psoriasis treatment and cures

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A.Gamat (SEA CUCUMBER)

In Healing power of gamat, we have publicity on Prof Hassan Yaacob, a pharmacologist, who appears to be promoting Gamat (a sea cucumber). The article cites Gamat, used in Malay traditional medicine, as being "effective" based on anectdotal case observation and animal studies. The only way to prove whether or not Gamat is effective is to perform randomised controlled clinical trials in humans. I searched PubMed for "sea cucumber" and I could not locate any such trials. Incidentally I tried to look for publications listed in PubMed by Prof Hassan Yaacob but I could not find any either.In the meantime, the article goes on to quote that Prof Yaacob has "set up Healwell Pharmaceuticals Sdn Bhd in Shah Alam. He is executive chairman and director of Healwell and Eastern Biotech Resources Sdn Bhd, a local company dealing in production and consultation of gamat and anti-ageing skincare products. He is also chairman of Dermatech Sdn Bhd, a joint local and Singaporean company exporting cosmetic products to the United States." It seems to me that commercial interests supercede adequate peer-reviewed scientific proof of efficacy. Academics should stick to academia. It does not go down well with many people if academics have much vested commercial interest. It's like political parties doing business. The public should realise that products associated with academic's names on the label and endorsements does not necessarily mean the product works as claimed or there has been any proper clinical studies in the first place. It only goes to show how much we need proper regulation in this country. If one sells a product with a claimed clinical benefit (wound healing for instance) we should demand there be adequate clinical studies before one is allowed to market the product. But this is Malaysia - anything goes!In the meantime, the poor Gamat are being threatened with extinction as the Star also reports that Sea cucumber are being over harvested.

Possible New Cure for Psoriasis FoundBONN, GERMANY -- August 16, 2004 -- Cell biologists of the University of Bonn, in cooperation with the University of Leeds (U.K.) and industry may have discovered a new effective therapy for psoriasis -- a specific group of what are known as metalloproteinase inhibitors that can normalise the increased tendency of epidermis cells (keratinocytes) to divide, which is the cause of this unpleasant lepidosis.The researchers were not able to detect any toxic side-effects, at least not in cell cultures. Their findings are being published in the Journal of Investigative Dermatology (Vol. 123, No. 3).cont..

B. Methotrexate?

Methotrexate (MTX) has been used to treat severe and/or disabling psoriasis since the early 1960s. It is also used to treat psoriatic arthritis. MTX was used initially to treat cancer. By chance, it was discovered to be effective in clearing psoriasis.

Generally, MTX is reserved for people with at least 30 percent of their skin covered with psoriasis who are not responsive to, or eligible for, conventional topical or ultraviolet light treatments (UVB and PUVA). The palm of the hand represents about one percent of the skin’s surface area.



1.How Effective is MTX for Psoriasis?

MTX works best on extensive psoriasis, erythrodermic and acute pustular psoriasis, physically disabling psoriasis of the palms and soles, psoriasis in the elderly, and severe psoriatic arthritis.

The majority of patients achieve significant or even complete clearing of their disease with MTX. The clearance or remission can last for a few weeks to a year or more after stopping therapy.

MTX can be highly effective in reducing symptoms of psoriatic arthritis and arresting joint destruction caused by certain forms of psoriatic arthritis.



2. Can Anyone Use MTX for Psoriasis?

There are medical conditions and histories that may disqualify some patients from using MTX:

women who are pregnant
men or women who are trying to conceive a child (conception should be avoided during and for at least 12 weeks after discontinuing MTX therapy)
people who have blood disorders
people with an active peptic ulcer
people with severe anemia
people with cirrhosis of the liver
people with active hepatitis
people with significant liver or kidney abnormalities
people with active infectious disease
people who consume alcohol (beer, wine, liquor)
patients who are unreliable


3. How Is MTX Used?

MTX can be taken either by mouth or by injection. The most common way people take MTX is by mouth, either as a pill or in a liquid form. The physician will gradually adjust the dose to the smallest amount needed to achieve clearance. This minimizes the possibility of the patient experiencing side effects. MTX is usually taken in a single dose once a week.

