Talk:Psoriasis/Archive 1

The process

This article reads " Psoriasis does not seem to be a true autoimmune disease.[36] In an autoimmune disease, the immune system confuses an outside antigen with a normal body component, and attacks them both." I don't believe this is accurate. According to wikipedia: "Autoimmune diseases arise from an inappropriate immune response of the body against substances and tissues normally present in the body." By that definition, psoriasis is an autoimmune disease. — Preceding unsigned comment added by Bensfriends (talk • contribs) 20:51, 17 February 2013 (UTC)

Psoriasis is listed as autoimmune disease in the classification table here: http://en.wikipedia.org/wiki/Autoimmune_disease — Preceding unsigned comment added by Bensfriends (talk • contribs) 20:55, 17 February 2013 (UTC)

I read about the process that occurs during psoriasis and I think it's quite interesting and should be added to the article. Especially because it gives laypeople a sense of what's going on. http://www.ehealthmd.com/library/psoriasis/PSO_causes.html

The fact that immunosuppressive drugs help to cure psoriasis does not make psoriasis an autoimmune disease. Likewise psoriasis is no cortisone deficiency syndrome. This are merely secondary phenomena.

There is NO cure. Only temporary relief.

None of the sources sited give evidence that this is an autoimmune disease. Psoriasis is clearly an immune-mediated phenomenon, but there is no evidence that it is an autoimmune disease. There is a difference. Can someone please correct this misinformation?Kldawson (talk) 08:22, 2 June 2011 (UTC)

Tho onset Psoriasis can be provoked by a number of factors, such as:

Trauma –Koebner Phenomenon, or the development of lesions (plaque psoarisis) at the site of infection is aggravated by all types of trauma (chemical, physical, infective or inflammatory).

Infection – Infections such aas HIV or streptococcal pharyngitis may provoke eruption of Psoarisis.

Pharmaceutical Drugs such as Beta-blockers, systemic corticosteroisds, antimalarials, Lithium and NSAIDs could result in lesions from flaring.

Sunlight – Strong U.V. rays can have adverse effects on individuals suffering from psoarisis, although mild exposure of sunlight can in most caases be beneficial.

       Stress – Psychological stress has been reported to increase severity of psoarisis symptoms in most patients.

Smoking - Strong nicotine dependence is said to raise the risk associated with Chronic plaque psoriasis.

       Alcohol – Alcohol tends to further induce inflammation amongst psoriasis patients, particularly males between the age of 18 – 35. 

Endocrine – Hormonal changes causes fluctuation in infected individuals. The flush of hormones during pregnancy may tend to alleviate the symptoms. However there might be a post-partum flare.

Hope this is helpful to any of you that suffer this problem. — Preceding unsigned comment added by AdamAswani (talk • contribs) 12:07, 29 October 2012 (UTC)

A new theory about the origin of Psoriasis

In M. D. Anderson researchers discover key protein in psoriasis (12-Dec-2004) you find a detailed new explanation. Due to a small injury the production of a protein called STAT3 is started but it will not be stopped. The healing process will not be finished. The growing of skin cells and the inflation is not ending. I find this very convincing, more than the simple theory of something going wrong with the autoimmune system.-- 82.82.129.112 00:18, 13 Jan 2005 (UTC)

Interesting, but it doesn't explain psoriatic arthritis. Why couldn't it be a combination of factors? 151.203.241.164 18:52, 27 May 2005 (UTC)

The researchers don't say that humans continue to express active STAT3 after healing process finished. They only found active STAT3 in psoriatic skin and that's what you would expect as psoriatic skin is lesioned skin.

The same phenomena could occur in joints as well as in skin. Nothing precludes this causing inflammation of the joints.

PASI score

In a Clinical Trial Update news item in Genetic Engineering News (vol 25, #3, 2005, pg 5), I noted the following passage "...data from 10 patients with moderate-to-severe psoriasis demonstrated a reduction in the PASI score (a symptom severity score in psoriatic patients) by an avera of 50% ..." (bold added by me). I thought I'd look in Wikipedia for more details on the PASI score and couldn't find any. Is this something that should/could be added here by someone with knowledge of the measure? Courtland 17:53, 2005 Feb 15 (UTC)

See Psoriasis Area Severity Index Rod57 (talk) 15:47, 29 November 2008 (UTC)

consistency

In Psoriasis#Calcipotriol/Calcipotriene (Daivonex/Dovonex) I read:

[This drug] is sometimes combined with topical corticosteroids to reduce irritation.

but the following section says:

Calcipotriol/Calcipotriene based ointments are usually not to be mixed with corticosteroids at the same time due to problems with the active substances interfering with each other.

These two statements appear to be flatly contradicting each other. Hv 14:19, 31 July 2005 (UTC)

In regard to consistency, the dermatologist will usually recommend the patient use the calcipotriol and the topical steroid daily, but at different times--for example, the calcipotriol in the morning and the topical steroid at night. It is true that mixing the medications is not advised, both for inactivation of the ingredients and because it dilutes each.24.94.5.149 23:05, 23 October 2005 (UTC)

What is "Pustubeular"?

Google doesn't recognize this word. Typed in by itself it doesn't give any suggestions, but "Pustubeular Psoriasis" gives the suggestion "Pustular Psoriasis", which has many hits, but before I just change the header, I wanted to ask here if anyone knew what the original author might have been going for, in case there is an implied distinction between Pustular and the word the original author meant. --Arcadian 00:43, 8 December 2005 (UTC)

Pustulobullar? JFW | T@lk 21:18, 8 January 2006 (UTC)

Etanercept

A phase III trial with etanercept showed 50% disease score improvement (but not 75%, which was the primary end point) but also marked improvement in fatigue (and less so, depression) associated with psoriasis[1]. JFW | T@lk 21:18, 8 January 2006 (UTC)

To what the last guy said-->

I would disagree with the last statement made. I believe to find a cure for Psoriasis we should be looking in history. For if you find the roots of the problem the solution not far off. With today's world adding in more synthetic materials to our foods, more hormones, and chemicals we need to find what time period Psorasis came about. If then we can find that gap in time, we could start clinical studies to find out just exactly what is causing this problem. After all if we could find a cure for AIDS the same way do you think it would not be worth it? ------Problems tend to worsen over time( like autism ). I would not be surprised 10 years from now(2017)if the number of Psoriasis cases had risen from the 2-3% (now) to an estimated 8-10%.

t r u s h a f t y 3 8 @ h o t m a i l ..com 4.188.255.224 20:58, 1 June 2006 (UTC)shafty

I think I may have just deleted the section you were responding to. I just deleted a section because the original post was self-promoting, non-NPOV, and intolerant. I apologize if removing it now means you're responding to a statement that's now deleted. Evernut (talk) 14:37, 28 June 2011 (UTC)

What on earth?

