Latest news with #psoriasis
Medscape
15 hours ago
- General
- Medscape
Systemic Psoriasis Therapy Linked to Less Dementia
SAN DIEGO — While psoriasis is linked to higher rates of dementia, a new study suggested that older patients with psoriasis on systemic treatments may have a much lower risk than those not treated systemically. In fact, the research hints — but doesn't prove — that the medications could lower the dementia risk even below that of the general population. The study, which retrospectively evaluated US medical records of people aged 65-95 years from 2004 to 2024, found that patients with psoriasis on systemic therapies (n = 14,679) had a lower risk of developing dementia than those not on systemic treatment (n = 39,601) and lower than a matched general population group (5.77 million). The adjusted odds ratios (aORs) for the treated psoriasis group vs the untreated group were 0.49 (0.39-0.61) for Alzheimer's disease, 0.65 (0.51-0.83) for vascular dementia, and 0.60 (0.53-0.68) for nonvascular dementia. For the treated group vs the matched general population, the aORs were 0.69 (0.54-0.86), 0.85 (0.65-1.10), and 0.85 (0.75-0.97), respectively. The findings, presented at the Society for Investigative Dermatology (SID) 2025 Annual Meeting, are too preliminary to affect clinical practice. But the study does add to 'a growing body of evidence linking chronic inflammation to neurodegeneration,' study lead author Madison Olexson, a dermatology research fellow at Eastern Virginia Medical School, Norfolk, Virginia, told Medscape Medical News . 'It reinforces [how] treating systemic diseases like psoriasis may not only improve cutaneous symptoms but may have extra-cutaneous benefits as well,' she said. Sparse Data on Systemic Treatments and Psoriasis Several international reports have linked psoriasis with dementia, including a 2019 study that found an elevated risk associated with the skin disease and vascular dementia (hazard ratio [HR], 1.73; 95% CI, 1.21-2.47) and a 2023 study that identified an increased risk for dementia (HR, 1.24; 95% CI, 1.14-1.35). Also, a 2019 study linked dementia to a higher risk for psoriasis (OR, 1.46). Other autoimmune disorders such as rheumatoid arthritis and inflammatory bowel disease have also been linked to higher incidence and risk for cognitive impairment and dementia, Olexson said. 'This is believed to be linked to systemic inflammation and the sustained activity of proinflammatory cytokines such as [tumor necrosis factor] TNF alpha and [interleukin 17] IL-17, which can affect the brain and potentially lead to neurodegeneration. However, the exact mechanisms remain unclear.' She added that 'it's still a mystery whether psoriasis alone drives the development of dementia or if the increased likelihood is due to shared comorbidities or overlapping inflammatory pathways. Furthermore, we don't yet fully understand whether treatments provide direct cognitive protection or how long treatment needs to continue for maximal benefit.' Biologics and Non-Biologics Both Linked to Benefit The researchers launched the new study 'to address the limited and inconsistent data on whether psoriasis associates with dementia outcomes and systemic treatments for psoriasis could influence the likelihood of developing dementia,' Olexson said. The study retrospectively tracked patients via the TriNetX research network database. Before propensity score matching, the mean age was 66.6 ± 8.9 years for non-treated patients and 67.8 ± 9.0 years for the general population. Respectively, the groups were 42.8% and 51.7% women and 65.9% and 72.6% White. Data for the treated psoriasis group were not provided, but Olexson said their characteristics were similar. The study included both biologic medications, which target specific immune pathways, and non-biologic systemic treatments. Patients were treated for a median of 4 years (for both). The biologics were adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, ustekinumab, guselkumab, tildrakizumab, risankizumab, secukinumab, ixekizumab, and brodalumab. The non-biologic treatments were methotrexate, apremilast, acitretin, and ultraviolet phototherapy. Both drug classes were linked to lower risks for dementia at roughly the same rates, but it was not clear if specific medications may have greater effects. Less Inflammation May Protect Against Dementia The adjusted incidence rates of Alzheimer's disease were 1.9% vs 1.2% in the non-psoriasis group vs the treated psoriasis group. For vascular dementia, the rates were 1.2% vs 0.74%, respectively. For nonvascular dementia, they were 5.4% vs 3.7%, respectively. For untreated patients with psoriasis vs treated patients with psoriasis, the adjusted incident rates were 1.7% and 0.84% for Alzheimer's disease, 1.1% and 0.72% for vascular dementia, and 5.1% and 3.1% for nonvascular dementia, respectively, which Olexson reported were statistically significant differences. 'Systemic therapies likely reduce neuroinflammation by suppressing inflammatory cytokines like TNF alpha and IL-17, both of which have been implicated in neurodegenerative processes,' Olexson said. 