The physician will not increase the dose of MTX to achieve total clearing (100 percent) if a few stubborn lesions remain. Instead, another therapy will generally be added, such as UVB, cortisones, or anthralin, to clear the remaining lesions.

The physician will perform a number of tests, including kidney and liver tests, to ensure the drug is safely metabolized by the body and is not adversely affecting the liver or bone marrow.

If long-term MTX therapy is anticipated, the physician may require a needle biopsy of the liver. The biopsy may be given before or after starting the drug and at intervals while the drug is taken.

The initial liver biopsy may be postponed for several months after MTX therapy has begun. This is to avoid an unnecessary procedure in case MTX therapy is stopped for any reason in a short period of time. Reasons for stopping MTX would include lack of patient response, unacceptable side effects, or rapid response not requiring any additional drug.



4. How Quickly Will MTX Work?

In most psoriasis patients, improvement will begin within four to six weeks. The majority of patients have substantial clearing within two or three months of starting therapy.

In psoriatic arthritis patients, it may take up to six months for the drug to have maximum effect. Effects can include decreased inflammation and pain and improved flexibility.



5. How Long Do People Take MTX?

Once initial clearance is achieved, the physician will generally taper or decrease the dose of MTX. If possible the physician will stop the drug all together until the symptoms return. Some people may require a maintenance dose of MTX to sustain clearance.



6. Short-term Side Effects

MTX can cause varying degrees of discomfort during treatment. Some people experience no complaints. The most common short-term side effects:

Anemia
Nausea

Insomnia
Loss of appetite

Tiredness
Temporary hair loss in some patients

Other less frequent side effects can include:
Phototoxicity (sunburn)
Headaches

Mouth ulcers
Chills and fever

Skin rash or sores
Light-headedness

Vomiting
Easy bruising, bleeding

Stomach upset and diarrhea, sometimes with blood in the stools

Reduced white blood cell count which can make one more susceptible to infection


Nausea can sometimes be reduced by drinking milk or eating before taking the medication. Severe nausea may mean the dose is too high. Also, if sores appear in the mouth, the dose may be too high. Although physicians have hesitated to use folic acid with MTX in the past, recently it has been shown that folic acid at a dose of 5 milligrams per day can reverse MTX-induced nausea without interfering with the beneficial effects of the drug on psoriasis.

MTX may occasionally cause a sunburn if the patient gets too much sunlight or ultraviolet light while taking the drug. This reaction has been reported even when MTX was taken several days after ultraviolet exposure.



7. Long-term Side Effects

MTX’s principal long-term risk is to the liver. However, the risk is less than originally thought. A small percentage of patients, generally estimated to be 1 out of 200, will develop reversible liver scarring after a cumulative dose of 1.5 grams. The risk can increase if the patient has had a cumulative dose of MTX above 1.5 grams, (one gram equals 1,000 milligrams) or if the patient has one or more of the following risk factors:

drinks alcohol
over weight

takes arsenic
has diabetes

has abnormal kidney function
has had prior liver disease


All studies indicate that the incidence of cirrhosis of the liver is minimal with a total MTX dose below 1.5 grams. A large-scale European study confirmed that liver damage caused by MTX frequently reverses once the drug is stopped.

The risk of liver damage depends on the cumulative dose, the treatment schedule, and the rest periods from taking the drug. It can take a few years or 10 to 20 years to reach the cumulative doses that pose greater risk to the liver.

The liver biopsy is considered the only reliable test for liver damage. Follow-up liver biopsies are recommended when the cumulative MTX dose exceeds 1.5 grams. If significant liver fibrosis develops, therapy is usually discontinued.

Liver damage that falls short of cirrhosis will generally reverse. As a rule, a year off the therapy should be sufficient for the liver to return to normal, though the length or time it takes will depend on the severity of the damage.



