Psoriasis and psoriatic arthritis: An overview

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1 Psoriasis and psoriatic arthritis: An overview

2 Agenda Welcome and introductions Overview of psoriasis and psoriatic arthritis Available treatments Questions and answers

3 What is psoriasis? Chronic (lifelong), inflammatory disease; symptoms present on skin and in joints Complex genetic disease of the immune system with environmental triggers Immune system malfunctions and makes the skin grow too quickly, creating a build-up of skin cells - called plaques Not contagious

4 How common is psoriasis? According to the National Institutes of Health, as many as 7.5 million Americans have psoriasis Affects two percent to three percent of the population worldwide Occurs nearly equally in men and women across all socioeconomic groups Present in all racial groups but in varying rates

5 When does psoriasis emerge? Possible to develop psoriasis at any age Commonly appears between the ages of 15 and 25 Is a lifelong condition Tends to wax and wane

6 What causes psoriasis? Genetic predisposition (family history) to psoriasis coupled with an environmental trigger causes an inappropriate immune response and the production of immunologic factors (cytokines) in the skin Inappropriate immune responses accelerate the production of new skin cells, causing them to pile up on the skin s surface as visible lesions and plaques

7 What are psoriasis triggers? Many things can affect psoriasis, triggering the onset, worsening or improvement of symptoms Some triggers include: certain medications certain illnesses (e.g., strep throat) weather diet allergies injuries to skin (including tattoos, piercings) stress

8 Types of psoriasis Plaque Patches of raised, red skin covered by flaky, white buildup called scale Most common form

9 Types of psoriasis Guttate: Small, red, individual spots on skin. Usually appears on trunk and limbs. Not usually as thick as plaque lesions. Inverse: Found in skin folds. Lesions are very red and usually lack scale. May appear smooth and shiny. Pustular: White pustules (blisters of noninfectious pus) surrounded by red skin. Erythrodermic: Fiery redness of large areas of skin. Scales tend to shed in large sheets. Often accompanied by severe itching and pain.

10 Psoriasis on specific skin sites Scalp Powdery scales with silver sheen around the scalp line, forehead, ears, and back of neck Palms of hands and soles of feet Cracks, blistering, swelling Very difficult and painful to walk when soles of the feet are involved

11 What are the symptoms of psoriasis? Psoriasis can make the skin itch, burn, sting and/or bleed Flaking and scaling are most common symptoms Constant itching is often described as the most frustrating symptom

12 How severe is psoriasis? Psoriasis affects everyone differently Severity can be determined by the percentage of body covered, or by impact on quality of life Generally considered severe if it limits the ability to function normally For example, if it affects the palms of the hands or the soles of the feet, it can prevent the ability to perform normal activities

13 How severe is psoriasis? Recent studies show that psoriasis increases one s risk of cardiovascular disease The greater the psoriasis severity, the greater the risk Controlling psoriasis with certain medications shows promising results for reducing risk of cardiovascular disease

14 How severe is psoriasis? Psoriasis is also related to other chronic health conditions: Hypertension Diabetes Cancer Depression Obesity Crohn s disease Kimball, et al., J. Amer. Acad. Derm. June, 2008; volume 58(6);

15 What is psoriatic arthritis? Inflammatory joint disease that occurs in as many as thirty percent of people with psoriasis Stiffness, pain and swelling in and around the joints and surrounding ligaments and tendons Skin symptoms appear before joint symptoms in 85% of cases Early recognition, diagnosis and treatment can help prevent progressive joint involvement and damage Without treatment, psoriatic arthritis can be disabling and crippling

16 Types of psoriatic arthritis Localized mild psoriatic arthritis Affects only one or two joints Causes less deformity and long-term disability Generalized disabling psoriatic arthritis Affects multiple joints Can be disabling and cause joint deformities

17 Psoriasis treatment options Psoriasis is chronic, but treatable Many effective treatments are available Unpredictable nature makes treating it a challenge Treatments vary by: How well they work Safety and side effects Duration of response Convenience Method of delivery Cost

18 Treatments for psoriasis No single treatment works for everyone Combination treatment Very common to be on two or more medications Used to speed clearance or reduce the effects of any one treatment

19 Treatment delivery types Topical Applied to the skin (steroids, tar, OTC products) Phototherapy Systemic and biologic Oral (pills, liquid) Injection (intramuscular or subcutaneous) Intravenous infusion

20 Topical treatments Most commonly prescribed class of treatment Frequently used in combination with other treatments Best for localized psoriasis Available as creams, ointments, lotions, solutions, foams, gels, baths or shampoos Wide variety of options Over the counter (OTC) Stronger topicals available by prescription Typically applied once or twice a day

21 Phototherapy Light unit directs specific bands of ultraviolet light to areas affected by psoriasis Effective for many patients who follow through with treatment plan Typically requires two to three weekly dermatologist visits over several weeks to clear, then less frequent treatments to maintain clearing

22 Systemic and biologic medications Prescription drugs that are given in the form of a pill, injection or infusion Commonly prescribed for moderate to severe psoriasis Can have effects on other parts of the body

23 Treatments for psoriatic arthritis Many different treatments are available to help control psoriatic arthritis, including systemic and biologic drugs Early treatment can slow down the progression of the disease and help preserve function and range of motion of the joints No single treatment works for everyone Treatments for psoriatic arthritis can help relieve pain, reduce swelling and keep joints working properly

24 National Psoriasis Foundation: Finding a cure The National Psoriasis Foundation is the world's largest nonprofit psoriasis patient advocacy organization, and the voice for millions of Americans who are affected by psoriasis and psoriatic arthritis.

25 National Psoriasis Foundation: Finding a cure Our mission is to find a cure for psoriasis and psoriatic arthritis and to eliminate their devastating effects through research, advocacy and education.

26 Current key initiatives Working toward a cure Discovery grants for researchers that target cure pathways Creating world s largest collection of DNA for psoriasis & psoriatic arthritis research First ever psoriasis & psoriatic arthritis legislation Find out more:

27 Current key initiatives Improving access to care Working with insurance companies to change restrictive policies and provide better coverage for psoriasis treatment Recently launched legislative initiative in Illinois to reduce phototherapy co-payments Find out more:

28 Current key initiatives Community programming Education Live webcasts with psoriasis experts, community events and virtual support network Walk to Cure Psoriasis Walks in 19 cities across the USA, mobilizing thousands of volunteers to raise funds for research, advocacy & education Find out more: walk.psoriasis.org

29 Current key initiatives Building awareness that psoriasis is A serious chronic disease with associated health risks The most common autoimmune disease in the U.S. Encouraging those with psoriasis To seek treatment appropriate to the severity of their disease To pay careful attention to their joints and see the doctor if they experience pain or swelling Be diligent with treatments Find out more:

30 Questions and answers

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