'These cytokines can disrupt the blood-brain barrier, promote amyloid beta accumulation, and impair neuronal function. By modulating this inflammatory cascade, systemic treatments may protect against or slow the onset of dementia.' Findings Are 'Intriguing' but Not Definitive Asked to comment on the results, Steven R. Feldman, MD, PhD, professor of dermatology, Wake Forest University, Winston-Salem, North Carolina, who was not involved in the study, noted that while the findings are 'intriguing,' they come with caveats because of the observational study design. 'If patients with dementia aren't bothered by their psoriasis or aren't given biologics for that or some other reason, getting a biologic might be associated with less dementia,' he said in an interview. 'It may be that having or not having dementia determines to some degree who gets a biologic, not that taking a biologic determines who gets dementia.' Olexson agreed that the observational design has limitations. While cohorts were matched by demographics, body mass index, and several comorbidities, she said other factors such as disease severity, socioeconomic status, and access to care could play a role in the findings. What's next? Moving forward, Olexson said, 'We have plans to conduct prospective studies related to psoriasis and cognitive health at our institution.'
Associated Press
2 days ago
- Business
- Associated Press
NPF Expands Seal of Recognition to FDA-approved Treatments and Awards its First to Arcutis' ZORYVE® (roflumilast)
ALEXANDRIA, VA, UNITED STATES, June 2, 2025 / / -- ● The NPF Seal of Recognition highlights products that prove a commitment to being safe and non-irritating for people with psoriasis or psoriatic arthritis. ● NPF has expanded its Seal of Recognition to include FDA approved prescription drugs to better represent the full toolbox of options available for people with psoriatic disease ● Recognition underscores ZORYVE's non-irritating use, even on hard-to-treat areas ● ZORYVE is the first and only FDA-approved branded topical in foam and cream options for plaque psoriasis treatment ● Psoriasis impacts more than 8 million people in the United States National Psoriasis Foundation (NPF), the leading advocacy, education, and research groups supporting people with psoriatic disease, and Arcutis Biotherapeutics, Inc. (Nasdaq: ARQT), a commercial-stage biopharmaceutical company focused on developing meaningful innovations in immuno-dermatology, today announced the awarding of the NPF's Seal of Recognition to Arcutis' ZORYVE® (roflumilast) cream 0.3% and ZORYVE® (roflumilast) topical foam 0.3%, both FDA approved for the treatment of plaque psoriasis. ZORYVE is the first FDA-approved product to receive the Seal of Recognition, which highlights products that have been created to be non-irritating and safe for people with psoriasis. 'The NPF Seal of Recognition is awarded to products that meet our rigorous standards for people living with psoriasis or psoriatic arthritis,' said Leah M. Howard, J.D., president and CEO of the NPF. 'We are pleased to expand our directory beyond over-the-counter items to recognize FDA-approved treatments like this one. It is great for our community to have multiple formulations that are suitable for sensitive and hard-to-treat areas. This reflects real progress in addressing the daily needs of people with psoriasis.' NPF's Seal of Recognition helps people with psoriasis and psoriatic arthritis find products that are safe and non-irritating for skin and joints. The program was launched in February 2012 and has grown over time, with NPF now adding new products regularly. The decision to expand the directory to include FDA approved products helps health care providers and people with the disease to see the full array of options for addressing psoriatic disease and its impactful symptoms. 'It is a tremendous honor that ZORYVE is the first FDA-approved product to receive the NPF Seal of Recognition. This is a testament to the dedication of our research, development, and technical operations teams to develop advanced targeted topical therapies,' said Frank Watanabe, president and CEO of Arcutis. 'Individuals living with psoriasis want steroid-free treatments that are safe and effective for long-term use, as well as convenient and versatile. With cream and foam formulations, ZORYVE offers individuals with psoriasis and their physicians a choice of their preferred formulation of ZORYVE, each providing powerful, long-term relief of plaques and itch anywhere on the body—including thin-skinned and hair-bearing areas—with no limitation on duration of use. This recognition reinforces our commitment to developing innovative therapies that meet the real-world needs of people with chronic inflammatory skin diseases.' For more information about the NPF Seal of Recognition, please visit For more information on ZORYVE, including prescribing information, please visit About Plaque Psoriasis Plaque psoriasis is the most common form of psoriasis, a chronic, systemic disease associated with inflammation throughout the body. Psoriasis