8. Does MTX pose any risk for conception or pregnancies?

MTX can cause birth defects if taken during a pregnancy. Women should not become pregnant while on MTX. Both men and women should stop MTX at least three months prior to trying to conceive a child.

MTX for psoriasis has not been reported to pose any major risk to fertility in men or women and their future pregnancies. Studies of women treated with high doses of MTX for uterine cancer showed a normal pattern of fertility and normal babies after MTX treatment. Men have conceived normal offspring while taking MTX.



9. Precautions

If you are on MTX, you should not receive a live virus vaccines. You need to be off of MTX for 3 months before being vaccinated with a live virus. If you are scheduled for any vaccinations, be sure to let your doctor know before receiving the vaccine.

C. Tar
What is tar and how does it work?

Tar used for medicinal purposes is derived from both coal and wood (e.g., juniper, pine). However, coal tar is the type used most commonly to treat psoriasis. Tar can help slow the rapid proliferation of skin cells and restore the skin's appearance. In addition, tar can help reduce the inflammation, itching and scaling of psoriasis.

How well does tar work?

Patients may see improvement within a couple of weeks of starting tar treatment, but it may take up to eight weeks to see the maximum benefit.
The best candidates for use of tar as a primary treatment are people with limited psoriasis or those with well-defined lesions.
When reading labels on tar products, including shampoos, keep in mind that generally the higher the concentration of tar, the more potent the product. Also remember that the greater the concentration of tar, the greater the odor and mess the product may cause.

How do you apply tar to the skin?

Tar can be applied directly to the psoriasis lesion, added to bath water or applied to the scalp. Follow the directions supplied on the tar medication or the instructions from your doctor. Tar medications are generally left on the skin for at least two hours.
Apply tar medications in the same direction the hair grows. Applying against the direction of hair growth can cause inflammation and pimple-like eruptions at the base of the hair follicles. This is called folliculitis.
Tar can stain clothing and bed linen. To help reduce staining, allow the medication to air dry on the skin before covering it with clothing.


Tar shampoos

Tar is sold in special shampoo formulations to treat scalp psoriasis. Medicated tar shampoo is normally left on the scalp for five to 10 minutes before being rinsed out, to allow the shampoo to penetrate the scales. If scaling is sufficiently heavy, pretreatment with a scale remover (known as a keratolytic) may help the tar shampoo better penetrate the lesions.
The tar shampoo can be followed by a more cosmetically pleasing shampoo or conditioner. Tar shampoos should primarily be considered a medication, rather than a hair cleanser.

Tar can stain bleached, light blond and gray hair. Because tar gels usually cause less staining, they may be a good alternative to other forms of tar products for people with light-colored hair.

Tar in the bath
Tar solutions can be added to bath water for a 15- to 30-minute soak. Tar bath solutions are generally considered ineffective at clearing psoriasis lesions, but they can reduce itching and scaling.
Side effects of using tar
Tar can irritate and redden the skin. Test a tar product on a small area of the skin first. If reddening occurs, try applying the tar on top of a moisturizer. Or, have a pharmacist mix 5%, 10% or 20% Liquor Carbonis Detergens (LCD), a prescription coal tar, with Aquaphor, an OTC moisturizing agent.
It may be more difficult to find OTC tar medications in California, due to state guidelines regarding tar products. As of January 2002, California requires OTC coal tar shampoos, lotions and creams that contain more than 0.5% coal tar to be labeled with cancer warnings. As a result, some companies have stopped selling their products in California or replaced coal tar with another active ingredient. However, the U.S. Food and Drug Administration (FDA) maintains that OTC products with coal tar concentrations between 0.5% and 5% are safe and effective for psoriasis and that no scientific evidence suggests that the coal tar in OTC products is carcinogenic.

Studies show some of the chemicals in coal tar may cause cancer, but only in very high concentrations, such as in coal tar used in industrial paving. Anyone using tar regularly should be aware of the signs of skin cancer and have a dermatologist recommend a skin cancer checkup schedule.



