This is a video from the National Psoriasis Foundation, it is
the first part of a collection of three videos about psoriasis.
I recommend to watch all the videos here:
Jun 14, 2010
HISTORY
A Historical Look at Psoriasis
From the Perspective of Dr. Von Hebra - the First "Official" Dermatologist
Updated: February 02, 2008
Some 20 years ago, I picked up a little treasure at our medical school library's book sale: Von Hebra on: Diseases of the Skin(1867). While it is of little other than historical value at present, I thought it might be entertaining to take a look at the chapter on psoriasis.
Von Hebra was the head of what is ostensibly considered the first "official" department of dermatology at the University of Vienna
By researching literature of the ancient Greeks, Egyptians and medieval scholars, he separated out the many diseases confused and lumped together with psoriasis into their proper categories. The disease he describes and categorized as psoriasis is in fact the disease we consider as psoriasis today.
Many people wonder why psoriasis has such a strange sounding name, but it's certainly much less of a tongue twister than Dartre squameuse centrifuge of Alibert another name for this disease laid to rest by the esteemed professor (thank you Dr. Von Hebra).
Among the causes of psoriasis Von Hebra lists climatic conditions, habits (including brandy) and nervous temperaments. Not too far off the mark from what we understand today (genetics was not yet considered). He claims to have treated more than 1,000 patients with psoriasis and found that, in general, they were overall healthy and free from other significant illness, and that no particular occupation predisposed people to the condition. These findings were somewhat divergent from his contemporaries of the day.
Treatment-wise, Von Hebra was not very happy with the various medications of the day which he claimed tended to cause "violent reactions." Instead he preferred to use arsenicals (medications derived from arsenic). Although these medicines did work and were employed for a variety of ailments, they are obviously much too toxic to be considered as a medical treatment for any disease today. Tar preparations were also a part of his treatment armamentarium. It makes you wonder: What will doctors 100 years from now say about our current treatments?
That concludes this brief look at psoriasis from a historical perspective. From a practical point of view, the most important thing to glean from Von Hebra might be to look at treatments with a somewhat cynical view -- to not just accept historical or anecdotal evidence as a means of establishing whether or not a treatment is useful, but to use scientific observation and testing instead.
SUMARY- ABSTRACT
PSORIASIS A CHRONIC, NON-CONTAGIOUS AUTOIMMUNE DISEASE:
A CONVENTIONAL TREATMENT
Shivanand Pandey*
Email: dot.shivanand@gmail.com
Psoriasis is a chronic, non-contagious autoimmune disease that affects the skin and joints. It commonly causes red, scaly patches to appear on the skin. The disadvantages of topical agents are variably that they can often irritate normal skin, can be time consuming and awkward to apply, cannot be used for long periods, can stain clothing or have a strong odor. As a result, it is sometimes difficult for people to maintain the regular application of these medications. Abrupt withdrawal of some topical agents, particularly corticosteroids, can cause an aggressive recurrence of the condition. This is known as a rebound of the condition. While alternative like spa, balneo, ischyotherapy takes long time consuming, TNF- α blockers have the potential to provide symptomatic relief and help prevent disease progression in PsA. Although these drugs are relatively expensive, concerns over an increased drug budget must be balanced against the potential long-term cost savings. At the present time there are no health economic studies concerning the role of TNF- α blockade in PsA. However, possible long- term benefits include: reduced need for joint replacement surgery, reduced demand on therapy services, reduced demands on medical and nursing services, reduced needs for other medicines, reduced demands on social services and carers, improved quality of life, improved prospect of remaining in work, increased life expectancy.
Keywords: Psoriasis, autoimmune disease, corticosteroids, TNF- α blockers.
Volume 1, Issue 2, March – April 2010; Article 012 ISSN 0976 – 044X
International Journal of Pharmaceutical Sciences Review and Research Page 61
Available online at www.globalresearchonline.net
PREVENTION
Can Psoriasis be Prevented?
Updated October 22, 2007
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
The short answer is yes and no. Like many diseases, psoriasis is influenced by both genetics and the environment.The exact role these factors play is still a developing story, however we already have quite a bit of insight into how each can affect the course of psoriasis. Our genes are inherited from our parents, and certain genes may predispose us to develop psoriasis at some point in our lives.