I think the term 'aggressive food' is a little bit too ambiguous...what on earth is an agressive food? Is it going to try to eat me? Jokes aside, maybe another word would be better...such as 'high GI food' 'known allergenic foods'. Something a little more specific.

—Preceding unsigned comment added by Nicgeorge (talk • contribs) 7 June 2006

Welcome Nicgeorge - I agree a poor term, but I have no idea what is actually being implied here. A reference might have helped clarify , plus of course help verify a possible alternative health claim. David Ruben ^Talk 13:31, 7 June 2006 (UTC)

psoriasisdating.com

i tried to add a link to the dating website psoriasisdating.com but it was removed. there is a small membership fee to the site to use certain features, but it's not a pay site. i think it's an incredibly important link to have on this page. most of the people accessing this page are probably people with psoriasis (like myself) who are trying to cope with the frustrations and depression that come along with the disease. the emotional impact of psoriasis is probably the worst affect of the disease. meeting others who have it is life altering. i actually met my boyfriend on that site and it really changed my life. i think it's an important resource related to this issue, especially because it's not a well known site.

—Preceding unsigned comment added by 199.243.154.211 (talk • contribs) 17:17, 7 June 2006

If by your own admission it is "not a well known site", then it is hardly notable to the wider community of those with psoriaisis. I can appreciate your position (as you set out) and that the site therefore been of benefit to you. An individual merely suggesting that a site is good (whether or not the case) counts as a personal opinion; which is excluded by WP:No original research. Forums and blog sites are generally considered not to be WP:Appropriate sources. To be worthy of encyclopedic inclusion, one must be able to WP:Cite another appropriate source to WP:Verify that it has WP:Notability, otherwise it will not merit inclusion in wikipedia. Hope this helps clarify the wikipedia framework.David Ruben ^Talk 17:10, 7 June 2006 (UTC)

photo

Could this photo be of use in the article? The Wednesday Island 03:26, 8 June 2006 (UTC)

It is a good picture of psoriasis. However I'm not sure what wiki policy is (if there is one) on pictures of patients. The image itself is tagged as being created by your partner, so no copyright issues. However does not some indication need to be made as to the patient's consent for its wider viewing. The patient obviously consented for a photograph to be taken for some purpose, but did this included the widest possible distrubtion (they may have only consented to use for medical studients or as a "snapshot" of their condition for their own confidential medical records). David Ruben ^Talk 17:04, 8 June 2006 (UTC)

Sorry, I should have been more clear: I'm the model, and I'm quite happy for it to be used. (The upload form only asked who the creator was, so I only mentioned that.) The Wednesday Island 18:23, 8 June 2006 (UTC)

OK - Thank you for the generosity of the photo. Can you please then edit the Images's Summary section here to add this info and your consent :-). Then we can add the image, thumbnailled down, into the article). David Ruben ^Talk 19:30, 8 June 2006 (UTC)

Done. Thank you for your help! The Wednesday Island 19:50, 8 June 2006 (UTC)

This picture is perfect. It represents psoriasis better than any of the close up shots I'm used to seeing. Rocketqueen 14:50, 9 June 2006 (UTC)

It looks just like my younger brother who's suffering from psoriasis. Currently, he's on chemotherapy since some weeks back. he's tried basically everything else there is. I have psoriasis myself, though far from his degree. My older brother has no traces of it, as far as I can see. I have some other relatives with it too.

Jens Persson (213.67.64.22 04:01, 18 March 2007 (UTC))

HEY, What type is the psoriasis in the photo?? thank you very much

DAL — Preceding unsigned comment added by 89.138.128.92 (talk) 12:58, 11 June 2011 (UTC)

Fumaric acid therapy in psoriasis

I think it is important to tell you about this almost 50 years old therapy, because it is still quite unknown outside of Germany. It might be the best cure for severe! psoriasis on the market. The drug is called Fumaderm in Germany and it (or an offspring) might be released in other countries soon.

Please add the Fumaric acid therapy to the list of Systemic Treatment. My english is not good enough.

- A study at the Ruhr University Bochum, Germany showed it to be safe and efficient.

- It can be used for long term therapy (some people used it for 15 years).

- It works on psoriasis arthritis too.

- The pioneer Dr. Schaefer used it over decades on thousands of patients, 2 year old children, people with only one kidney, with great success.

- Fumaric acid is a natural substance occuring in the body (in the citric acid cycle).

- The side-effects are mainly flushing and gastrointestinal complaints. The concentrations of some substances in the blood change in the beginning of the therapy. The blood must be controlled continuously. I told you it is for severe psoriasis only.

________

Comment on the above:

Fumaric acid does not work, you need fumaric acid esters. They have been used for decades and are safe. I can't believe that they are not even mentioned in the text and that all the people take poison instead. Just use it and be happy. —Preceding unsigned comment added by 79.212.83.72 (talk) 10:51, 10 March 2011 (UTC)

Other stuff

I just have some other things that might be worth addressing from my own experience with psoriasis. I was wondering if someone with psoriasis might be more prone to develop other skin-related things. I have psoriasis, and I have also been affected by a secondary skin infection on two separate occasions, as well as having chronic dandruff. I also noticed that the article didn't mention anything about whether or not the seasons has any effect upon the intensity of psoriasis. DroEsperanto 16:10, 19 June 2006 (UTC)

I think the seasons do have an effect on Psoriasis. Since I have it, my dermatologist told me that a sudden change in weather (eg. sunny season to rainy season) can flare up Psoriasis. I've experienced itching when it happened. Lily090 16:28, 2 December 2007

Anthralin

The active compound of Anthralin is Dithranol. The article states that it often fails to adequately improve the skin. This is pessimistic. There are many clinical trials that proof it to be as efficient as PUVA, corticosteroids or calcipotriol. Dithranol causes skin irritation if not used proper, but long term side effects are unknown in contrast to most other medicaments mentioned here.

________

Comment on the above:

Dithranol is a brand name; anthralin is the generic name. The active ingredient in Dithranol is anthralin, which is a synthetic version of chrysarobin, which in turn is a constituent of "Goa powder" derived from the bark of the araroba tree - found principally in Brazil. Anthralin compounds can be effective, but anthralin, (and corticosteroids and Dovonex) are not even close to being in the same class of efficacy as PUVA.