D. Dovonex

What is Dovonex and how does it work?
Dovonex (also known by its generic name calcipotriene) is a form of synthetic vitamin D3 approved by the FDA for treating psoriasis. It slows down the rate of skin cell growth, flattens psoriasis lesions and removes scale. It is not effective at decreasing inflammation, though for most patients redness will improve over time.
Dovonex is sold as a cream, ointment and scalp solution. All Dovonex products come in 0.005% strength, and they are odorless and nonstaining.

Dovonex is not related to vitamin D found in vitamin supplements taken by mouth. These supplements should not be used to treat psoriasis. Ingesting large doses of vitamin D–even though it is sold without a prescription–can cause serious side effects.

How well does Dovonex work?
Patients using Dovonex often see results after two weeks of treatment, but clearance or full effect usually takes at least eight weeks. Doctors typically prescribe Dovonex for an initial treatment period of six to eight weeks.
In general, Dovonex does not work as quickly as superpotent topical steroids, but unlike steroids, Dovonex has no known serious side effects when used according to directions. Dovonex is FDA-approved for long-term use.

For psoriasis plaques on the body, studies have shown that Dovonex ointment is slightly more effective than the cream.

How is Dovonex used?
Dovonex should be applied directly to psoriasis lesions in a thin layer. It is important to follow your doctor's directions in applying Dovonex. Dovonex can irritate unaffected skin. Patients should always wash their hands thoroughly after applying the medication to avoid spreading it to unaffected areas of skin.
Covering or wrapping (occlusion) of Dovonex-treated skin can result in rapid clearance but should only be done under a doctor's guidance. Doctors usually recommend applying Dovonex twice per day.

A ring of scaling around Dovonex-treated psoriasis plaques leads some people to worry that their psoriasis is spreading. In fact, it may be a sign that the psoriasis is about to clear.

Using Dovonex on the scalp
Dovonex scalp solution is a water- and alcohol-based formulation specifically designed for treating scalp psoriasis.
Rub the solution gently into scalp lesions at night, and then cover (occlude) the scalp with a shower cap or plastic bag overnight. The Dovonex may be washed out in the morning.

Avoid getting the mixture on the face or around the eyes, where it can cause irritation. Sweat can carry the medication onto the face and neck as well, so it is important to protect unaffected areas of skin. Also, Dovonex scalp solution should not be used during a flare of scalp lesions; the alcohol in the solution may irritate the skin.

Using Dovonex for nail psoriasis
Dovonex has proven successful in treating nail psoriasis for some patients. In one study, Dovonex ointment proved about as effective for nail psoriasis as a combination ointment of salicylic acid and a topical steroid.
Side effects of using Dovonex
Dovonex has no known serious side effects when used according to guidelines. The most common minor side effect is skin irritation, usually in the form of stinging or burning. This adverse reaction to Dovonex is generally mild, and the irritation should decrease as the skin becomes accustomed to the medication. Some dermatologists recommend mixing Dovonex with petroleum jelly, first at a ratio of 1-to-1 and then in increasing amounts of Dovonex to help the skin adjust.
Less common side effects for Dovonex include dry skin, peeling, rash, dermatitis and worsening of psoriasis.

The face, the genitals and skin folds can be extremely sensitive to Dovonex irritation. Wash hands thoroughly after applying Dovonex to prevent transferring the medication to sensitive areas.

Do not overuse Dovonex, as the medication can be absorbed into the body, increasing the risk of side effects. Guidelines recommend using no more than 100 grams of Dovonex cream or ointment, or 60 milliliters of the scalp solution in one week.

Dovonex is not recommended for use during pregnancy unless the benefits outweigh the possible risks to the fetus. It should not be used during breast-feeding, as the medication may be passed through breast milk.

Using Dovonex with other treatments
Because Dovonex is relatively safe and free of serious side effects, it is used in combination with many other treatments.
Combining Dovonex with topical steroids—for example, applying one at night and the other in the morning—can be more effective and less irritating than using Dovonex alone. Also, according to one study, a combined maintenance treatment of daily Dovonex plus weekend use of a superpotent topical steroid (called pulse therapy) may prolong remissions.

