August is psoriasis awareness month. Several of my patients are afflicted with psoriasis as are an estimated 7.5 million Americans. Thousands more will be diagnosed this year. Psoriasis is a somewhat common disorder of the autoimmune system that causes skin cells to multiply 10 times faster than normal.
Instead of shedding off, these skin cells build up into dry, red/silvery, scaly, itchy, painful plaques on the skin. These plaques can cover the entire body or just in small patches. It can be an upsetting condition to live with as flare-ups can be triggered by many things – environment, medications, stress, etc. If you have psoriasis, I’d like to tell you about what’s on the horizon through research and possible new treatments.
New Directions for Psoriasis Treatments
As a dermatologist, I like to keep up on the latest research on psoriasis in order to help my patients. As such, I’d like to share with my readers some of the newest directions in psoriasis that have come across my desk recently.
1. Psoriasis Hope From Sweden. In January 2012, researchers at Sweden’s Linkoping University discovered a protein abundant in psoriasis – psoriasin – and breast cancer. The researchers found that the interaction of psoriasis, free radicals, and VEGF (vascular endothelial growth factor) triggers increased growth of blood vessels. Blocking the psoriasin resulted in decreasing VEGF which, in turn, lessened blood vessel growth. Previous studies in mice showed that inhibiting growth of blood vessels resulted in the inability of cells to multiply excessively – a process that occurs in psoriasis as well as cancer. It also decreased inflammation.
Conclusions: Psoriasin is being looked at as a target for psoriasis therapy. By inhibiting psoriasin, researchers believe they can reduce vascular formation and psoriasis’ scope and intensity.
2. Gene identified in 3 forms of psoriasis. In April 2012, researchers at Washington University School of Medicine discovered the first gene to be associated with the most common form of psoriasis, plaque psoriasis, which accounts for 80% of all cases. The gene was also found to be present in pustular psoriasis and a very debilitating form, psoriatic arthritis. They found that rare mutations in the CARD14 gene occurred when activated by environmental triggers that brought on the conditions.
Conclusions: These new findings shed light on the idea that an overactive immune system – as has always been thought – may not be to blame for psoriasis. Rather, defects in the skin may be the primary culprit with the immune system being secondary. Researchers feel that finding this gene is important to developing new, more effective treatments.
3. Protein Key in Psoriasis Care. In June 2012, researchers at the University of California San Diego found that inhibiting a certain protein in the skin may help heal psoriatic plaques. They identified the REG3A gene that is highly expressed in both psoriasis outbreaks and in wounds trying to heal themselves. By inhibiting the gene, psoriasis plaques cleared but wound healing slowed down. The REG3A gene acts together with the immune system’s interleukin-17 – a protein that seems to signal over-production and build up of skin cells of psoriasis.
Conclusions: The findings point to the development of medications that could treat psoriasis more directly by inhibiting the REG3A gene. Currently, most psoriasis treatment medications work by suppressing the immune system, which can result in undesirable side effects.
What You Can Do To Reduce Risk of Psoriasis
In other research, it has been noted that a few things help diminish outbreaks in psoriasis as well as decrease the risk of developing the condition. They include the following:
1. Get regular vigorous exercise. Research reported in the Archives of Dermatology revealed that regular vigorous exercise was associated with a reduced risk of psoriasis in women. Participating in at least 20.9 hours/week of running and performing aerobic-type calisthenics resulted in a 25% to 30% decrease risk of psoriasis. The benefit was thought due to the highly variable intensity of these activities. Walking, swimming, running, playing tennis, bicycling were not associated with the benefits. It should also be noted that regular exercise helps decrease inflammation throughout the body – a risk factor for psoriasis as well as cancer, type 2 diabetes and heart disease.
2. Keep a normal weight. Research out of Kaiser Permanente’s Southern California Department of Research and Evaluation revealed that obesity greatly increases the risk of developing psoriasis. Moderately obese children were 40% more likely to develop psoriasis and severely obese children were 80% more likely to develop it. Adult obesity is also a risk factor for developing psoriasis. Obesity is associated with the increased production of cytokines – cells which cause inflammation throughout the body.
3. Control Triggers. Stress, excess alcohol, dry, cold weather, skin injuries, Strep infections, and certain medications (lithium, malaria drugs, beta blocker cardiac drugs, oral steroids) can all be triggers for psoriasis outbreaks.
4. Psoriasis research study. You can have the opportunity to participate in psoriasis research aimed at testing medications. By answering some questions, you can find out if you qualify for specific trials. See: http://www.newpsoriasisstudy.com/DoIQualify.aspx.
5. Watch Webcast August 14: A webcast from the National Psoriasis Foundation is available on August 14, 4 pm PT/7 pm ET on the topic, “What You Eat, or Don’t Eat, May Improve Your Psoriasis.” Register at: http://www.psoriasis.org/events/educational/webcasts/diet-may-improve-psoriasis
Though psoriasis can be a frustrating condition to live with, some exciting new inroads to treatment are being discovered every day. Do all you can to reduce your triggers for psoriasis, take your medications regularly and follow up regularly with your dermatologist.
Jay Brachfeld, M.D.
Natural Health News
Common Questions About Psoriasis, http://www.stelarainfo.com/common-questions/about-psoriasis
New Hope for Better Treatment of Psoriasis, http://www.sciencedaily.com/releases/2012/01/120110114448.htm
First Gene Linked to Common Form of Psoriasis Identified, http://www.sciencedaily.com/releases/2012/04/120419121436.htm
Protein May Be Key To Psoriasis and Wound Care, http://www.sciencedaily.com/releases/2012/06/120621124940.htm
Obesity in childhood may lead to psoriasis, http://articles.latimes.com/2011/may/18/news/la-heb-psoriasis-obesity-05182011