—Preceding unsigned comment added by 71.139.168.11 (talk • contribs) 10:09, 21 September 2006

Disagree - British National Formulary clearly confirms Dithranol as International Nonproprietary Name with Anthralin being a older depreciated term. BNF lists Dithranol therefoe as generic name (UK brands are Dithrocream, Micanol & Psorin). David Ruben ^Talk 10:51, 21 September 2006 (UTC)

In line with Wikipedia:WikiProject Drugs/General/Naming of drug pages policy, I have been WP:BOLD and moved Anthralin to the INN Dithranol. David Ruben ^Talk 03:16, 22 September 2006 (UTC)

I just registered in order to continue the conversation I started above without being anonymous. I see three issues: 1) The original statement is incorrect because it implies dithranol is a constituent of anthralin and/or that anthralin is a brand name. Anthralin is the original generic name for 9(10H)-Anthracenone, 1,8-dihydroxy-. 2) You're right - dithranol is not a brand name - I confused it with drithrocreme, which is a brand name. 3) I'm not as familiar with the term "dithranol", because I'm in the U.S. The U.S. National Institutes of Health use "anthralin" as the principal term for the substance, and only lists "dithranol" as a synonym. [See http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202048.html] The U.S. Federal Drug administration does not use the term "dithranol" in any of their drug databases and formularies; only the term "anthralin" is used. I now understand that the term "anthralin" has been superceded by "dithranol" in the UK and the EU, but if you want this page to be understood by readers from the U.S., then you'll make some type of regional distinction. Edv3 04:53, 26 September 2006 (UTC)

Welcome Edv3. I've tidied up the Dithranol article to both make clearer that Anthralin is current USAN, and also eliminate possible double or nested brackets. David Ruben ^Talk 12:47, 26 September 2006 (UTC)

Problems with this article

This article does not describe the the process which generates psoriasis. It concentrates too much on treatments for the disease and their side effects.

The article is taking shape. Most of the concerns raised in the discussions above have been addressed. There is still plenty of scope to tidy up, add further information and references, and to remove superfluous info. Personally I think that the treatment section is too long and reads like a cookbook of therapies. I don't think that the efficacy and side effect need to be stated for each treatment. Especially since the systemic drugs, for example, are linked to other Wikipedia pages. The article should be indepth about psoriasis not about individual therapeutic agents. I don't think the balance is quite right yet.

I suggest a ruthless cull of the individual medicines in the treatment section.

Batrobin 17:40, 11 August 2006 (UTC)

I appreciate the sentiments, but I would not be overly harsh in deleting details of treatment - this article acts also as an overview of treatments (what is used, for which types of psoriasis and pros/cons that affect decisions whether to use or not). What would not be good would be to have this article just mentioning the disease process and merely having a list of linked drug names without any overview as set out above or as currently the case. I think the depth of discussion about various treatmens is about right - however as this is now getting a long article, one approach might be to have a brief summary here that is linked to a separate article of Psoriasis treatment. David Ruben ^Talk 00:27, 14 August 2006 (UTC)

None of the sources sited give evidence that this is an autoimmune disease. Psoriasis is clearly an immune-mediated phenomenon, but there is no evidence that it is an autoimmune disease. There is a difference. Can someone please correct this misinformation? Kldawson (talk) 08:23, 2 June 2011 (UTC)— Preceding unsigned comment added by Kldawson (talk • contribs) 08:14, 2 June 2011 (UTC)

External links

Some editors seem to have an annoying discussion about which external links are actually helpful and which ones are SPAM. I say we reach a consensus here. Further links should be listed here and discussed or may be removed on sight if they look like spam. Sign your name with four tildes ~~~~.--Steven Fruitsmaak (Reply) 18:35, 12 September 2006 (UTC)

The WP:EL guidelines are quite clear and there isn't much to discuss IMO. Web forums are specifically banned (unless the forum is the topic of the article itself) and sites that require registration are also strongly discouraged. The "helpful"ness of a web site (or the organisation behind it) is not relevant to Wikipedia. As per WP:NOT, we are not a directory listing of useful charities and support groups. Google does that job quite adequately, as do other directory projects. So, of the current crop of external links, the only valid entry would be National Psoriasis Foundation since that site contains "neutral and accurate material not already in the article" which can't be incorporated into the article since it "has a level of detail which is inappropriate for the Wikipedia article" (see WP:EL). The EL could be phrased e.g. "The National Psoriasis Foundation have further information for patients and medical providers on their web site". Colin°^Talk 13:00, 25 September 2006 (UTC)

Babycenter.com

Psoriasis Forum for Parents with Children/Babies with Psoriasis

• Remove as SPAM

1. It is NOT a resource, it's a forum.
2. It contains unverified original thought.
3. You are not neutral.
4. It contains lots of advertisement and you need a login to participate.

--Steven Fruitsmaak (Reply) 18:35, 12 September 2006 (UTC)

• Remove as SPAM. This is a highly commercial site with little scientific information. I think linking to it is spam. Please state how you have found it useful or it will be removed. Batrobin 23:40, 13 September 2006 (UTC)
• Remove Agree poor choice of site to list - WP is not a directory listings. David Ruben ^Talk 23:25, 24 September 2006 (UTC)
• Remove per the above. This link to a web forum does not meet the guidelines at WP:EL.-AED 20:39, 25 September 2006 (UTC)
• Pile-on Remove - forum site; fails WP:EL -- MarcoTolo 01:53, 26 September 2006 (UTC)
• Remove as It is NOT a resource, it's a forum. NCurse _work 05:46, 30 September 2006 (UTC)

National Psoriasis Foundation

National Psoriasis Foundation "The National Psoriasis Foundation is the world's largest nonprofit organization dedicated to educating, serving and empowering people with psoriasis and psoriatic arthritis" The web site contains extensive pages of information for patients and medical professionals. It is not a commercial site (it neither buys nor sells goods, is a non-profit organization and is largely funded by donation.)[2]