If Dovonex is prescribed along with other topicals, apply the medications at different times of day and never mix them. The active ingredient in Dovonex is easily inactivated, particularly by acidic compounds like salicylic acid.

Dovonex increases the effectiveness of UVB treatments and PUVA treatments. Dovonex should be applied only after UV treatment because it may partially block the light during treatment, and UV rays can inactivate the medication.

In moderate to severe cases of psoriasis, Dovonex and several systemic treatments may be combined. With cyclosporine or Soriatane (also known by its generic name acitretin), Dovonex improves overall results and reduces the amount of systemic drugs needed, thereby reducing their risks and side effects. There are no known problems using Dovonex with methotrexate or biologics, but studies are limited.

Psoriasis penyakit kulit bersisik

Psoriasis penyakit kulit bersisik

Ketika penyakit mula menyerang, kalau boleh kebanyakannya mahu duduk berkurung dalam rumah supaya tidak menjadi tumpuan masyarakat yang tidak faham keperitan dan tekanan dirasai. Kebanyakan orang memandang, dan ada yang berani berbertanya penyakit ini.

Bila pesakit memberi jawapan, Bermacam-macam cadangan di ajukan saperti berjumpa doktor pakar kulit ditempat tertentu, jumpa bomoh atau dukun,ubat jualan lansung, ubat herba, mandi air panas, mandi air laut dan bermacam macam lagi.

Bila penyakit menyerang, kulit pesakit menjadi berbintik atau bertompok merah, membengkak dan kulit pada bahagian berkenaan menebal dan keras. Ada kalanya tompokan sel ini berubah menjadi hitam akibat kehadiran melanin.Dalam masa beberapa hari, kulit yang tebal itu menjadi tua dan apabila sel mati, ia tertanggal sendiri sebagai kepingan putih berkilat. Bahagian kulit yang tebal ini juga terasa gatal dan panas seolah-olah terbakar.Ada juga yang merekah dan berdarah apabila bahagian ini diregangkan, terutama jika ia menyerang kulit pada sendi seperti lutut, siku dan tangan. Bagi kulit normal, proses penggantian kulit berlaku secara perlahan-lahan dan mengambil masa 28 hingga 30 hari sebelum sel mati ini tanggal daripada badan.Dalam kes psoriasis, kecelaruan sistem imun badan ini menghantar isyarat untuk mempercepatkan proses kitaran kulit kepada tiga hingga enam hari saja. Ini menyebabkan kulit sel kulit membahagi dengan cepat (secara berlebihan atau dipanggil poliferasi).Sel kulit ini bertindih antara satu sama lain sehingga menyebabkan terbentuknya timbunan sel dan ia kelihatan seperti sisik dan tompokan keradangan tebal pada kulit. Tompokan sel ini tidak mendapat cukup bekalan darah dan ia mati dalam masa beberapa hari saja.Apabila sel ini mati dan kering, ia menggelupas menjadi kepingan putih berkilat. Biasanya kepingan kulit kering ini tanggal sendiri, tetapi jika dipaksa (dikopek), ia menyebabkan luka.Psoriasis boleh berlaku di mana-mana saja termasuk di kulit kepala, kemaluan, punggung, kaki atau belakang badan. Walaupun ia tidak menjangkiti orang lain, keadaan pesakit dan cebisan kulit yang tertanggal membuatkan ramai berasa tidak senang untuk duduk bersama mereka.Serangan psoriasis ringan jika hanya membabitkan kurang daripada dua peratus kulit, sederhana (tiga hingga 10 peratus) dan teruk jika lebih 10 peratus kulit mempunyai tompok merah. Malah, pesakit boleh menentukan keadaan penyakit dengan mengukur menggunakan tapak tangan. Satu tapak tangan dikira sebagai satu peratus.Banyak kaedah boleh digunakan untuk merawat psoriasis antaranya kortikosteroid, vitamin D3, retinoid, antralin, tar arang, psoralen, methotrexate dan terapi sinar UVA. Bagaimanapun, sehingga kini belum ada ubat dapat menyembuhkan penyakit ini.Kaedah terbaru ialah penggunaan krim herba yang dirumus daripada lima jenis halia liar ciptaan Profesor Azimahtol. Bahan aktif krim halia itu mampu menghentikan proses pembahagian sel dan mematikan sel berkenaan.“Untuk kesan lebih baik, pesakit boleh menggunakan cooltar yang diberikan doktor untuk menanggalkan lapisan kulit tebal . Apabila lapisan itu tertanggal, baru disapu dengan krim halia ini sebanyak lima hingga tujuh kali sehari.“Kesannya bergantung kepada keadaan setiap pesakit. Oleh kerana krim ini mempunyai bau kuat, pesakit disaran mengambil cuti beberapa hari untuk menjalani rawatan. Berdasarkan pengalaman 250 pesakit yang menggunakannya, biasanya ia mengambil masa antara lima hingga 14 hari untuk menunjukkan kesan.“Selain mengandungi bahan aktif yang boleh menghentikan pembahagian sel, krim halia ini mempunyai ciri anti alahan, anti fungus, anti bakteria dan anti melanin. Ini kerana pesakit juga biasanya mengalami masalah alahan, mudah dijangkiti fungus terutama pada kuku, mendapat jangkitan bakteria dan badan mengeluarkan banyak melanin yang menyebabkan plak psoriasis menjadi hitam,” katanya yang menjalankan kajian fototerapeutik halia sejak 1997.Bagi pesakit yang mengalami psoriasis pada kulit kepala, Profesor Azimahtol menyarankan krim ini dicampurkan dengan tonik rambut sebelum disapu rata pada kulit kepala. Malah, krim sama boleh digunakan bagi individu yang mengalami penyakit kulit lain seperti ekzema, kayap, kurap atau ruam lampin.“Paling penting, jangan berputus asa. Allah menjanjikan setiap penyakit ada ubatnya. Usah disebabkan penyakit kita hilang keyakinan diri. Kadangkala kita perlu menggabungkan beberapa kaedah rawatan sebelum penyakit dapat dikawal dan disembuhkan,” katanya.

