Health Tip: Treating Psoriasis on the Feet

(HealthDay News) -- Psoriasis is an autoimmune disease that causes red, flaky patches on the skin. It frequently occurs on the bottoms of the feet.

The American Podiatric Medical Association offers suggestions for treating the condition:

Take an oatmeal bath to soothe the itch.Use a hypoallergenic moisturizer regularly to keep feet well moisturized.Talk to your doctor about whether phototherapy (light therapy) is safe for you.Visit a podiatrist if your foot psoriasis doesn't improve.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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Atlanta Women Offers Hope for Those With Psoriasis

By Serena Gordon
HealthDay Reporter

FRIDAY, Sept. 13 (HealthDay News) -- Alisha Bridges spent most of her life covering up and hiding. She didn't want the world to see the scaly patches of psoriasis that cover a significant portion of her body.

She's tried almost every treatment that's out there, with varying degrees of success, she said. Topical corticosteroids tend to work best for her, but because they can be used for only limited periods of time, she tries to restrict their use to when she has a special occasion coming up and as warmer weather approaches.

As much as 90 percent of her body is often covered with psoriasis, Bridges said.

She was only 7 years old when she was diagnosed with the autoimmune skin disease after a bout of chickenpox. Bridges said she's spent most of her life worried that people would stare, or that they'd think she had something that was contagious.

"I was hiding and being ashamed -- I was my own worst enemy," admitted Bridges, who just turned 26.

But then she started blogging about what it's like to live with psoriasis, and people took notice. She was invited to the National Psoriasis Foundation meeting in Washington D.C., where she attended a number of workshops, including one on using social media to raise awareness and connect with others.

Since then, she's been busy raising awareness through Facebook and Twitter, and she's continued to blog about living with psoriasis. She's also become a National Psoriasis Foundation community ambassador.

"Finding support is imperative in the battle with psoriasis," Bridges said. "It's so important to know that you're not alone -- that other people are also dealing with this. And, don't be afraid to speak out. When you start talking about it, people are more understanding than you expect them to be. The majority of people don't know what psoriasis is, but many are open to hearing more about it."

Support groups, she said, are great places to learn about what works and what doesn't for psoriasis, and to pick up tips -- like learning to be persistent and patient with your medication.

"Sometimes treatment won't work until months later, so you have to be persistent in using them, even when you don't see results right away," she said.

Bridges also recommends getting comfortable with your disease.

"No matter what you show of your psoriasis, talk about it until you're comfortable with it," she said. "It's a process that takes time. Three years ago, I didn't talk about it at all. Now, I'm working on exposing my psoriasis," Bridges explained.

"I won't say I'm comfortable enough to go to the grocery store in shorts just yet," she said with a laugh, "but I'm working on it."

Copyright © 2013 HealthDay. All rights reserved. SOURCE: Alisha Bridges, National Psoriasis Foundation community ambassador, Atlanta

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Treatment Options Expand for Psoriasis Patients

By Serena Gordon
HealthDay Reporter

FRIDAY, Sept. 13 (HealthDay News) -- For the legions of Americans living with the red, scaly patches of psoriasis, doctors have good news.

"We are at a point where we can help almost anyone, and we can do it fairly safely," said Dr. Mark Lebwohl, who chairs the National Psoriasis Foundation's medical board. "If you have psoriasis, there's usually a treatment out there that will make you better."

Some 7.5 million people in the United States have the autoimmune disease, yet it's unknown to millions of others.

The telltale scaly patches often occur on the outside of the elbows, knees and scalp, but they can appear anywhere on the skin and may itch, sting or burn. Some people with psoriasis also develop psoriatic arthritis, which causes stiffness, pain, throbbing, swelling and tenderness in one or more joints.

Symptoms vary from person to person, as does severity of the disease. Some people are affected mildly, while others have signs of the disease over most of their body.

But Lebwohl said there are more treatment options available today than ever before, and more are on the way. "We have medicines that are pretty safe and incredibly effective for the large majority of patients," he said.

For most people, the first line of treatment is a topical medication. Topical corticosteroids are probably the most common first treatment, he said, and they often work very well but are prone to such side effects as thinning skin and stretch marks.

Dr. Janet Lin, a dermatologist at Mercy Medical Center in Baltimore, also noted that people can develop a resistance to topical corticosteroids, which means the medication won't work any longer.

Another topical treatment is a class of medications known as vitamin D analogues, which Lin said "help normalize the growth of the skin cells, and they don't have the side effects of corticosteroids." Examples are calcipotriol, calcitriol and tacalcitol.

Two other topical formulations approved for psoriasis treatment are salicylic acid and coal tar, according to the foundation.

Lin said that steroids injected into areas with psoriasis patches can help thin out the scales, but they can be used only in limited areas.

Light therapy can also help people with psoriasis. "There are certain wavelengths in the UVA and UVB spectrum that help suppress inflammation," she said. The problem with light therapy, though, is that it must be administered in a doctor's office two to three times a week, which makes it inconvenient.

Oral medications also are available and are often the first ones tried for widespread psoriasis. "If someone is covered from head to toe with psoriasis," Lebwohl said, "it's useless to try topical treatments."

Examples of oral medications are acitretin, cyclosporine and methotrexate. He said that most insurance companies prefer that people start with methotrexate because it's effective and considerably less expensive than some of the alternative treatments. Most oral drugs, however, are not considered advisable for use by women during their childbearing years.

The newest and perhaps most helpful drugs for people with psoriasis are called biologics and include such drugs as Enbrel, Humira, Remicade and Stelara. They work by suppressing certain parts of the immune system, and are given by injection or intravenously, Lebwohl said. Because they affect the immune system, however, they carry some increased risks.

"People usually do very well on these medications," Lin said, but she added that "they may see an increase in colds or in infections like strep throat."

For people with psoriatic arthritis, Lebwohl said, methotrexate and most of the biologics are the preferred treatments.

Many people end up using a combination of medications -- a biologic and topical corticosteroids, for instance.

Even more options are in the treatment pipeline.

Lebwohl said there are "at least two pills on the near horizon, and at least five new biologics in the works." And, according to the foundation, more oral medications and new topical treatments are currently being tested in clinical trials.

"There are good medications to control psoriasis, but there's no cure yet," Lin said, but she added that, with all the new medications in development, there's reason to be hopeful.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Mark Lebwohl, M.D., chairman, medical board, National Psoriasis Foundation, and Sol and Ciara Kest professor and chairman of dermatology, Icahn School of Medicine at Mount Sinai, New York City; Janet Lin, M.D., dermatologist, Mercy Medical Center, Baltimore

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