affects more than 8 million people in the U.S. Symptoms include itch, scaling, redness, and flaking. On darker skin tones, plaques may appear more grayish, purplish, or brown. Psoriasis can appear anywhere on the body, including the knees, elbows, torso and thin-skinned areas like the face, genitals and intertriginous areas, which are areas where skin touches skin, such as the armpits, under the breasts, stomach folds, between the buttocks, and in the groin area. In addition, scalp psoriasis sometimes extends to the forehead, back of the neck, or behind or inside the ears. Scalp psoriasis can also be associated with hair loss, likely due to damage to the hair from excessive scratching, rubbing, or combing of the affected area. About ZORYVE (roflumilast) ZORYVE is the first and only branded topical therapy for three major inflammatory dermatoses - including atopic dermatitis, seborrheic dermatitis, and plaque psoriasis. ZORYVE is a next generation topical PDE4 inhibitor. PDE4 – an established target in dermatology – is an intracellular enzyme that increases the production of pro-inflammatory mediators and decreases production of anti-inflammatory mediators. Roflumilast cream 0.3% (ZORYVE®) is approved by the FDA for the topical treatment of plaque psoriasis, including intertriginous areas, in patients 6 years of age and older. Roflumilast cream 0.15% (ZORYVE®) is approved by the FDA for the topical treatment of mild to moderate atopic dermatitis in patients 6 years of age and older. In 2024, ZORYVE cream 0.15% was awarded Glamour's Beauty and Wellness Award for 'Eczema Product.' ZORYVE (roflumilast) topical foam, 0.3%, is uniquely formulated for use anywhere on the body, including hair-bearing areas, and is indicated for treatment of plaque psoriasis of the scalp and body in patients 12 years of age and older, as well as seborrheic dermatitis in patients 9 years of age and older. INDICATIONS ZORYVE topical foam, 0.3%, is indicated for the treatment of plaque psoriasis of the scalp and body in adult and pediatric patients 12 years of age and older. ZORYVE topical foam, 0.3%, is indicated for the treatment of seborrheic dermatitis in adult and pediatric patients 9 years of age and older. ZORYVE cream, 0.3%, is indicated for topical treatment of plaque psoriasis, including intertriginous areas, in adult and pediatric patients 6 years of age and older. ZORYVE cream, 0.15%, is indicated for topical treatment of mild to moderate atopic dermatitis in adult and pediatric patients 6 years of age and older. IMPORTANT SAFETY INFORMATION ZORYVE is contraindicated in patients with moderate to severe liver impairment (Child-Pugh B or C). Flammability: The propellants in ZORYVE foam are flammable. Avoid fire, flame, and smoking during and immediately following application. The most common adverse reactions (≥1%) for ZORYVE foam 0.3% for plaque psoriasis include headache (3.1%), diarrhea (2.5%), nausea (1.7%), and nasopharyngitis (1.3%). The most common adverse reactions (≥1%) for ZORYVE foam 0.3% for seborrheic dermatitis include nasopharyngitis (1.5%), nausea (1.3%), and headache (1.1%). The most common adverse reactions (≥1%) for ZORYVE cream 0.3% for plaque psoriasis include diarrhea (3.1%), headache (2.4%), insomnia (1.4%), nausea (1.2%), application site pain (1.0%), upper respiratory tract infection (1.0%), and urinary tract infection (1.0%). The most common adverse reactions (≥1%) for ZORYVE cream 0.15% for atopic dermatitis include headache (2.9%), nausea (1.9%), application site pain (1.5%), diarrhea (1.5%), and vomiting (1.5%). Please see full Prescribing Information for ZORYVE cream and full Prescribing Information for ZORYVE foam. About the National Psoriasis Foundation The National Psoriasis Foundation is the leading nonprofit representing individuals with psoriasis and psoriatic arthritis. The mission of NPF is to drive efforts to cure psoriatic disease and improve the lives of more than 8 million individuals in the United States affected by this chronic immune-mediated disease. Learn more at About Arcutis Arcutis Biotherapeutics, Inc. (Nasdaq: ARQT) is a commercial-stage medical dermatology company that champions meaningful innovation to address the urgent needs of individuals living with immune-mediated dermatological diseases and conditions. With a commitment to solving the most persistent patient challenges in dermatology, Arcutis has a growing portfolio of advanced targeted topicals approved to treat three major inflammatory skin diseases. Arcutis' unique dermatology development platform coupled with our dermatology expertise allows us to invent differentiated therapies against biologically validated targets, and has produced a robust pipeline with multiple follow-on clinical programs for a range of inflammatory dermatological conditions including atopic dermatitis and alopecia areata. For more information, visit or follow Arcutis on LinkedIn, Facebook, Instagram, and X. Forward-Looking Statements This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. For example, statements contained in this press release regarding matters that are