Penyakit Psoriasis arthritis menyebabkan radang sendi. Sendi menjadi bengkok dan tidak boleh bergerak saperti sendi jari tangan. leher, lutut dan bergelangan kaki.

Psoriasis FAQs

Psoriasis FAQs


1. What is psoriasis?

Psoriasis is a chronic skin disease related to the immune system, affecting about 2-3 percent of Malaysians (similar to worldwide statistics). It is a condition that results in localised or extensive inflamed scaly skin lesions that can affect any part of the skin. It frequently occurs on the scalp, elbows, knees and shins. In a person with psoriasis, the skin immune system is altered and chemical messengers derived from activated white cells (T-cells) speed up the growth cycle of skin cells; instead of shedding, the cells pile up and form thickened scales on the skin surface. The severity of psoriasis varies from person to person; for most people, psoriasis tends to be mild.
2. What are psoriasis symptoms?

Below are some psoriasis and psoriatic arthritis symptoms. If you have experienced any of them, please consult your dermatologist (Refer to list of clinics and general hospitals provided):
Psoriasis

• 
  Red, scaly skin patches with sharply defined edges
• 
  Lesions that occur most commonly on both elbows or both knees, the scalp, and the cleft of the buttocks
• 
  Lesions that appear at sites of injuries to the skin
• 
  Changes in fingernails or toenails, such as pitting, loosening, or thickening
  Psoriatic Arthritis
• 
  Joint pain, especially with redness, swelling, and tenderness
• 
  Morning stiffness

