggested. Demyelinating diseases with possible association to anti-TNF-alpha therapy include MS, optic neuritis, GuillainBarre syndrome, transverse myelitis, and other peripheral neuropathies., The use of TNF-alpha inhibitors in PsO patients with a personal history of a demyelinating disorder or with a first-degree relative with MS is not recommended. However, one study has suggested that the number needed to treat in patients with PsO and MS is at least an order of magnitude smaller than the number needed to harm across all comparisons of anti-TNF-alpha therapies and first-degree relative relationships, suggesting TNF-alpha-inhibitor therapy could remain a treatment option for these patients after all other systemic treatment classes have been exhausted, in close collaboration with neurology colleagues, and while weighing the risks and benefits with the patient. After all, based on prior studies, it is unclear whether TNF-alpha inhibitors cause MS in patients who may be predisposed or rather unmask MS that would have presented at a later date. Several theories regarding the argument both for and against a pathogenic relationship between TNF-alpha inhibitors and demyelination have been proposed.

    Also Check: How Do You Treat Plaque Psoriasis

    Things About Psoriasis And Its Complications

    1. Psoriasis can progress to psoriatic arthritis

    Left untreated, patients with moderate-to-severe psoriasis could develop psoriatic arthritis , which affects up to 40% of patients. Similar to rheumatoid arthritis, PsA can cause pain, disability, and permanent joint deformities. Compared with patients with psoriasis who do not have PsA, patients with psoriasis and PsA have greater disease burdens and different treatment patterns. A 2015 study calculated the economic burden of psoriatic disease at up to $135 billion a year.

    2. Psoriasis has been linked to some cancers

    In particular, certain cancers may be a special concern. A recent meta-analysis found a number of site-specific cancers that seem to carry an elevated risk. Overall, in the 9 included studies of patients with severe disease, there was a significantly elevated risk ratio of 1.22 for all cancer types. By site, cancers that stood out as having particular risk for patients with severe disease include squamous cell carcinoma, lymphoma, and basal cell carcinoma.

    3. Psoriasis is more than just itchy skinit carries risk for other diseases

    More severe disease is also associated with more comorbidities. Patients with PsA may have more severe atherosclerotic disease as well as a higher risk of cardiovascular disease, endothelial dysfunction, metabolic syndrome, hypertension, hyperlipidemia, obesity, and diabetes.

    4. More psoriasis research is needed

    Public Offering And First Revenues In 1996

    The addition of Ridaura forced Connective Therapeutics to mature as a company. With a marketable product, the company needed to establish a sales and marketing dimension to its business. A sales team was formally established in March 1997, when the company decided to change its name to Connetics Corporation, a switch made to aid its newly formed marketing staff. Wiggans explained the reasoning behind the name change in a March 24, 1997 interview with Business Wire, stating, “As we begin to establish a commercial presence with our first marketed product, we decided to change the company’s name to Connetics, a name which is shorter, easier to remember, and, we believe, denotes an organization that is energetic and dynamic.”

    More profound changes followed the company’s adoption of a new corporate title, as Wiggans and his team honed their strategic focus and developed what would be Connetics’ corporate profile in the 21st century. The company took an important step toward that end in early 1998, when it signed a licensing agreement with Soltec Research Pty Ltd. to develop and bring to market the Australian company’s Clobetasol mousse in North America. The significance of the deal was the technology used by Soltec Research to administer its drug. The company’s mousse, or foam, technology became the central focus of Connetics’ strategy as it entered the 21st century, when the 1998 licensing agreement led to a much deeper relationship between the two companies.

    Recommended Reading: Is Nail Psoriasis A Fungus

    Limitations Of Existing Studies

    An inherent limitation of most studies regarding the relationship between PsO and MS is a small sample size, and often, an observational or retrospective design. Large patient numbers and a reduction in selection bias have been attained in some studies that use nationwide databases, but these databases often introduce a lack of diversity and therefore, limit the ability to extrapolate results to larger, more ethnically diverse populations. A limitation of nationwide database use or electronic medical record systems is also a reliance on correct coding, introducing the possibility of unverified or incorrect diagnoses. In studies that included patient-reported conditions or histories, the potential for ascertainment or reporting bias is large. Some of the above studies also used prevalence data available in the literature, without age and sex matching, instead of obtaining a control population from the same or a similar environment. Meta-analyses are limited by the quality of the studies included and the manner in which the information was obtained or collected in those studies. Psoriasis patients may also receive increased medical attention compared to patients without the disease which could lead to earlier, more frequent diagnoses of comorbid MS.

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    Multiple Sclerosis more talk on itchy scalp and skin

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    Also Check: How To Treat Guttate Psoriasis

    Risk Of Multiple Sclerosis In Patients With Psoriasis

    Journal of Investigative Dermatology

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