• Keep As an EL meeting requirements. In particular that it contains "neutral and accurate material not already in the article" which can't be incorporated into the article since it "has a level of detail which is inappropriate for the Wikipedia article". This link was removed by User:167.136.225.247 after I remove one of their links (cause-and-effect not implied per WP:AGF), which is why I won't continue this into an edit war by restoring it. Link may be restored if there is a consensus for it. Personally, I don't mind if all the ELs go – we all have Google. Colin°^Talk 18:42, 25 September 2006 (UTC)
• Keep per Colin, WP:EL, and WP:POINT: Don't disrupt Wikipedia to illustrate a point. -AED 20:43, 25 September 2006 (UTC)
• Keep. Almost a textbook case of an appropriate external link. -- MarcoTolo 01:53, 26 September 2006 (UTC)
• Remove. I found that this site is commercial and makes money by memberships. I am with the above statement about no links. This is a definition website and you either have links or no links. If you want certain links then it is your opinion as to which links are posted just as it will be others that visit this site to put links on. So....I say no links. Otherwise put up all the links. JMO —Preceding unsigned comment added by 71.55.157.16 (talk • contribs) 04:21, 26 September 2006
• Keep. I've done volunteer work for the Foundation, but I'm unfamiliar with the Wikipedia criteria for linking or not linking. For that reason, I wasn't going to participate in this thread. However, the above statement is false and requires correction. A donation of any amount will achieve membership, and the main difference between membership and non-membership online is access to chat and to the Foundation's bi-monthly magazine. All other resources are accessible without a donation, including pdf versions of their printed pamphlets and their peer-reviewed magazine for health care providers. These facts can be easily verified by visiting the web site as a non-member. Edv3 07:20, 26 September 2006 (UTC)
• Remove. I too see that a membership "donation" is REQUIRED to join. Donation or dues...They are getting paid and that is commercial by the definition. I too say all or none for links. If the whopping 5 links can be reposted I woudl agree that http://www.psoriasis.org should go at the top as is does seem to be the best of the links. PS-I also see http://www.psoriasis.org has a forum. I thought wiki did not link to forums as others here say? —Preceding unsigned comment added by 167.136.225.247 (talk • contribs) 13:37, 26 September 2006
• Comment. Those claiming it is "commercial" should consult a dictionary. A non-profit is entitled to raise funds by various means (including selling charity christmas cards, etc). A commercial organisation is in the business of making a profit by means of trading goods or services. There are quite strict rules in most countries as to what is considered commercial and what is non-profit/charity. This is definately non-profit. If they have a forum, then the forum part of the site should not be directly linked to. Ideally, only the "reference" material on the site should be linked to. Unfortunately, I haven't found a better top-level page for such material than the home page. The other sites above have too little reference material IMO. WP:EL does not endorse an all or nothing stance – it is guidance on what to include and what to exclude. I hope those participating in this discussion will accept any consensus that emerges, whilst keeping within policy requirements. Colin°^Talk 12:52, 26 September 2006 (UTC)
• Comment. Membership donation is NOT required to join. You can join as a web only member by just creating an online account with them and get most of the same benefits. While there are considerable resources available to non-members of either flavor. Truly commercial sites don't let you access anything, or only a small teaser sample, until you pay. As to forums - including a forum is not the same as being a forum. It's the content such as disease and treatment overviews, or research updates that you'd be linking to.Malincholia 03:21, 28 September 2006 (UTC)
• Comment. Has anyone else bothered to view this log: http://en.wikipedia.org/w/index.php?title=Special:Contributions&target=167.136.225.247 ? A reverse DNS lookup combined with viewing and carefully reading the four entries spanning September 25 and September 26 in chronological order may explain exactly what's going on here.Edv3 08:17, 28 September 2006 (UTC)
• Keep. NCurse _work 05:46, 30 September 2006 (UTC)
• Remove. It is heavily funded by drug companies, especially those companies involved in the production of biologics. It is not neutral and promotes the use of biologic treatment. Advocacy is not a neutral position. 86.1.203.57 08:45, 30 September 2006 (UTC)
• Comment. I don't care if the article stays or goes. They are non-profit, but require dues. They are helpful for people who know how and puts in the effort navigate their system. But people can google most of this stuff for free on google. I'd reccommend that if the national psorisasis foundation has anything fairly exlucisve to their membership section, that they copy it out to free public forums. If they whine with their lawyers, then they don't deserve to exist as a 'we are here to help' organization.--GreatInca 20:40, 14 February 2007 (UTC)

Need your help

An anonymous IP editor has been inserting banned links to a Yahoo! Groups chat board in several related articles. Links to online discussion groups are not encyclopedic and are banned (item 11) in the external links policy. I have left a note for the anon editor, but I'm not sure it will do any good. If you see these links being reinserted into this article, would you please take them out again? Thanks, WhatamIdoing (talk) 19:05, 15 January 2008 (UTC)

Autoimmune vs Immune-mediated

Psoriasis is not yet defined as an autoimmune disease. This is because it is not known what initiates the immune reactions which occur in psoriasis. If the initiating agent is foreign to the body then psoriasis is not an autoimmune disease - it is simply immune mediated. If the initiating agent is internal (ie part of the body) then psoriasis is an autoimmune disease but it is also immune mediated. Autoimmune diseases are a subset of immune-mediated diseases. Batrobin 07:55, 21 September 2006 (UTC)

Agree immune-mediated. The eMedicine link states "Current research suggests that the inflammatory mechanisms are immune based..." =not that an auto-immune disorder. Whereas the Diseases Database link categorises it as "Autoimmune diseases", but that said I am not sure how fine its category splitting is. Need some dermatologists I think to confirm what majority consensus is amongst physicians. David Ruben ^Talk 23:28, 24 September 2006 (UTC)

I third that.--Steven Fruitsmaak (Reply) 00:10, 25 September 2006 (UTC)

My Merck Manual doesn't make the strong statement about this being an autoimmune disease so I requested a reference. Remark knights (talk) 16:42, 19 October 2009 (UTC)

Why has this not been corrected yet? None of the sources cited give evidence that psoriasis is autoimmune. This is misinformation and should be corrected immediately.Kldawson (talk) 08:24, 2 June 2011 (UTC)

problems with this article, part II

I have to assume that the general public is more likely to use this article for reference rather than a medical doctor--why is the vocabulary so thick? Is it not possible to simplify a little for the rest of us? —The preceding unsigned comment was added by 70.73.80.248 (talk) 02:47, 26 September 2006 UTC.

Yes, that's a problem with dermatology articles in general I think. Point out any specific paragraphs and I'll see what I can do.--Steven Fruitsmaak (Reply) 14:11, 26 September 2006 (UTC)

Positive correlation between psoriasis and myocardial infarction

Interesting article in the Journal of the American Medical Association:

http://jama.ama-assn.org/cgi/content/full/296/14/1735

This is probably worth adding to the article. - FlyingOrca 17:57, 12 October 2006 (UTC)

But be careful with No original research... --Steven Fruitsmaak (Reply) 15:47, 13 October 2006 (UTC)

Um, I might be misunderstanding your caution... would you not consider JAMA a reliable source for citation? As I read WP:NOR, it means that I can't submit my own original non-peer-reviewed research. This is a peer-reviewed medical journal, and I had nothing to do with the research. - FlyingOrca 21:07, 13 October 2006 (UTC)

You're right, I ment this: WP:MEDMOS#General_pointers, although it's not a guideline yet, I think it's a sensible comment. --Steven Fruitsmaak (Reply) 23:26, 13 October 2006 (UTC)

Wikipedia Regulations Applied Capriciously to Psoriasis Page

Have you ever viewed Wikipedia pages for Alcoholism, Cancer, Breast Cancer, or Autism (see direct links for each below)? There is striking and inappropriate editorial discrimination against those who suffer from Psoriasis. You see, each of those pages include many helpful external links, while those who edit the Psoriasis page have imposed a strict ban on any and ALL external links.

One would think that if the National Cancer Institute, John Hopkins University, National Breast Cancer Coalition, and the Center for Autism were allowed links, why wouldn’t the National Psoriasis Foundation, Psoriasis Cure Now and the National Institutes of Health be allowed as external links on Wikipedia’s Psoriasis page?