not historical facts are forward-looking statements. These statements are based on the Company's current beliefs and expectations. Such forward-looking statements include, but are not limited to, statements regarding the potential real-world use results of ZORYVE cream and ZORYVE foam in plaque psoriasis patients and the potential for ZORYVE to advance the standard of care in plaque psoriasis, atopic dermatitis and seborrheic dermatitis. These statements are subject to substantial known and unknown risks, uncertainties and other factors that may cause our actual results, levels of activity, performance, or achievements to be materially different from the information expressed or implied by these forward-looking statements. Risks and uncertainties that may cause our actual results to differ include risks inherent in our business, reimbursement and access to our products, the impact of competition and other important factors discussed in the 'Risk Factors' section of our Form 10-K filed with the U.S. Securities and Exchange Commission (SEC) on February 25, 2025, as well as any subsequent filings with the SEC. Any forward-looking statements that the company makes in this press release are made pursuant to the Private Securities Litigation Reform Act of 1995, as amended, and speak only as of the date of this press release. Except as required by law, we undertake no obligation to revise or update information herein to reflect events or circumstances in the future, even if new information becomes available. Contacts: NPF Media Matt Werbach, NPF Director of Communications [email protected] Interested in Seal of Recognition? Nicole Kittelson, NPF Vice President of Corporate Relations Arcutis Media Amanda Sheldon, Arcutis Head of Corporate Communications [email protected] Investors Latha Vairavan, Arcutis Chief Financial Officer [email protected] Matthew Werbach National Psoriasis Foundation [email protected] Visit us on social media: LinkedIn Instagram Facebook X Legal Disclaimer: EIN Presswire provides this news content 'as is' without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above.
Medscape
5 days ago
- General
- Medscape
Skill Checkup: A Man With Plaque Psoriasis and Joint Pain
A 46-year-old White man with a 10-year history of moderate to severe plaque psoriasis presents with worsening joint symptoms. He has been treated with topical steroids for the past 2 years but reports that his psoriasis flare-ups have become more frequent and more severe over the past 6 months. Over the past 3 months, he has developed progressive joint pain, swelling, and stiffness primarily affecting the distal interphalangeal (DIP) joints of his hands. He notes that the stiffness is worst in the morning, lasting more than an hour, but improves with activity. He denies having recent trauma, fever, or infectious symptoms. On physical exam, there is visible swelling of several fingers and toes (described as "sausage digits," consistent with dactylitis) and nail pitting. No tenderness or decreased range of motion is noted in the axial skeleton. Laboratory results show an elevated C-reactive protein level and erythrocyte sedimentation rate, but rheumatoid factor (RF) and antinuclear antibody are negative. This patient's psoriasis history, DIP joint involvement, dactylitis, and nail pitting are characteristic of psoriatic arthritis (PsA). The presence of active psoriasis and nail changes strongly points to PsA as the most likely cause of this patient's joint disease as well. In contrast, rheumatoid arthritis (RA) typically causes a symmetric polyarthritis of the hands that favors the proximal joints (metacarpophalangeal and proximal interphalangeal joints), while DIP joints are usually not involved. Positive RF or anti–citrullinated peptide (anti-CCP) antibodies are seen in most cases; the patient's asymmetric DIP joint arthritis and negative RF make RA unlikely. Osteoarthritis (OA) can affect DIP joints, but it is a noninflammatory degenerative arthritis that usually presents at an older age with brief morning stiffness and pain that worsens with activity, often with bony enlargements (Heberden's nodes) rather than diffuse swelling; unlike PsA, OA does not often cause intense inflammation, dactylitis, or nail pitting. OA DIP joint changes are usually due to osteophytes ("bone spurs") without the psoriatic nail lesions. Reactive arthritis (ReA) is a seronegative spondyloarthritis like PsA and can cause asymmetric oligoarthritis with enthesitis/dactylitis; however, ReA is usually triggered by a recent infection and often involves the lower extremities (knees, ankles, and toes) with extra-articular features like urethritis or conjunctivitis, which are not seen here. PsA classically produces erosive changes with new bone formation on radiographs. In advanced disease, DIP joints can erode into a pencil-in-cup deformity, where the phalanx tapers and "cups" into an eroded adjacent bone. Though this can occur in other inflammatory diseases, it is most commonly associated with PsA. Such combined erosive and proliferative bone changes are highly suggestive of PsA and are