06 September 2018
THURSDAY, Sept. 6, 2018 (HealthDay News) — Though psoriasis is not contagious, many Americans shun people with the skin condition, new research indicates. The study included a cross-section of about 400 Americans who viewed images of people with visible psoriasis. Large numbers wrongly thought psoriasis was contagious or only affects the skin, and about one-third said they wouldn’t want to invite people with the condition into their homes. “People with psoriasis feel they can’t go to a public pool, go to a salon to get their hair done, or are worried about going on vacation with their families,” said study senior author Dr. Joel Gelfand, who called the burden on psoriasis patients “tremendous.” “This tells us how much work we need to do as a society to make sure people have good health literacy, and understand what these skin conditions are about and treat people with respect,” he said. Gelfand is a professor of dermatology and epidemiology at the University of Pennsylvania’s Perelman School of Medicine, in Philadelphia. A chronic autoimmune disease estimated to affect about 8 million Americans, psoriasis causes skin cells to grow too fast and accumulate, resulting in red, scaly patches. Lesions can come and go, and cover varying amounts of skin surface, triggering itching, pain and/or burning. In moderate-to-severe cases, psoriasis increases the risk of other health conditions related to inflammation, including heart attack and stroke. While the condition can be treated, there is no cure. Gelfand’s team surveyed 187 medical students and 198 laypeople about their perceptions of people with psoriasis. Participants in the online survey were shown eight images of people with psoriasis along with enlarged photos of psoriasis lesions. The survey participants’ reactions underscore the stigma and misconceptions associated with the disorder, the researchers said. More than 54 percent of lay participants said they didn’t want to date someone with psoriasis, and nearly 40 percent didn’t even want to shake hands with them. In addition, 32 percent didn’t want someone with psoriasis in their homes, and 45 percent said people with psoriasis were unattractive. The study also highlighted persistent myths: 27 percent of respondents thought psoriasis was contagious; and 53 percent considered psoriasis sufferers sick. About one-third of respondents thought psoriasis only affects the skin, and more than a quarter said psoriasis isn’t a serious disease, the findings showed. Notably, medical students who took the survey showed less stigmatizing views, which study lead author Rebecca Pearl called “encouraging.” “The trainees are going to become health care professionals who are not expressing as negative views as someone without as much medical knowledge or background,” said Pearl, an assistant professor of psychology at Perelman School of Medicine. Dr. Richard Fried is a dermatologist in private practice in Yardley, Pa., and wasn’t involved in the new research. Though he said the study was small, he called the findings “enormously important” and said they were consistent with what he sees in clinical practice. “I think it takes our breath away a little bit in terms of how truly burdened psoriasis sufferers are,” he said. “Psoriasis can be enormously capricious and can steal joy and involvement from people’s lives, but it’s often unrecognized,” said Fried, who is also a member of the medical board at the National Psoriasis Foundation. “The data from this study are enormously important.” The study authors said better education about the disease and contact with people who have it could help dispel myths and ease the stigma. Pearl said it might help if TV commercials for psoriasis medications — which are common — showed patients’ actual psoriasis lesions. This could educate the public about what psoriasis looks like to reduce misinformation, she said. “Could we test what would happen if we had commercials or educational campaigns of people with psoriasis shown with their lesions but still engaging in normal activities like playing outside with their kids?” she asked. “Just showing them as normal people — could those portrayals reduce stigma?” The study was published online recently in the Journal of the American Academy of Dermatology. More information Learn more about psoriasis from the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
26 July 2018
THURSDAY, July 26, 2018 (HealthDay News) — A study of more than 3,500 French psoriasis patients found that the healthier their diet, the less severe their symptoms. Specifically, the closer an individual adhered to the nutritious “Mediterranean” diet, the less onerous their psoriasis became. This was true regardless of whether or not the patient was obese, the French researchers noted. The Mediterranean diet is heavy on fruits, vegetables, whole grains, fish, olive oil and nuts, and light on red meat, dairy and alcohol. It’s long been recommended as “heart healthy” by groups such as the American Heart Association. Now, the new research bolsters the notion that the regimen might also help fight immune-system disorders such as psoriasis. One U.S. dermatologist agreed the idea has merit. “If this finding is confirmed by further studies, it would lead to a significant change in the way dermatologists manage psoriasis, as it would mean that even a patient who is not overweight could improve their psoriasis through dietary modifications,” said Dr. Scott Flugman. He practices dermatology at Northwell Health’s Huntington Hospital, in Huntington, N.Y. The new study was based on data from a nationwide health survey of citizens in France, involving almost 36,000 respondents. More than 3,500 of them had some form of psoriasis, said the team led by Dr. Celine Phan, of Henri Mondor University Hospital in Creteil, France. Besides asking psoriasis patients about the severity of their symptoms, the survey also gauged how closely they approached the ideal Mediterranean diet. Participants were divided into three groups — a “bottom” third whose diets were furthest away from the Mediterranean diet, a middle third whose eating habits were moving closer to the diet, and a top third who were closest to the Mediterranean diet. The researchers adjusted their findings for age, exercise levels, obesity, smoking and other potential risk factors for psoriasis. Compared to people in the bottom third, those in the middle and top groups were 29 percent and 22 percent less likely to have severe symptoms, Phan’s group found. The researchers stressed that the study couldn’t prove cause and effect. For example, it might not be that the Mediterranean diet itself somehow eases symptoms, but instead that its opposite — the fatty, sugary “Western” diet — exacerbates psoriasis. But the investigators pointed to research that the inflammatory-dampening Mediterranean diet might have direct, healthy effects on the lymphoid (immune) system or the “microbiome” of healthful germs in the human gut. The Mediterranean diet is rich in vitamins A, D, E, folate and omega-3 fatty acids, all of which have an anti-inflammatory effect, the research team said. In contrast, it’s long been known that Western diets set up an unhealthy, pro-inflammatory state in the body. “Dermatologists have for years have seen mounting evidence linking psoriasis with systemic inflammation,” Flugman noted, and “we see psoriatic patients who exhibit significant improvement in their skin after lifestyle changes,” especially when that change involves weight loss. But he stressed that psoriasis severity eased for people eating the healthier diet, even if their weight wasn’t an issue. Dr. Michele Green is a dermatologist at Lenox Hill Hospital in New York City. Reviewing the new findings, she agreed that “with the Mediterranean diet, individuals consume more nutrient-dense foods, which are not processed. The ‘cleaner’ your diet, the less likelihood of triggering an autoimmune response.” The findings were published July 25 in JAMA Dermatology. More information The National Psoriasis Foundation offers more on psoriasis.
