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MedWorm: Psoriasis

How My Wake-Up Call Helped Me Discover My Inner GPS (Wed, 26 Nov 2014)
In Thrive, Arianna Huffington talks about her personal wake-up call: A collapse from exhaustion, a broken cheekbone and a gash over her eye. I had my own wake-up call in May 2013. At the time, it was one of the most frightening and painful experiences of my life; but now looking back, I consider it to be an amazing blessing that changed everything. Upon graduating from college, I started working at a job that was both enriching and challenging. I was determined to be the best, to climb the ladder, to succeed. About once a year, I would have psoriasis outbreaks, a devastating skin condition that would cover my body. It always struck me in the hot New York summers. Instead of spending my time outside with my friends, I would hide my scarred body inside my cool air-conditioned apartment, fi... MedWorm Sponsor Message: MedWorm Search is coming back soon. Watch this space...
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Psoriasis and the Life Cycle of Persistent Life Effects (Tue, 25 Nov 2014)
Psoriasis is associated with significant physical, social, and behavioral comorbidities that create a substantial burden. We outline herein that these comorbidities start early in life and persist for decades, ultimately impacting the entire life course of patients with psoriasis. By highlighting the ages that psoriasis patients are affected with physical, social, behavioral and emotional comorbidities, we demonstrate the age-appropriate considerations for psoriasis patients. (Source: Dermatologic Clinics)
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The Immunopathogenesis of Psoriasis (Tue, 25 Nov 2014)
Psoriasis vulgaris is a chronic inflammatory skin disease that results from the complex interplay between keratinocytes, dendritic cells, and T cells. Keratinocytes trigger innate and adaptive immune responses. Dermal myeloid dendritic cells regulate T cell activation and production of cytokines and chemokines that amplify inflammation. Most of the psoriatic T cells discretely produce interferon-γ, interleukin (IL)-17, and IL-22. The initiation phase of psoriasis involves Toll-like receptors, antimicrobial peptide LL37, and plasmacytoid dendritic cells. Keratinocytes are the main cutaneous cell type expressing IL-17 receptors and hence the immune circuit is amplified by keratinocytes upregulating mRNAs for a range of inflammatory products. (Source: Dermatologic Clinics)
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Genetics of Psoriasis (Tue, 25 Nov 2014)
This article focuses on the results of genetic association studies, which provide evidence that psoriasis susceptibility genes are involved in innate and adaptive immunity and skin barrier functions. The potential for disease stratification and the development of more effective treatments with fewer side effects using genetic data are highlighted. (Source: Dermatologic Clinics)
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Ten Years On (Tue, 25 Nov 2014)
This review delivers a commentary on the first decade of biologics’ use in psoriasis and provides a glimpse of the pipeline of therapies currently in development for psoriasis that will enhance the therapeutic armamentarium available to the dermatologist. In addition, the authors revisit the rationale for the development of biological therapies, inventory the available therapies of today, and retrospectively assess their impact on the dermatology practice as it relates to the management of patients with psoriasis. (Source: Dermatologic Clinics)
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Current and Future Oral Systemic Therapies for Psoriasis (Tue, 25 Nov 2014)
For patients with moderate to severe psoriasis, there is a large range of variably effective and safe oral, systemic medications. With appropriate monitoring, these therapies may be used as either monotherapy or in combination with other therapies. Newer drugs in the research pipeline hold significant promise. (Source: Dermatologic Clinics) MedWorm Sponsor Message: MedWorm Search is coming back soon. Watch this space...
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Phototherapy and Photochemotherapy for Psoriasis (Tue, 25 Nov 2014)
Phototherapy is a first-line option for the treatment of moderate to severe psoriasis. Systematic reviews indicate near comparable efficacy of the different forms of phototherapy. Localized phototherapy can be an adjunctive treatment of recalcitrant plaques during systemic treatment of psoriasis. More than 200 psoralen–UV-A therapy treatment sessions is associated with an increased risk of keratinocytic cancers, whereas no increased risk has been demonstrated for narrow-band UV-B therapy. The mechanism of action of phototherapy in psoriasis is via inhibition of keratinocyte proliferation; induction of apoptosis in keratinocytes, dendritic, and T cells; and inhibition of Th1 and Th17 pathways, but activation of Th2. (Source: Dermatologic Clinics)
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An Update on Topical Therapies for Mild-Moderate Psoriasis (Tue, 25 Nov 2014)
Topical therapies are the mainstream treatment of psoriasis because most patients have mild disease. First-line treatments are vitamin D derivatives and corticosteroids. These treatments are usually given in combination schedules. For topical treatments the selection of the most appropriate vehicle is of major importance, thus improving adherence to the treatment, which frequently is impaired by the complexities of topical therapeutic choices. Evidence for efficacy and safety of topical treatments is readily available for vitamin D treatments and short-term treatment with corticosteroids. However, the scientific evidence for longer-term treatments is limited. Multiple new small molecules are in various stages of development and are reviewed. (Source: Dermatologic Clinics)
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Assessing Psoriasis Severity and Outcomes for Clinical Trials and Routine Clinical Practice (Tue, 25 Nov 2014)
Psoriasis is a complex disease. Dermatologists have not documented psoriasis severity, except in clinical trials; doing so requires tools for assessing psoriasis and an understanding of what changes in those assessments mean in terms of outcome. Two psoriasis assessment tools have dominated: The Psoriasis Area and Severity Index and the Dermatology Life Quality Index. There are advantages and disadvantages to each. Newer instruments may not be more suitable for documenting psoriasis. There may be benefits in terms of patient ownership of disease management from using self-assessment tools for documenting severity, for example, the Self-assessment version of the Simplified Psoriasis Index. (Source: Dermatologic Clinics)
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Psoriasis Is a Systemic Disease with Multiple Cardiovascular and Metabolic Comorbidities (Tue, 25 Nov 2014)
This article summarizes the current literature on cardiovascular and metabolic comorbidities in psoriasis, identifies research gaps, and suggests management strategies to reduce cardiovascular risk in patients with moderate to severe psoriasis. (Source: Dermatologic Clinics)
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