not typically seen in RA (which shows only erosions with osteopenia) . Positive anti-CCP antibody more strongly supports RA rather than PsA, as PsA is usually seronegative for RA markers, such as the RF and anti-CCP antibodies. Uric acid crystals in joint fluid would more likely indicate gout, not PsA. While patients with PsA have been shown to experience a higher risk for gout, the presentation in this case (chronic DIP joint arthritis with nail changes) is not consistent with it. HLA-B27 antigen is associated with PsA in those who have axial (spinal) involvement, but it is less common patients with PsA and without spine disease. The patient has no axial symptoms, so HLA-B27 testing would be of limited value. Moreover, HLA-B27 is not required to diagnose PsA. The Classification of PsA (CASPAR) criteria is the internationally accepted standard for classifying PsA. It requires the presence of inflammatory arthritis (joints, spine, or entheses) plus a total of at least 3 points from features including: Current psoriasis (2 points) or personal/family history of psoriasis (1 point); psoriatic nail changes (pitting or onycholysis, 1 point); dactylitis (swelling of an entire digit, 1 point); negative RF (1 point); and juxta-articular new bone formation on radiography (1 point). PsA is diagnosed using the CASPAR criteria in patients with inflammatory arthritis who score at least 3 points, with the criteria demonstrating high specificity and sensitivity and serving as the preferred diagnostic tool once other differentials are excluded. This patient meets the CASPAR criteria as he has inflammatory arthritis with psoriasis, nail pitting, and dactylitis and is RF-negative. The American College of Rheumatology and European League Against Rheumatism (ACR/EULAR) criteria are typically used for RA, not PsA, and emphasize symmetric joint involvement and RA-specific antibodies (RF/anti-CCP) and do not apply here. The modified New York criteria are used to classify ankylosing spondylitis, focusing on axial skeletal findings (eg, sacroiliitis on radiography and low back pain), which are not the primary issue in this patient. The Jones Criteria are designed for acute rheumatic fever diagnosis and are unrelated to PsA. The patient is diagnosed with moderate to severe PsA, and given his dactylitis, arthritis, and skin involvement, he is given methotrexate as initial therapy owing to cost-effectiveness; however, he returns to his next appointment, and his PsA remains active. In a patient with moderate to severe PsA that is inadequately controlled on a conventional synthetic DMARD (methotrexate), experts recommend escalating to a biologic DMARD. Tumor necrosis factor (TNF) inhibitors (such as adalimumab, etanercept, or infliximab) are a proven biologic choice for PsA, effective for both joint and skin symptoms. The latest Group for Research and Assessment of Psoriasis and PsA (GRAPPA), ACR, and EULAR guidelines endorse using a TNF inhibitor (or another biologic/targeted therapy) once conventional DMARD therapy fails to achieve remission. In this case, adding a TNF inhibitor is appropriate to control joint inflammation and prevent further damage while also improving psoriasis. Switching to another conventional DMARD (like sulfasalazine or leflunomide) is generally less effective in patients with moderate to severe disease; this method is typically more effective in mild to moderate cases. Oral corticosteroid are generally not recommended for routine PsA management, as they might worsen disease. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help symptomatically, but they are most appropriate in mild PsA, not moderate to severe disease. This patient has active polyarthritis and progressive symptoms, requiring disease-modifying therapy, and using NSAIDs without advancing systemic treatment would allow ongoing joint damage. An oral phosphodiesterase 4 (PDE-4) inhibitor can be used as an alternative for patients who prefer an oral medication and want to avoid injections. Further, current GRAPPA guidelines and ACR guidelines include PDE-4 inhibitors among the recommended treatment options for active PsA. The potency of PDE-4 inhibitors (such as apremilast) are likely not as strong as Janus kinase inhibitors in moderate to severe cases of PsA. However, the latter needs to be weighed carefully against PDE-4 inhibitors due to higher risks for infection among other long-term side effects. In moderate to severe cases of PsA, 5-aminosalicylic acid derivatives, such as sulfasalazine, are typically not very effective; they are reserved for add-on therapy in case of mild disease activity. Calcineurin inhibitor can help severe psoriatic skin lesions, but they are not a preferred therapy for PsA joint manifestations. Antimalarial drugs can be considered when previous DMARDs use is ineffective or if joint inflammation remains a significant concern, but they are not typically recommended in PsA as they might lead to psoriasis flare-ups. Editor's Note: Skill Checkups are wholly fictional or fictionalized clinical scenarios intended to provide evidence-based educational takeaways.
