Psoriasis in Children – Risk Increases with Increasing Age.

Posted on May 13, 2010 | 2 Comments

“Incidence of psoriasis in children” is a new study published in the June 2010 issue of the Journal of the American Academy of Dermatology (JAAD) that investigated the incidence of psoriasis in children.

The study of mostly white patients in the upper Midwest investigated medical records over 20 years, starting in January 1970. Each record was reviewed by a dermatologist.

A diagnosis of psoriasis was made by a dermatologist in 33.2 cases per 100,000. Plaque psoriasis was the most common type of psoriasis, occurring in 73.7% of patients studied. The extremities and scalp were the most common areas for psoriasis lesions to appear,  59.9% and 46.8% of cases respectively. The incidence of psoriasis in children was found to increase with increasing age in both boys and girls.

Interestingly, the study also showed that the incidence of psoriasis in children increased over time from 29.6 per 100,000 in 1970 to 62.7 per 100,000 from 1995 to 1999.

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Methoxsalen Shortage Creates Challenges for Psoriasis Patients

Posted on May 7, 2010 | 2 Comments

Dermatologists have reported a shortage of methoxsalen to the FDA.

Methoxsalen, is a psoralen, a key component of PUVA therapy used for the treatment of psoriasis, eczema, vitiligo and other skin conditions. PUVA involves the application of a psoralen to the skin prior to exposing the skin to UV light. The psoralen sensitizes the skin for improved clinical outcomes.  Without the psoralen medication, psoriasis patients cannot be treated with PUVA.

The manufacturer of the medication, Valeant Pharmaceuticals, reports that the shortage is “due to an unanticipated change in supplier of the active ingredient.” In response the Food and Drug Administration (FDA) has agreed to allow the mportation of the drug under its personal importation policy (PIP).

Refer to the American Academy of Dermatology for more information about the methoxsalen shortage.

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Psoriatic Arthritis Development May be Predicted by Psoriasis Severity and Family History

Posted on April 26, 2010 | 1 Comment

Psoriatric arthritis is more likely to develop among people with a family history of psoriatic arthritis and a greater greater maximum body surface (BSA) affected by psoriasis. This was the conclusion of a study published in the April issue of the The Journal of Dermatology “Risk factors associated with having psoriatic arthritis in patients with cutaneous psoriasis“.

The study recruited 400 people with psoriasis attending a psoriasis clinic in Singapore. 134 (33.5%) of the participants also had psoriatic arthritis.

The researcher found that 25% of participants with a family history of psoriatic arthritis were 20.5 times more likely to also have psoriatic arthritis than those without a family history. Previous episodes of severe psoriasis, as defined by the body surface area (BSA) affected by psoriasis and documented in previous medical records, was also a risk factor for developing psoriatic arthritis.

Psoriatic arthritis was not significantly associated with sex, race, age of onset of psoriasis, a family history of psoriasis, smoking and alcohol consumption

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Clobex® Spray for Psoriasis Now with New Nozzle

Posted on April 19, 2010 | 2 Comments

Clobex® (clobetasol propionate 0.05%) is the brand name of a super-potent topical corticosteroid that is prescribed for the treatment of moderate to severe plaque psoriasis. It is manufactured by Galderma in several formulations, including a spray, lotion and shampoo.

Clobex spray is now available with a new targeted nozzle delivery system designed to help psoriasis patients apply the product more precisely to affected areas of the body and scalp. This is helpful to to reduce side effects that might be caused by the inadvertent application of the medication to unaffected areas of skin.

The efficacy of Clobex® Spray as a psoriasis treatment was established in two independent clinical trials with 240 patients. On average, 8 out of 10 patients with moderate to severe plaque psoriasis became clear or almost clear after four weeks of treatment, and the efficacy of Clobex® Spray to treat moderate to severe plaque psoriasis has been confirmed in various clinical studies since its approval.

Corticosteroids are a commonly prescribed topical medication for the treatment of psoriasis, along with anthralin, coal tar, vitamin D derivatives, and topical retinoids. The use of corticosteroids on the skin must, however, be limited due to the many side effects that result from long-term use. Careful use of corticosteroids is particularly important for potent or super potent formulations, such as clobetasol, the active ingredient of Clobex®.

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Severe Psoriasis Associated with a Higher Risk of Death from Heart Disease

Posted on April 19, 2010 | Leave a comment

Several clinical studies have been published in recent month pointing to the association of psoriasis with heart disease. They have presented data that psoriasis may be an independent risk factor for atherosclerosis, heart attack (myocardial infarction), and stroke. The risk appears to be greatest for severe psoriasis that has the greatest degree of inflammation that impacts the body.

However, it was not shown that this risk of developing heart disease resulted in any increase of death.

Now, a study published in the April 2010 issue of the European Heart Journal has found that people with severe psoriasis do, in fact, have an increased risk of death from cardiovascular disease (CV disease), such as a heart attack. And this risk is independent of traditional cardiovascular risk factors, such as obesity and smoking. This means that the risk is there for someone with severe psoriasis even if he or she is otherwise without other risk factors.

The study compared the medical records of over 14,000 patients with severe psoriasis to others with similar risk factors without psoriasis.

An editorial in the same issue suggested that those with moderate or severe psoriasis be aware of the importance of regular exercise, a healthy diet and the importance of smoking cessation.

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Stelara for psoriasis treatment reviewed by Dermatologist Steve Feldman, M.D.

Posted on April 12, 2010 | Leave a comment

Steve Feldman MD DermatologistDermatologist Steven Feldman, M.D., PhD, of Wake Forest University Baptist Medical Center in Winston-Salem, North Carolina provided his expert opinion regarding the use of Stelara™ for psoriasis treatment.

Dr. Steve Feldman wrote, “Stelara™ appears to be an excellent new option for moderate-to-severe psoriasis, offering patients who have failed other treatments new hope, and offering the most convenient option yet for treating severe disease”

Dr. Feldman added, “The primary benefits are high efficacy and, so far, good safety (measured over about 2 years of use). In addition, the drug is injected at baseline, a month later, then only once every 3 months, so it doesn’t require many injections. Being the newest of our options, we don’t yet have as much safety data as we do for other drugs, so we don’t have quite the same confidence in what the long term safety will be.”

Stelara™ (ustekinumab), was approved by the FDA in September of 2009 for the treatment of moderate to severe psoriasis. It is the latest biologic medication to become available for the treatment of psoriasis. Results of a Stelara clinical trial published in Lancet showed that Stelara reduced the severity of plaque psoriasis by 75 percent in as many as 76 percent of patients treated.

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Psoriasis Severity Not Impacted by Age of Onset

Posted on April 12, 2010 | Leave a comment

The age at which people first experience psoriasis does not appear to have a significant impact on the course of the illness through a person’s life. This information was published in a April issue of the Journal of the European Academy of Dermatology and Venereology.

Researchers surveyed nearly 2,000 people with plaque psoriasis and found that the severity of psoriasis symptoms did not differ significantly between those people whose psoriasis first developed in childhood and those who had adult-onset psoriasis.

Plaque psoriasis

Plaque psoriasis is the most common form of psoriasis. It is diagnosed in 80% of people with psoriasis.

The plaques appear as red, raised, inflamed lesions covered with a silvery white layer of flakey scales. They may vary in size from a half inch to six inches in diameter. Plaques may grow together, creating large affected areas.

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