Psoriasis

[yatakitumbi]

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visit www.cebup.blogspot.com and get to meet those who have psoriasis in Cebu...They have just celebrated world psoriasis day at Rajah Hotel...

[naomi6000]

Dr. Marilou Ong

[leo_trams]

Aside from Daivonex naa pud Daivobet...murag same pharmaceutical company ang naghimo.

mas smaller lang ang Daivobet at 15g ang Daivonex kay 30g man.

I am using Daivobet now...wala lang, sulayan lang nako ug unsa iya effect.

After two weeks of daily treatment, kadtong mga stubborn lessions nga gahi pakalmahon sa Daivonex...nikalma na! Maybe because naa added nga active ingredient ang Daivobet. Anyway, lets wait and see kung asa ni siya kutob....

Daivobet is available at approx. half-price sa Daivonex, well, half-size man pud siya sa Daivonex. hehehe

[rockart9]

@yatakitumbi

i think i'll take a look at this club... gotta love the name "cebu Flakers"

[yatakitumbi]

yeah...to all who has psoriasis please visit the blog...

[bakerboy]

naa sad ko psoriasis. mas grabe when i was younger. karon isolated nalang to the fingers. mu grabe kung stressed out.

i use dermovate. ma control man dayon ang outbreaks.

[spriggan]

so kung mas stressed ka mas mu grabe ang psoriasis?

[leo_trams]

Got this from the internet...

Page 1 of 10

The Surprising Psoriasis Treatment!

"Medical data is for informational purposes only. You should always consult your family physician or one of our referral physicians prior to treatment - The Arthritis Trust of America
Article provided by:

The Arthritis Trust of America

Sources are given in references.
Authors of contributions\quotations are alphabetically arranged; major author, if any, is underlined.
Robert F. Cathcart, M.D., Perry A. Chapdelaine, Jr., M.D., Helmut Christ, M.D., Goeckerman, Wayne Martin, B.S., Gus J. Prosch, Jr., M.D./Responsible editor/writer Anthony di Fabio.
Copyright 1990
All rights reserved by The Roger Wyburn-Mason and Jack M. Blount Foundation for the Eradication of Rheumatoid Disease
AKA The Arthritis Trust of America,
7111 Sweetgum Road, Suite A, Fairview, TN 37062-9384

I will make no apology for the technical material that is to be read in this chapter. Those with Psoriasis will be happy to use a dictionary to better understand their terrible affliction, and in any case, it is sure that this chapter will be brought to a physician for interpretation and use. That physician will want more than lay language.

The treatment protocol for Psoriasis is simple, and can be read without difficulty.

Brief Background
In July of 1986 The Rheumatoid Disease Foundation brought to its Second National Medical Seminar, Dr. Helmut Christ, M.D. of Bisingen, West Germany, as a speaker.
One of Dr. Christ's subjects was "Psoriasis Under Control at Last".
Gus J. Prosch, M.D., referral physician (AL), was the first to try this new treatment on a patient with success. He obtained Psoriasis medicines from a pharmacy in Germany recommended by Dr. Helmut Christ.
Dr. Prosch's patient had tried everything possible, and he had reached a point of suicidal intent if this next treatment did not help, such was his despair.
Prosch proceeded with a successful trial.
On page 138 of The Art of Getting Well, Helmut Christ, M.D. reported 100% successes11.
Helmut, a physician who wished to be a general practitioner, and did not choose to be a specialist on Psoriasis, as of this writing has 900 patients for Psoriasis, mostly by referral from successful patients and physicians. He did not invent the treatment, but rather received it from another physician who had had Psoriasis himself, and eventually developed the successful treatment protocol which is now being tested through studies by various universities and clinics.
It should be clear from the start that "Fumaric Acid" per se, is useless, but that "Fumaric Acid Monoethylester" and "Fumaric Acid di-Methylester" are the proper medicines.
There are those who sell "Fumaric Acid" alone for this treatment thereby misleading with a substance that will be of no effect whatsoever by itself.