Medical News Today
5 days ago
- Health
- Medical News Today
Psoriasis healing stages: Explanation and duration
Flare-ups Improvement Remission Symptom duration Treament Summary Psoriasis symptoms generally develop in three stages: flare-ups, improvement, and remission. The condition causes lifelong skin symptoms, but a person can stay in remission for many months if they follow their proposed treatment schedule. Psoriasis is an immune system disorder that causes skin cells to multiply too quickly. It can lead to inflamed, cracked skin and white scales, often on the elbows, knees, scalp, and other areas of the body, but symptoms vary from person to person. For many people with psoriasis, symptoms get worse during periods called flares and improve during remission. Flares often occur in response to triggers, including stress, illness, dry air, skin injuries, or certain medications and foods. This article explains the healing stages of psoriasis, how long they last, and what psoriasis treatment involves. CatherineDuring flare-ups, symptoms develop or get worse. These often last for weeks or months before improving. These occur because the process that causes skin cells to grow in deeper layers of skin and move to the surface speeds up. This usually takes about a month, but it may occur in days for people with psoriasis. stress illness, which may cause flares 2-6 weeks after an infection skin injury, which may lead to symptoms around 10-14 days later at the injury site weather changes, such as dry air or low sunlight rarely, allergies, specific foods, alcohol, or factors in the environment may contribute to psoriasis flares Avoiding these triggers may help people prevent flares, but this is not always possible. When a person starts psoriasis treatment, they should see symptoms improving. If plaques have a smaller surface area, fewer plaques are visible, or they are becoming less severe, medical professionals would likely deem these to be signs of improving psoriasis. A doctor may use a Psoriasis Area and Severity Index (PASI) to track how symptoms respond to treatments or move through the healing stages. This index rates the redness, thickness, and scaling of psoriasis plaques on a scale from 0 to 4, with 0 being complete remission and 4 being very severe. The score also uses an estimated percentage of the head and neck, upper limbs, trunk, and lower limbs that the plaque or plaques take up. The time this takes depends on the treatment applied. For example, topical treatments such as creams and ointments are usually the first a doctor recommends. It can take up to six weeks before an individual notices improving symptoms. Others, such as calcineurin inhibitors, have more potent side effects, including burning and irritation. However, they may start to improve symptoms within a week. Treatment is essential for extending remission periods in people with psoriasis. For example, a 2021 study surveyed 930 people with psoriasis that covered less than 3% of their body. Of these, 51.7% claimed to have psoriasis that was in remission. Remission periods lasted 31 months on average, and 79.1% of those in remission reported receiving ongoing treatment. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, psoriasis symptoms can flare for weeks or months . As the duration of symptoms may be hard to predict, a person should speak to their dermatologist about the expected course of healing and how to support their healing time while symptoms move through the improvement stage. Psoriasis can last for a long time, and some types may even be lifelong. However, treatments may help to reduce the severity, duration, and frequency of flare-ups and speed up recovery. Topical treatments: These involve using lotions, ointments, creams, solutions, and foams, often corticosteroids, to treat mild or moderate psoriasis. Nonsteroidal treatments include retinoids, medicines containing vitamin D, tar products such as coal tar or anthralin, and drugs that activate the aryl hydrocarbon receptor. These involve using lotions, ointments, creams, solutions, and foams, often corticosteroids, to treat mild or moderate psoriasis. Nonsteroidal treatments include retinoids, medicines containing vitamin D, tar products such as coal tar or anthralin, and drugs that activate the aryl hydrocarbon receptor. Methotrexate: This is an antimetabolite drug that may slow down skin