3. How do I determine if I suffer from psoriasis?

Psoriasis is often misdiagnosed by patients, pharmacists and doctors as dandruff, ringworm or eczema.)
No special blood tests or diagnostic tools exist to diagnose psoriasis. The physician or dermatologist usually examines the affected skin and decides if psoriasis is the cause. It is very seldom that the physician needs to examines a piece of skin (biopsy) under the microscope. 4. How does psoriasis impact a person’s life?
Psoriasis can affect people in different ways – emotionally, socially as well as physically. People with psoriasis have to cope not only with the disease, but also people’s reaction to it. Depression is common among people who suffer from psoriasis.
Skin lesions may make the person feel unattractive, and some may feel ashamed of their bodies. Some have difficulty interacting with co-workers and even family members and friends because of the appearance of their skin. Some stay home to avoid social situations. Psoriasis can have a strong negative impact on their lives.

5. Is psoriasis contagious?

No, psoriasis is not contagious. Psoriatic lesions may look like infections or open wounds, but they are not. It is not something you can "catch" or "pass on." People with psoriasis do not pose a health or safety threat to others. 6. Who is likely to get psoriasis?
Psoriasis may run in families. Usually, psoriasis appears in individuals between the ages of 15 and 35, but can develop at any age. Approximately 10-15 percent of those with psoriasis get it before age ten. There have been rare cases of infants having psoriasis.
7. Are there ‘triggers’ for psoriasis?Yes, there are triggers but they vary from person to person. Triggers can include physical injuries or infections, certain medicines, and emotional stress. Stress can cause psoriasis to flare for the first time or aggravate existing psoriasis. Psoriasis can also be triggered in areas of the skin that have been injured or traumatized. This is known as the "Koebner phenomenon." Vaccinations, sunburns and scratches can all trigger a Koebner response. The Koebner response can be treated if it is caught early enough. Certain medications, like antimalarial drugs, lithium and certain beta-blockers, are also known to cause people's psoriasis to flare.

8. Is there a cure for psoriasis?

Currently, psoriasis is not curable. Once triggered, psoriasis is a lifelong condition that often waxes and wanes in severity. Quality of life for a person with psoriasis can be improved with early diagnosis, so that the symptoms can be managed from the start.9. Will a person with psoriasis also develop psoriatic arthritis?
Only about 10-30 percent of people with psoriasis will develop psoriatic arthritis. This affects the joints of the fingers and toes and may involve the neck, lower back, knees and ankles. In severe cases, if not treated, psoriatic arthritis can be disabling and cause irreversible damage to joints. 10. What are the treatments available for psoriasis?
There are many different treatments available to people with psoriasis: topical (applied directly to the skin), ultraviolet light (also called phototherapy) and systemic drug therapy (including biologics, a new form of injectable treatment ). Treatments may help improve the skin, but the underlying condition can cause flare-ups if treatment is discontinued. People often need to try out different treatments before they find what works best for them.

11. What questions about treatment can I ask my doctor?
What treatments are available?
Why have you chosen this particular treatment for my condition?
Can I use other medications while I am taking this treatment?
How long will it take to see results?
How will you monitor my progress on this treatment?
What will happen it I stop using this treatment?
Does this treatment have any side effects?
Can I take this medication if I am trying to get pregnant?

12. What can a person with psoriasis do to maintain a healthy lifestyle?
Exercise regularly and get as much rest as you need. Exercise and rest help maintain your health and reduce stress.
Eat a healthy diet and avoid excessive alcohol.
Reduce stress with relaxation techniques such as meditation and deep breathing.
Keep a diary to pinpoint situations, places, or events that trigger your stress.
Understanding your triggers can empower you to avoid flares and help make psoriasis more manageable.

13. How can psoriasis sufferers help others understand their condition?
Learn as much as you can. The more you know about psoriasis, the better you can explain it.
Teach people the facts about your condition. For example, tell them it is not contagious and that there is currently no cure.
Being open and honest will go a long way toward keeping your relationships healthy.
Don’t take yourself too seriously. Remember to laugh. A good sense of humour helps relieve stress. .