If Wiki regulations prohibit such useful information for one, then the regulations should apply to all…including the Jimmy Wales page, which links to his own blog! Wikipedia’s board of directors should insist that all external links be eliminated or insist that the above legitimate psoriasis groups’ links be restored.

-DM

http://en.wikipedia.org/wiki/Alcoholism#External_links http://en.wikipedia.org/wiki/Cancer#External_links http://en.wikipedia.org/wiki/Breast_Cancer#External_links http://en.wikipedia.org/wiki/Autism#External_links

http://en.wikipedia.org/wiki/Jimmy_Wales#Further_reading

Useful Links for Psoriasis Patients:
http://www.niams.nih.gov/hi/topics/psoriasis/ffpsoriasis.htm
http://www.psoriasis.org/home/
http://www.psoriasis-cure-now.org/
—The preceding unsigned comment was added by 69.244.99.253 (talk) 14:09, 9 January 2007 (UTC).

I have two thoughts on external links: First, that some of them can be DESCRIBED - for example instead of a link to the psoriasis dating site, a simple sentence could mention that groups exist to facilitate such. Then, the enlightened reader might find his or her own site easily. Second, that if a neutral accredited educational or governmental institution provides a list of links that are found helpful to those with, or interested in, the disease, then those links might be presented along with that bit of explanation. Mydogtrouble (talk) 01:33, 2 November 2009 (UTC)

Phototherapy / Light Treatment works!

Treatment must be continual though despite medicare getting nailed for $150+ per visit. My mother has severe psorisasis with over 50% coverage with infection at it's worse. Light treatment works, though it takes about two or three months (she will get a regression if she burns). Reduces 'severe' to 'mild' basicly. Only problem is that they tend to kick you out once you're cleared up and for my mom, it takes less than a month to regress back to the worst. My mom does not use immunosupressants. --GreatInca 20:36, 14 February 2007 (UTC)

An exploration of psoriasis should be done in comparison to eczema and dermatitis

What is mean by this statement? Is it saying people should read about this other illnesses? Daniel.Cardenas 00:00, 16 March 2007 (UTC)

I've removed the above from the introduction:

• The introduction should be just that, an introduction and summary about this condition, not listing out differential diagnosis of rashes in general.
• Wikipedia does not give medical advice, and so likewise it would not be appropriate to start adding other caveats (eg that this rash is benign, but that the patient should take care to ensure not a non-blanching rash of meningococcal septicaemia)
• If mention has to be made at all, then should be under Diagnosis section, where after discussing that this is made on the appearance, one might mention that often cases without all the classic features may need to be distinguished from other differential diagnoses for the rash of dermatitis/eczema. But I urge caution here, as lichen planus and some other skin disorders are also uncommon differentials (uncommon both that have lower incidence rates, and that psoriasis is less likely to be mistaken for these conditions than dermatitis), and it is not the place of a general encyclopaedia to act as a medical textbook. David Ruben ^Talk 01:42, 16 March 2007 (UTC)

A somewhat related point: I would like to see some commentary about the frequency of childhood eczema being replaced in later life with psoriasis. Both articles mention pseudoceramides as looking useful for both diseases. Jpaulm 17:41, 11 October 2007 (UTC)

Why silvery?

Which are the components found in the scales that make the psoriatic and not the other dermatitis scales appear silvery? Jclerman 13:50, 23 May 2007 (UTC)

Nothing special, as far as I know, but rather it is the rate of skin production that aloow large scales to be formed, rather than the microscopic dust of normal skin with its slower formation rate. Othe rdermatitis are essentially normal skin getting irritated and having a reactive healing response that is somewhat faster than normal skin cell turnover, whereas in psoriasis it is essentially a problem of skin formation that is itself abnormal. David Ruben ^Talk 21:54, 21 July 2007 (UTC)

Ah, it is not mercury. I thought so because it looks also silvery and there are many people which believe that there is a connection between mercury and psoriasis. Many thanks for the answer!

Cause of Psoriasis

Psoriasis is caused by uncontrolled cell division in the stratum basale of the epidermis. —Preceding unsigned comment added by 12.147.134.77 (talk) 14:20, 11 October 2007 (UTC)

Emu oil

It works, I have Psoriasis (Not as much as those on the pics) but it really works great. —Preceding unsigned comment added by 90.185.211.226 (talk) 16:27, 1 November 2007 (UTC)

Hitler & Psoriasis

I googled this and the only hit seems to be this article - I suspect this was a hoax/vandalism... Delete? Jpaulm (talk) 15:05, 13 December 2007 (UTC)

Treatment ladder.png

Very nice-looking image, congrats to the author. I was going to nab it to include in a workshop I'm running on psoriasis when I noticed that corticosteroids was spelt incorrectly! Don't know how easy it would be to fix this but if you could that would be ace! :) —Preceding unsigned comment added by 81.178.218.231 (talk) 16:54, 14 December 2007 (UTC)

I have redone it as an SVG, which means that any text changes you'd like to make in future will be trivial. I think I've fixed the spellings; is it OK now, or is there anything else you'd like changed? Marnanel (talk) 07:08, 16 December 2007 (UTC)

Notable Persons with Psoriasis

The Notable Persons area seems to come and go. It had a fairly good size list and then it was removed at 18:24, 2 January 2007 by 86.1.203.57.

The list returned at 14:05, 30 September 2007 when 71.215.193.139 added Browyn Sherman... but who is this person? I have removed Browyn Sherman unless her notability is substantiated.

I have also removed Robert Bunn III -- there seems to be zero substantiation that he's an Olympic medalist.

I can't substantiate Ben Franklin, but all the others have references substantiating their psoriasis.

When the list was removed on 2 January 2007, the reason given was "unverified trivia." I agree, there should be citations, but it seems there's a desire also to put a debilitating disease into a human context.