For example, if a parent has psoriasis and one child develops the condition before age 15, siblings have a 50% chance of developing psoriasis, too. Identical twins have a 67% risk of sharing the disease. Certain HLA types can increase the risk of developing psoriasis by up to 6 times. Race can also be a predisposing genetic factor; those with fair-skin have a higher likelihood of developing the disease than darker-skinned individuals.While you cannot change your genes, you can alter your environment and make choices that influence your risk of a psoriasis breakout.
Related Conditions
Managing related conditions may help you also fend off psoriasis. Stress, anxiety, depression and related emotional disorders can trigger psoriasis. In addition, psoriasis has been known to appear after an upper-respiratory tract infection, such strep throat or sinusitis. Psoriasis tends to be particularly severe in those with HIV/AIDS. Treating conditions such as these may also help keep psoriasis in check.
Medications
Certain medications can trigger or worsen psoriasis. These include:
beta blockers and ACE inhibitors, used to treat high blood pressure
the mood disorder drug lithium
antimalarials related to hydroxychloroquine (which, today, are more likely to be prescribed for arthritis or lupus)
If it's an option for you, switching drugs or reducing your dose may help reduce risk of a psoriasis breakout.
Lifestyle
Of particular importance are those risk factors for which you have the most control over: physical environment, obesity, diet, alcohol consumption, and cigarette smoking.
Cold, dry air tends to worsen psoriasis, while a warm and humid climate is typically helpful, especially when natural sunlight can reach the skin. Although many reports have positioned obesity as a risk factor for psoriasis, one study demonstrated that obesity appears to be a result of psoriasis. A fruit and vegetable-rich "healthy" diet may be somewhat protective. Alcohol consumption increases the risk of developing and the severity of psoriasis to a small degree. Cigarette smoking worsens psoriasis with a demonstrable dose-response relationship implying a causal effect. Nevertheless, it is not entirely clear if alcohol and smoking are increased due to the stress of psoriasis or being a significant cause of the disease.
What You Can Do
You can't choose your parents (or your genes), but you can take measures to minimize the risks of psoriasis if you are genetically predisposed it. Remember to:
Treat conditions associated the psoriasis breakouts early and thoroughly.
Avoid medications known to flare psoriasis whenever possible.
Maintain a normal body weight.
Eat a diet rich in fresh fruits and vegetables.
Eliminate or minimize smoking and alcohol.
Keep skin moist with a humidifier and moisturizer.
Plan moderate exposure to natural sunlight, without burning (take a walk outside on your lunch break, for example).
Sources:
Camisa C. Handbook of Psoriasis, 2nd Ed. Blackwell Publishing, USA 2004
Medical nutrition therapy as a potential complementary treatment for psoriasis--five case reports
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PSORIASIS REVIEW ARTICLE
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INTERVIEW
LeAnn Rimes Interview: Her Courageous Battle With Psoriasis 
July 10, 2009 11:45 pm by Catherine Morgan in Health
So...A few weeks ago I was asked if I would like to interview LeAnn Rimes about her struggles with psoriasis and her awareness campaign Stop Hiding & Start Living. I think it's a great campaign and I was happy to help bring more awareness to this physically and emotionally debilitating skin condition. **Psoriasis is a chronic autoimmune disease that is NOT contagious.
As women we so often feel bad about ourselves because of the way we look. We might be having a bad hair day, or have a bit of acne on our face, or feel like we could stand to lose a few more pounds...It's really a vicious cycle and sometimes even a pit of despair that we never seem to quite be able to climb out of. I think that's why stories like the one LeAnn Rimes will share with us in this interview are so empowering.
The American Academy of Dermatology and the National Psoriasis Foundation have joined together to form the Stop Hiding from Psoriasis public education campaign. This campaign is dedicated to:
- Educating the general public about how this chronic immune disorder affects nearly 7 million Americans.
Motivating patients suffering from psoriasis to Stop Hiding andStart Living.
Encouraging patients to see a dermatologist and discuss appropriate ways to managetheir disease.LeAnn Rimes stands up to psoriasis...The spotlight has followed singer LeAnn Rimes for most of her life. Unfortunately, so has the embarrassment of her psoriasis. But not anymore. LeAnn is taking a stand to Stop Hiding from her psoriasis and wants you to Stop Hiding and Start Living too.
Earlier this week I spoke with LeAnn...
How difficult was it growing up with psoriasis and at such a young age?