What is Psoriasis?
There are many forms of psoriasis, a skin disease characterized by the formation of scaly red patches on the extensor (following the muscles that perform extension) surfaces of the body.
Annularis Psoriasis in ring-shaped patches
Arthropathica A form associated with chronic arthritis
Buccalis Marked by white, thickened patches in mucuous membrane of cheeks, gums, tongue
Circinata (See Annularis above)

[leo_trams]

Page 2 of 10

The Surprising Psoriasis Treatment!

Diffusa Coalescence of large contiguous lesions (Bakers, grocers', bricklayers itch, etc.)
Discoides Occurring in solid patches
Figurata Lesions in curved linear patterns
Follicularis Small, scaly lesions located at openings of sebaceous and sweat glands
Guttata Occurs in small, distinct, irregular patches
Gyrata Having serpentine arrangement
Inveterata With confluent lesions and thickening and hardening skin
Linguae (See Buccalis above)
Nummularis In circular patches that resembles coins
Osteacea In Old, thick, tough patches covered with scales resembling outside of oyster shells
Palmaris et plantaris Syphiloderm of palms or soles
Punctata Lesions consist of minute, red, pinhead-shaped papules, often surmounted with pearly scales
Pustular p. Lesions are covered with pustules
Rupioides Rupia-like crusts (skin eruptions usually from syphilis)
Universalis Lesions over whole body

As one can easily see, these complex Latin terms are simply means for classifying various views of a skin condition and are not at all meaningful for the purpose of treating and controlling the disease except in certain few cases, such as Rupioides, which seems to be related to a germ organism.
If you are one who suffers from Psoriasis, surely you know more about your symptoms than simply how to describe it. You know that it flares up worse then gets better from time to time, that it sometimes can create great embarrassment, pain, guilt - in short, it can indeed control your life.
According to Helmut Christ, M.D.: "It has now been established, that Psoriasis is not a SKIN DISORDER strictly speaking, but instead an inherited metabolic disturbance which is set on by environmental or stressful conditions, like faults in the diet, flu-like conditions, the administration of Penicillin, death of a family member, [medical] operations, etc."
We know that patients with Psoriasis have a higher incidence of Rheumatoid Diseases than others.

What is Psoriasis?
Simply, it is a hyperproliferation (overgrowth) of the epidermis (outer skin covering), and apparently cell division is not normal.
Traditional Treatments
Many treatments are directed at interference with DNA synthesis and interruption of cell division as it is presumed this function is in error in our bodies.
Some patients move to warmer climates to increase sun exposure and humidity, although overexposure to sunlight can also aggravate the condition.
The traditional treatments for psoriasis include topical tars and ultraviolet light, keratolytics, anthralin and glucocorticosteroids. Current systemic therapies using psoralen-photochemotherapy or methotrexate are still largely investigational and may produce adverse effects. Besides blocking the abnormal rapid proliferation of psoriasis, methotrexate affects other normally rapidly growing tissues such as bone marrow, gastrointestinal tissues and hair roots.
Fluorinated steroids may be useful on a short-term basis for treatment of resistant, highly inflamed, or irritated plaques, but are not advisable for treatment of widespread psoriasis. Hydrocortisone creams are commonly used with mixed results for intetriginous (chafed) areas or on the face since they do not atrophy the skin. However, systemic steroids are generally contraindicated, as cessation is usually accompanied by rebound worsening of the disease.
PUVA (Psoralen and long-wave ultraviolet light) have been useful therapies but are still investigational. Side effects include phototoxicity with erythema and blistering, pruritis and nausea. Potential chronic side effects such as actinic damage and aging of the skin, carcinogenesis and cataract formation are of great concern. Moreover, patient compliance is generally poor. An average of 25 treatments given 2 or 3 times weekly are required for 80% clearing of Psoriasis. Patients who work outdoors do not like to wear goggles. Psoralen and long-wave ultraviolet light (PUVA) is only a palliative treatment and requires

[leo_trams]

Page 3 of 10

The Surprising Psoriasis Treatment!

continued maintenance therapy. At Stanford University, experience with PUVA has shown that over 90% of patients develop recurrent psoriasis in the first year of therapy.
Crude coal tars, often combined with zinc and salicylic acid, has been a valuable adjunctive treatment for psoriasis. Coal tar products are able to suppress DNA synthesis in the epidermis within the first few hours after application. The Goeckerman regimen, combining coal tar with exposure to UV light, has induced remissions for several weeks and is a relatively safe method. Patient compliance is still a problem as these tars are messy and stain clothing. Some patients develop acanthomas (tumor or excessive development of skin). Coal tars also produce folliculitis (inflammation of hair folliculs). The absorbed mutagens may increase the risk of some forms of cancer. Crude coal tar is a mixture of 10,000 non-standarized components, which may create a potential problem of contact allergic sensitization.