25 June 2018
MONDAY, June 25, 2018 (HealthDay News) — Skin conditions are significantly impacted by your skin color, a dermatologist says. “Ethnicity and skin tone can make a big difference in terms of diagnosis and treatment options with a number of different skin conditions,” said Dr. Amy McMichael, chair of dermatology at Wake Forest Baptist Medical Center in Winston-Salem, N.C. The amount of melanin — the pigment that gives skin its color — can greatly influence a person’s risk of and reaction to many different skin conditions. For example, a fair-skinned person with a low level of melanin has a far higher risk of sunburn than someone with a melanin-rich dark complexion. But darker-skinned people aren’t totally protected from the sun’s ultraviolet rays. Also, their higher melanin levels make their skin more reactive to inflammation and injury, McMichael said. This can result in problems such as long-lasting or permanent dark spots (hyperpigmentation) at the sites of even relatively minor irritations, such as insect bites. “There are a lot of myths out there about which groups are or are not affected by certain conditions,” McMichael said in a medical center news release. She is the only black woman to chair a university dermatology department in the United States. “That African-Americans don’t get psoriasis is a big one. We’ve found that a number of people of African descent not only have it but that it can be a lot worse and a lot more extensive. And psoriasis is one of the conditions that can look so different in people with darker skin that it’s confusing and often not recognized by family physicians or even people trained in dermatology,” she added. The distinctions are important, McMichael noted, because the U.S. population by 2050 will have minorities in the majority. “This means that many [doctors] are going to be dealing with patients of all ethnicities, even ones we’re not necessarily familiar with,” she said. “We’ll have to be versatile, to take into consideration how their pigmentation or cultural practices affect their particular problem and how it can best be addressed.” More information The U.S. National Institutes of Health offers advice on keeping your skin healthy.
28 December 2017
THURSDAY, Dec. 28, 2017 (HealthDay News) — Among people with the skin disease psoriasis, could skin color play a role in whether or not they visit a dermatologist? An analysis of federal government health survey data from 2001 to 2013 found that black, Asian and other minorities are less likely than white people in the United States to see a doctor for treatment of the chronic inflammatory disease. The researchers found that among 842 people with psoriasis included in the study, nearly 51 percent of whites saw a dermatologist versus about 47 percent of Hispanics. In comparison, only 38 percent of blacks, Asians, native Hawaiians/Pacific Islanders and other non-Hispanic minorities saw a dermatologist for their psoriasis. White patients also visited a dermatologist more often, the study found. They averaged 2.69 visits a year, compared with 1.87 for Hispanics and 1.30 for non-Hispanic minorities. Nationwide, this would translate into more than 3 million fewer visits a year for psoriasis among non-Hispanic racial minorities than among whites. “While psoriasis is less common among minorities, previous research has shown their disease can be more severe,” senior author Dr. Junko Takeshita, an assistant professor of dermatology and epidemiology at the University of Pennsylvania, said in a university news release. “Despite that, this study shows minorities are less likely to see a dermatologist for treatment,” Takeshita added. Psoriasis affects about 7.5 million Americans, according to the National Psoriasis Foundation. Along with affecting the skin, causing raised red patches with silvery scales, psoriasis has been linked with an increased risk for heart attack, stroke and premature death. “When you combine the results of our study with the knowledge that psoriasis severity and quality-of-life impact suggest a larger burden of psoriasis among minorities, it brings into focus the racial gaps that exist in psoriasis care,” Takeshita said. Further research is needed to learn more about the reasons for these disparities, the study authors said. “Ultimately, increasing awareness of these disparities is the first step in trying to provide equitable care and improve outcomes for all individuals with psoriasis,” Takeshita concluded. The findings were published recently in the Journal of the American Academy of Dermatology. More information The American Academy of Family Physicians has more on psoriasis.