cell division. People take it as an injection or by mouth. This is an antimetabolite drug that may slow down skin cell division. People take it as an injection or by mouth. Oral retinoids: This is a form of vitamin A that, along with phototherapy, may support people with severe psoriasis. This is a form of vitamin A that, along with phototherapy, may support people with severe psoriasis. Biologics: These injected drugs block certain molecules in the immune system, helping to slow disease progression and inflammation. These injected drugs block certain molecules in the immune system, helping to slow disease progression and inflammation. Immunosuppressants: For people with severe psoriasis, these can help to suppress immune activity. For people with severe psoriasis, these can help to suppress immune activity. Oral phosphodiesterase 4 (PDE4) inhibitors : These slow the production of new skin cells by targeting enzymes inside immune cells. : These slow the production of new skin cells by targeting enzymes inside immune cells. Oral tyrosine kinase 2 (TYK2) inhibitors : People with psoriasis take TYK2 inhibitors to prevent certain immune cells from activating. : People with psoriasis take TYK2 inhibitors to prevent certain immune cells from activating. Phototherapy: This involves shining specific wavelengths of ultraviolet (UV) light on the skin in a clinician's office. Doctors may prescribe this for people whose plaques cover a large surface area. Some people will need to administer phototherapy at home using a special light unit. Psoriasis symptoms flare up and heal in three stages. They can last from weeks to months before starting to improve, usually with the help of treatments such as creams or systemic medications. The recovery time can vary based on the type, severity, and treatment received. Treatment aims to achieve complete remission, or a complete absence of symptoms and clear skin. This often lasts up to 12 months, but psoriasis may flare up again in response to a trigger.
Medscape
6 days ago
- Health
- Medscape
Bariatric Surgery Linked With Psoriasis Improvement
Most patients with psoriasis experienced clinical improvement or remission after metabolic and bariatric surgery (MBS) in a systematic review. METHODOLOGY: Researchers conducted a systematic review of 14 studies that included 169 patients (mean age, 46.8 years; 74% women) with psoriasis who underwent MBS. Participants underwent various surgical procedures; gastric bypass was the most common (75.1%), followed by sleeve gastrectomy (17.8%), gastric banding (5.3%), and jejunoileal bypass (0.6%). Psoriasis treatments prior to surgery included topical treatments (46.2%), non-biologic systemic treatments (35.5%), and biologics (16.6%). At baseline, psoriasis severity was predominantly moderate (76.3%); 8.2% were severe and 15.6% were mild cases, based on psoriasis area and severity index and percent body surface area scores. TAKEAWAY: Average body mass index (BMI) decreased from 43.7 at baseline to 32.9after surgery, with BMI reduction ranging from 8 to 25 during follow-up periods of 4 months to 9 years. Psoriasis was either mild or had completely resolved in 97.2% of patients after bariatric surgery, whereas 2.4% experienced worsening of psoriasis. A total of 78.1% of patients continued psoriasis treatment post-surgery, but medications were downgraded to a lower category (such as systemic to topical treatments, or no treatment) in many patients. IN PRACTICE: 'MBS may improve psoriasis outcomes following surgery,' the study authors wrote. 'While initial findings are promising, further controlled trials are necessary to validate the long-term effects of MBS on psoriasis and explore its potential role as an adjunctive therapy.' SOURCE: The study was led by Miranda K. Branyiczky, BSc, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada, and was published online on May 24 in the Journal of the American Academy of Dermatology . LIMITATIONS: Limitations were reporting bias, variability in outcome measures, and the inclusion of case reports or series. DISCLOSURES: This study did not receive any funding. One author reported receiving grants, research support, speaker fees, and honoraria from multiple pharmaceutical companies including AbbVie, Alumis, Amgen, Arcutis Biotherapeutics, Bristol Myers Squibb, Eli Lilly and Company, Janssen Pharmaceuticals, Novartis, and Pfizer.