Well yes, I was diagnosed when I was two, so I pretty much don’t know anything other than having it...by the time I was six I was 80% covered, everything but my hands, feet and face. It was very debilitating physically and mentally. Even as a child having people really not understanding what the disease is and thinking it was contagious and trying to stay away from me. My parents really did a good job of covering it up, especially my mom, [with] the way she dressed me. And it was hard, it was hard being in the public eye. 'Til the time I was 13 I wasn't really able to wear dresses (short dresses) on the red carpet, or shorts in the middle of the summer…I would always wear jeans. It was really tough; it took a toll on my self esteem for a long time.
Did other children tease you when you were a child?
Yes, I would sometimes miss out on pool parties and things because I would never want to be around other girls with my bathing suite on – because they really didn’t understand what it was. Was this before there were effective treatments? There were effective treatments, but not as many as there are now. When I was six and I was really badly covered, I did a treatment where they literally take coal tar and wrap you in saran wrap for six hours, for two in a half weeks, five days a week. You sit there, and it’s just the most excruciating thing I think I’ve ever been through – but it works for like two and a half months, and then it comes right back. Are some of the treatments worth the trouble of side effects? If I wasn’t on the medicine that I am on now (which has kept me clear for the last five years), I would be completely covered. For me, the negative effects of the medications I can overlook - because it’s my life, it’s what I do...But it’s also my well being and my mental well being, and it definitely takes a toll. And we now know that psoriasis is linked to depression. So I think sometimes the benefits do outweigh the negative effects of the medicine. Then sometimes it doesn't...I mean, I've been on medication where I had to give blood every couple of weeks to check my liver functions and my kidney functions, and my blood pressure...but that was for a very short period of time because it took a toll on me and my body. Do your symptoms prevent you from enjoying summer activities? Like going to the beach and swimming in chlorinated swimming pools? I have to be really careful. The beach is great, salt water has always been great for my skin. I do get in the sun, my Dermatologist has always said 20 minutes of unprotected sun is really good for psoriasis; so I do that, and I'm really careful about my skin though, I do wear a lot of sunscreen. I am careful about going into chlorinated pools, and I don't stay in there very long when I do. The chlorine really dries my skin out, and I think from having psoriasis so young and feeling the tightness on my skin...I cant get out the pool or shower without immediately applying lotion, because I hate that feeling. When it comes to treatments, are some helpful for some people and not for others? Treatment varies. There are so many different treatments, and through the campaign we are trying to encourage people with psoriasis to partner with their dermatologist to figure out what treatment is right for them. What about people with psoriasis who are uninsured or under insured? You can find information on all of that on the website stophiding.org and I think the National Psoriasis Foundation actually has even more information on their website about that too. It's such a big issue right now, and it's a shame that people have a condition that is treatable but they can't afford the treatment. I know several people that have it and can’t get the medication they need. It is very frustrating. The medication I am on now was not approved for psoriasis when I was started on it, so until it was approved I paid $1400 for every shot (getting shots every two weeks). I had tried every treatment out there except for this one treatment, so it’s the only thing that worked.So, after the interview was over I realized there had been one important issue I wanted to ask LeAnn about, but I had totally forgot to ask her.
In researching for this interview I came across a study done by the Archives of Dermatology. Here is an excerpt from the article...
If you are one of the millions of Americans who currently suffer from psoriasis, you may have an increased risk of heart attack, stroke, or blockages in the legs, arms and groin, according to new research. Those who suffer with psoriasis, an irritating skin condition, which is also associated with atherosclerosis, a disease of the blood vessels signaled by plaque buildup, might also have an increased risk of dying. Psoriasis, a condition that causes raised, silvery plaque-looking skin, affects around 7 million Americans. Several previously released studies have indicated a link between psoriasis and several other systemic, inflammatory diseases. Now, a new study published in the June issue of the Archives of Dermatology, indicates a greater risk of strokes, heart conditions and blockages for psoriasis sufferers.
I was wondering if LeAnn had heard about this study, and what she thought about it? Thankfully, I was able to get her response via email.
It is important that people understand psoriasis is more than a skin disease – it’s a chronic immune disorder and people with the disease are at increased risk for developing other serious conditions, such as cardiovascular disease, diabetes, obesity, and depression.Well, it was great to have the opportunity to talk with LeAnn this week about her struggles and triumphs over psoriasis. I could tell she was genuine in her concern for others suffering with this condition. I think her story has the power to inspire other young women who might be suffering with psoriasis, and even women who are simply struggling with body image issues.
And as non-psoriasis sufferers, we need to work hard at educating ourselves and others while helping to lift the stigma associated with this condition - so we are not adding to the pain that people with psoriasis are already suffering.
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