I don't think this section is necessary. -RiverHockey (talk) 20:01, 9 June 2008 (UTC)

I think it's quite nice for psoriasis sufferers (who will make a substantial proportion of the visitors to this page) to see that they're not alone (see the stuff about self-esteem) but I do think that every example should have a good citation almost-instinct 21:58, 9 June 2008 (UTC)

This section is not necessary and should be removed. Wikipedia is not here to comfort people, it is here to provide encyclopedic information. Would you expect to see a list like this in any other encyclopedia? Of course not. Kaldari (talk) 00:35, 24 July 2008 (UTC)

By definition, there are lot of things you'll see in Wikipedia that you would not expect in any other encyclopedia -- the form itself allows a level of information and connectivity not possible in a normal encylopedia. We are not to avoid things that could never have been done before. We are to be bold. As long as the information is true, beneficial, and straightforward we should include it. 842U (talk) 19:20, 27 January 2009 (UTC)

The Vitiligo page has a list of notable cases, so I don't see why this article shouldn't. This article is meant to provide information and that's what a list of notable cases is. In fact, that's the reason I came to this article in the first place - to try to find a list of people with psoriasis. Evernut (talk) 14:55, 28 June 2011 (UTC)

Treatment with topical macrolide immunosuppressants

The use of treatments such as Protopic (tacrolimus) and Elidel (Pimecrolimus) should be mentioned in the article. 69.115.223.105 (talk) 17:52, 8 January 2008 (UTC)

Removing format breakign images

There were "example" images that broke the formating i removed them. however it may need some clean up. —Preceding unsigned comment added by 206.75.33.118 (talk) 04:18, 17 January 2008 (UTC)

Throw-away sentence in introduction

"Individuals with psoriasis may suffer from depression and loss of self-esteem." The same is true for individuals with blue eyes. Also, this sentence and the sentence that follows it are identical to a sentence in the third paragraph of http://www.ndri.com/news/severity_of_psoriasis_depends_on_household_income_quality_of_life-201.html

I suggest making the sentence more specific (... suffer from ... at a higher rate) with a citation such as http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B75J2-4GX1583-H&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=00f8bf28af22d6a2fc8fe61301f1b32f) WeigelRS (talk) 03:45, 4 March 2008 (UTC)

Be bold. You can make that edit yourself. If you're not sure how to format the reference, I'll be glad to help you. --Tkynerd (talk) 04:16, 4 March 2008 (UTC)

question

how does psoriasis affect the patient's ability to get tattoos? —Preceding unsigned comment added by 76.125.103.253 (talk) 12:53, 6 March 2008 (UTC)

red scaly patches

I know it reads "common," but wouldn't the color depend on the person's skin color? I have very dark skin; the patches I get (which may or may not be psoriasis, I haven't been diagnosed) have no distinguishing color (just dry patches), or they are darker brown-black. NBK1122 (talk) 00:53, 1 April 2008 (UTC)

Unreferenced claim

I removed this from the main page: Almost-instinct 18:02, 1 June 2008 (UTC)

CURE

Follow these steps and cure is guaranteed. Psoriasis will never come back. You need lot of self control for this though. Here we go without any waste of time ...

1. No Gluten ...No breads....No wheat ,rye ,Barley 2. No Processed Foods...No Cereals,Soft Drinks,Biscuits,Croissants,any packed food is to be avoided completely. 3. Avoid Citric Acid ,Acetic Acid and Food Acid E300 and E330 4. Avoid Citrus Fruits....Oranges ,Lemons etc... 5. Eat Organic ...Natural ....Chicken and Fish in Meats only 6. No Red Meat, Pork 7. No Dairy and No sugar...Use Honey instead.

Follow this diet for 3 months and a 90% clearance is guaranteed. Trust my word. You will not regret and I am not charging you anything for this information !!!!!

Good Luck

There is no cure for psoriasis, you're mistaken. Certainly, behaviors can mitigate and lessen the symptoms, but that is not a cure. There is also only questionable credibility to your examples which may have worked for YOU, but may not work for others. Saffloped (talk) 19:50, 9 September 2011 (UTC)

Psoriatic arthritis

This article states "Ten to fifteen percent of people with psoriasis have psoriatic arthritis." yet the article for psoriatic arthritis states that it "affects around 5-7% of people suffering from the chronic skin condition psoriasis." 99.245.224.80 (talk) 16:40, 3 August 2008 (UTC)

I could not find the "ten to fifteen percent" in the source cited below (EMA guideline). A new source for this information would be helpful. —Preceding unsigned comment added by 160.62.4.10 (talk) 06:59, 15 April 2010 (UTC)

Herbal Cure

Quoted From "The Cure For All Diseases" by Hulda Clark, PH.D., N.D.Reprint 2006 "Psoriasis and eczema are both caused by Ascaris. Their molting chemicals are quite allergenic; perhaps it is these that are affecting the skin. Since pets pick these worms up daily, there is chronic reinfection in families with pets. Herbal Parasite Programe- Balckwalnut Tincture, Wormwood, Cloves. Take over a 18 day period as prescribed by Herbalist/ Naturpath. Put in place a Maintainance Parasite Programe. 29/8/08Raefon72 (talk) 21:49, 28 August 2008 (UTC)

"perhaps"? (it is Ascaris). This "cure" needs a randomized, controlled, double-blind cross-over study. 142.59.225.155 (talk) 23:50, 12 April 2012 (UTC)

How can i be affected more?

I am a fourteen year old girl and i have had psoriasis for as long as i can remember. I have only recently been diagnosed(about 3 years ago). I am doing extremely better but i am very worried about what could happen to me. I talked to a woman who had to shave her head due to psoriasis and i am afraid of that happening to me. i have low self-confidence and think i may have depression. i honestly just need a couple answers. 1. Can i suddenly get joint pains and get severly worse? 2. Does depression caused from psoriasis cause neck pains or joint pains? 3. How do u know when to see a doctor? —Preceding unsigned comment added by Krings (talk • contribs) 02:36, 12 December 2008 (UTC)

Well, the answer to 3) is easy: see a doctor if you want medical advice. Don't ask on Wikipedia because nobody here is allowed to give medical advice. Ask on WP:RD if you want to know anything else; talk pages aren't a place to ask for any kind of advice other than advice on improving the article. The Wednesday Island (talk) 03:36, 12 December 2008 (UTC)

Epidemiology

It could be useful to include major genetic loci associated with the disease (HLA, LCE3B, LCE3C) along with the following links: [3] [4] (e.g. emre) 16:07, 30 January 2009 (UTC) —Preceding unsigned comment added by Emreg00 (talk • contribs)

Book of eugenics

The book Heredity in Relation to Eugenics tells on pages 133 and 134 :"b. Psoriasis (itch). — The question of the inherit ability of this disease has been much discussed. Some declare it is due to infection, others deny it. Various experiments have been tried. Schamberg (1908) performed auto-inoculation in 23 cases and got a positive result in only 3. Inoculation into normal human subjects — usually the experunenter's own body — have produced the disease in only one case (that of Dr. Destot). On the other hand in about a third of the cases observed by various physicians psoriasis was recognized as a family disease. The most reasonable explana- tion is that the disease is due to a parasite to which most persons are immune; and that lack of immunity is an inheritable trait."Agre22 (talk) 00:39, 22 April 2009 (UTC)agre22

And....?Fuzbaby (talk) 19:23, 21 June 2009 (UTC)

216.70.22.249 (talk) 21:32, 18 April 2012 (UTC) Reading wiki psorasis no new info as to cause. I think the above may be correct. I suggest it is a scabies result that occurs when the individual is particularly exhausted or compromised or a familial lack of immunity. It may even be the original scabies infection that goes dormant only to reoccur in the altered version. The identification of the beginning would be informative as suggested above. Medical science seems not have much interest in the solution.