The synthetic retinoids are a major advance in the treatment of both localized as well as generalized pusular Psoriasis. The dosage must be carefully monitored, as some patients experience a local recurrence of pustules with the lowered dosage. All of the important factors concerning toxicity and side effects of these drugs need to be considered carefully, especially the teratogenic effects. Some of the side effects are dose-dependent (e.g. dryness of the lips and oral mucosa) and are reversible after discontinuation of therapy. Other side effects include exfoliation (a falling off in scales or layers) of palms and soles, hair loss, conjunctivitis (inflammation of the layer that lines the eyelids), pruritis, paronchia, elevated serum lipids, muscle pain, neuralgia and hyperostosis (bone disorder). Considering the possible long-term effects of retinoid-induced lipid modulation on atherosclerosis and coronary artery disease, it is necessary to closely monitor the levels of serum lipids during therapy, particularly in patients with CHD risk factors. Some of the non-toxic therapies which may be used prophylactically in patients treated with retinoids include niacin (400 mg b.i.d) and L-Carnitine (250 mg b.i.d.).

Methotrexate is often used as a third-line therapy for patients with severe psoriasis (e.g. acute pustular Psoriasis, Psoriatic Arthritis, Psoriatic Erythroderma) unresponsive to other, less toxic therapies. Liver and renal functions must be carefully monitored prior to treatment. Severe liver disease, such as fibrosis and cirrhosis, may be present in patients with Psoriasis, especially in alcoholics. Unfortunately, no liver function tests are reliable indicators of severe liver toxicity. Other risk factors include obesity, diabetes and lowered renal function. One can minimize the risk by titrating the patient to the lowest possible dose to achieve and maintain adequate control, rather than 100% clearing of the Psoriasis. Like many other treatments for Psoriasis, methotrexate is a known teratogen.

Regardless of the treatment used, patient education remains a critical component in the successful management of Psoriasis. Therefore patient education manuals and even support groups will enhance the prognosis of the disease and may even strengthen the base of patient referrals to a dermatologist's practice. Patients should be advised on those factors which make Psoriasis worse. Trauma and irritation of the skin, induced by rubbing, scratching or scrubbing off scales all can produce Psoriasis. Some throat and upper respiratory infections may flare Psoriasis and should be promptly treated by a physician. Some dermatologists are so absorbed in their subspecialty that they overlook the common patient complaints, normally encountered by a general practitioner (e.g. strep infections). Guttate Psoriasis (lesions that are drop shaped) particularly occurs in children and adolescents after strep infections.
Patients should be encouraged to discuss other illnesses besides their chief complaint. Most patients do not understand the fact that sun exposure should be used in moderation. While sunlight in moderation usually helps Psoriasis, sunburn may cause Psoriasis to flare up. A similar situation exists with topical steroids. Patients should be advised not to use these creams on areas in which the Psoriasis is cleared and to follow their dermatologist's directions carefully to preclude a rebound phenomenon. Stress and anxiety should be minimized. Dietary recommendations are outlined in conjunction with our recommended treatment which is also the new European fumaric acid protocol.

Recent evidence points to abonormalities in the arachidonic acid metabolism in patients with Psoriasis. The cyclic AMP/cyclic GMP ratio is decreased in involved epidermis of Psoriasis compared with uninvolved epidermis from Psoriasis patients or epidermis from normal volunteers. The imbalance of the two cyclic nucleotides plays a central role in the pathogenesis of Psoriasis. Usually, tissue levels of free fatty acids are quite low. However, involved epidermis of Psoriasis contains high concentrations of free arachidonic acid. Elevated levels of the prostaglandin series leads to increased