Pediatric Psoriasis

I am interested in adding a section on pediatric psoriasis. I will be using peer-reviewed journal articles to support the new information I add. I'm new at this and am working slowly through the formatting, with exercise at the sandbox, but will welcome any help with formatting and such as I add information. Thanks, Martinla (talk) 13:23, 13 July 2009 (UTC)martinla

Remove the random reference to Zithranol-RR?

If you notice under the treatment section, Zithranol-RR is given as *the* example of a topical cream. That's not exactly the best example of a topical psoriasis treatment--it's far from common, and so the example seems kind of random. Furthermore, that line reads like a PR firm's description of the drug. Also, the IP address that added this line (see [5]) seems mostly to have done most of his/her contributions to the page about the company that makes the drug ([6]), which makes me suspect sock-puppeting, or whatever it's called when a representative of a company tries to improve its image through putting positive reference in articles. I'd delete the line myself, but I first wanted to make sure I'm not missing something obvious....

Iamringo87 (talk) 21:52, 2 December 2009 (UTC)

K, I'm removing it.

Iamringo87 (talk) 07:28, 5 December 2009 (UTC)

Sea water

Some bright spark removed my comments about (sun and) sea water - while there may be no official research addressing this, it's the only thing that works reliably and predictably for me - every d**n time I go to the Caribbean! I grant that, if there is an active ingredient in sea water, it's going to be hard to find, as there are many different chemicals in sea water, and tens of thousands of different species of bacteria and viruses. And, yes, I know that experiments with salt water alone didn't work. The locals differentiate between "live water" and "dead water" (water which has been covered for several hours), which suggests that some living organism is involved. I said all this in my comments which were removed. IMO, this deserves more than a throwaway comment about historical treatments, next to urine and goose oil, and is probably more accessible for most people than doctor fish in Turkey. Jpaulm (talk) 14:24, 18 April 2010 (UTC)

Hi my name is Jason over the past 20 years i`v had psoriasis i`v tryed lots of things to help reduce the affects of psoriasis.over the last 5 years i`v been using chinese medicine through a qualifide practitioner but very expensive.i`v recently moved on to fish oil can you please tell me if its worth continueing and approximatly whats the recomended amount to have.very big Thankyou.

Sorry, maybe I wasn't clear - the sea water is taken externally, not internally. Wish I could help - I also take flax oil and Omega-3 regularly (for general health, I think), but it doesn't seem to have much effect on the psoriasis. All the best. Jpaulm (talk) 00:44, 2 May 2010 (UTC)

"there may be no official research addressing this" - I think you've just answered your own question as to why it's been removed. Saffloped (talk) 19:46, 9 September 2011 (UTC)

Psoriasis

I have noticed miracle improvement in psoriasis and arthritis when shifted at Jakarta,Indonesia from India without any special medicines.During my two year stay at Jakarta,there was no symptoms of these diseases.But when i came back to india,again Psoriasis reoccure without arthirits.I expect this was only due to climate,type of underground water which were used by me at Jakarta.If somebody have any experince or know the reasons to cure the same,may describe here.Thanks —Preceding unsigned comment added by 202.151.195.57 (talk) 12:54, 27 June 2010 (UTC)

Thanks for your interest. Have a look at Wikipedia's guidelines and Help pages. You will see that these Talk pages are for discussing how to improve the article, and not really for discussing the topic itself. A basic Wikipedia principle is that no original research is allowed here. All information in the article must be supported by reputable published sources. Also no Wikipedia editor is allowed to give medical advice. For that you need to talk to qualified medical practitioners. To discuss your ideas with people who have similar experience to you, you may be able to find a local support group, or online forums. -- Bricaniwi (talk) 09:04, 11 August 2010 (UTC)

Not always a skin disease

The article states that psoriasis may never present on the skin (true) and then goes on to describe the disease as if this is always a symptom. Many people, myself included, have psoriatic arthritis and other symptoms and have never presented with any skin problems related to psoriasis. I think the entire article is written assuming everyone has skin symptoms and it misleads people who have no skin symptoms into thinking they must not have the disease. —Preceding unsigned comment added by 174.51.53.147 (talk) 03:59, 5 August 2010 (UTC)

Psiriosis

The main article uses the term "Plaque Psiriosis" in the 2nd para: is there such a thing? MedicineNet doesn't list it... Jpaulm (talk) 01:31, 13 October 2010 (UTC)

This seems to be a simple spelling error; should be Psoriasis. I'll change it. Haploidavey (talk) 17:30, 16 October 2010 (UTC)

Thanks! But the odd thing is that there is a web site called psiriosis.com! I haven't dared to open it :-) Jpaulm (talk) 14:34, 17 October 2010 (UTC)

Hm. Perhaps best left unopened. My anti-virus marks the site as "untested". You might get more than you want... Haploidavey (talk) 14:41, 17 October 2010 (UTC)

sorises

can we treat so-rises with stem cells therapy —Preceding unsigned comment added by 123.237.87.107 (talk) 10:58, 21 October 2010 (UTC)

Statement

I am dedicating my time and experience to help others cure psoriasis threw a simple healthy diet. I did it! and so can anybody.

the true fact and cause of this skin disorder was discovered via extensive private research by Yosi Baron. the material is published also by various online sites that focus on natural healing so it is not a new phenomenon.

the cause of Psoriasis is due to access of toxins in the liver, since the toxin stay in the blood stream the body tries to shoot it out threw the skin. and that's what we get-this itchy reaction. it is also considered to be an auto immune disease because the body attacks that body.

overall it reflects a weak immune system.

my Psoriasis was curable and my diet of mostly raw and healthy foods proved to be effective. hope to publish and advocate more details in the close future about identifying nutrition foods and avoiding processed foods. —Preceding unsigned comment added by 70.107.229.87 (talk) 20:07, 1 February 2011 (UTC)

We can't and won't build article content on blog-links, or material that hasn't been published in peer-reviewed, reputable sources, or material based on personal opinion, anecdote or untested research. I know you mean well, and happen to agree that auto-immune responses are involved in some psoriases. However, this is not the place to discuss such issues. Nor is it a news-spot or a "how to" guide. I wish you luck with your plans to publish. Haploidavey (talk) 20:49, 1 February 2011 (UTC)

Your link connects to a site with virtually no content. It's unlikely to prove useful in developing this article (see the talk-page notice above), so I've removed it. Haploidavey (talk) 20:55, 1 February 2011 (UTC)

Contradiction clarification

Under the heading "Cause" the last paragraph opens with the statement, "Psoriasis occurs more likely in dry skin than oily or well-moisturized skin". The final two sentences of the same paragraph are as follows, "It is recommended to use talc powder after washing, as that helps absorb excess moisture which would otherwise go to the infecting agent. Additionally, moisturizers can be applied to moisturize the skin, and lotions used to promote skin oil gland functions". This is/seems contradictory - it is more prevalent in dry skin but one should use talcum powder to absorb moisture but simultaneously moisturise. Earlier in the article under the heading "Other" it states, "It occurs in skin folds, particularly around the genitals (between the thigh and groin), the armpits, under an overweight abdomen (panniculus), and under the breasts (inframammary fold). It is aggravated by friction and sweat, and is vulnerable to fungal infections." So now it is moist skin causing the problem!

This is not all helpful to those seaking advice. — Preceding unsigned comment added by Michaelfinisar (talk • contribs) 11:43, 10 March 2011 (UTC)

I don't think it contradictory; but it does need careful reading. As sweat contains water, it's "moist", of course; but it's also chemically complex and a potential irritant. "Moisturisers" are emulsions ("creams") of oil and pure water. Talc absorbs more or less anything, indiscriminately; oil, water or sweat; and of course it can't moisturise. So "moisturisers" restore the skin's natural, healthy oil-water balance - and this reduces ingress of irritants (including sweat). By the way, the article is meant to be strictly informative and descriptive; it doesn't and shouldn't offer advice. Haploidavey (talk) 15:20, 10 March 2011 (UTC)

Hi, Please anyone can tell me what type does the patient in the photo (in the article) have? thank you 13 june 2011 — Preceding unsigned comment added by 132.72.88.184 (talk) 09:29, 13 June 2011 (UTC)

Does Leif Garrett have this?

You see, I watched the season of Celebrity Rehab he was on and I couldn't help noticing that he had a skin condition of some sort. He had one or two powdery white patches on his face near his chin and a smooth pink patch on his neck. I didn't notice it on Smoking Gun Presents: World's Dumbest..., but after Celebrity Rehab I took a closer look and there it was. I ruled out vitiligo because of the pink patch, but since I don't know a lot about skin diseases, I'm stumped. I know that he was in a car accident years ago (though I thought they said that it was only his friend who got harmed), and that drug use can damage tissue, so maybe it's a result of that. I apologize if I'm wasting anyone's time, but if anyone could straighten out this mystery for me, I'd be thankful. Evernut (talk) 15:12, 28 June 2011 (UTC)

I just wanted to make it clear that I'm not making fun of Leif nor am I trying to make a big deal about whatever it is he has. I know it's really none of my business. I'm just curious. My late father had psoriasis, so I have more interest in psoriasis cases than the average person. Evernut (talk) 20:23, 28 June 2011 (UTC)

Motion to remove statement and citation for hypotherapy as a treatment for psoriasis

While many autoimmune disease are closely associated with stress levels, and hypotherapy can be effective in reducing such stress, I think it's important to use evidence based litertuare for statements about the effectiveness of certain therapies. I read the cited article and raise a few objections. First off, the article itself contains no original research, it can't even be called a meta-analysis. Specifically, the articles cited regarding psoriasis are only case studies. Because the plural of anecdote is anecdotes, not evidence, they are unable to produce a measure of statistical significance (p-value or confidence interval). In fact, conclusions based on case reports are rarely, if ever, correct due to selection bias. If there is no objection, I will remove the line and citation which I believe to be errant. Saffloped (talk) 16:43, 7 September 2011 (UTC)

About antibiotic efficacy in the treatment of Psoriasis and the streptococcal cause of the condition

Though a quick search I have found hindu.com article and health-time.org comments

While neither of these pages are reliable enough to change the article, someone more knowledgeable than me might find more evidence about the efficacy long term penicillin and generic antibiotic treatments have on the condition. I have searched more and i can't see anyone denying antibiotic treatments are effective. If the efficacy is confirmed, this would also give credit to streptococcal infection as cause for the condition (in more than one form). A mention of long term antibiotic treatments in the "alternative therapy" section could at least help popularize the idea enough to debunk it, as many people who discover the condition will probably refer to this page first before seeking medical advice. Those kinds of antibiotic doses are prescription-only anyway, so a doctor's approval would be necessary before engaging in them. — Preceding unsigned comment added by Ayreos (talk • contribs) 11:29, 2 April 2012 (UTC)

Genetics

This recent edit added

Recently the first gene directly linked to psoriasis has been identified. Studies conducted at University of Washington school of medicine by Anne Bowcock, PhD, have suggested that a rare mutation in the gene encoding for the CARD14 protein plus an environmental trigger was enough to cause plaque psoriasis (the most common form of psoriasis).

to the genetics section.

The two papers it refers to are

• Jordan CT, Cao L, Roberson EDO et al. "Rare and common variants in CARD14, encoding an epidermal regulator of NF-kappaB, in psoriasis." The American Journal of Human Genetics. April 19 2012. doi:10.1016/j.ajhg.2012.03.013.

• Jordan CT, Cao L, Roberson EDO et al. "PSORS2 is due to mutations in CARD14." The American Journal of Human Genetics. April 19 2012. doi:10.1016/j.ajhg.2012.03.012.

I've added these citations to the article. Does anybody think it's too early for this? The studies were online 19/4/12 but their official publication date is 4/5/12 (according to my porous memory). I can't find any expert commentary; we may have to wait until the publication date to read the journal's editorial commentary, if there is to be any. It has appeared in a couple of popular press articles. --Anthonyhcole (talk) 13:10, 20 April 2012 (UTC)

my husband

my husband has been having puva treatment he now has been told there is something else there y would he need to have a skin biopsy — Preceding unsigned comment added by 81.151.229.64 (talk) 09:19, 27 February 2013 (UTC)

First sentence

• First sentence: "Psoriasis is an immune-mediated disease that affects the skin."
• From the second paragraph: "Some patients, though, have no dermatological signs or symptoms"

Could we do better with opening sentence? Something along the lines of "...most freqently affecting the skin, but also...." Thanks, almost-instinct 22:26, 18 March 2013 (UTC)

Oral plaque caused by psoriasis

Wikipedia cannot provide medical advice
The following discussion has been closed. Please do not modify it.
I have a whitish/yellow scum which forms in my mouth. I also have psoriasis and psoriatic arthritis. This scum flakes and goes down my throat causing me to cough and choke. My doctor diagnosed me with dry mouth caused by medication. I am off that medication and the scum is just as bad if not worse than it was. I was given Biotene Mounthwash and toothpaste to use, but it doesn't help and my mouth is no longer dry. Do you think it could be caused by the psoriasis? Is there anything I can do to cure it because it is so bad when I lay down that I can't stop the coughing and it makes me feel like I am going to throw up. I hate it!! Please help me anyone??? thanks — Preceding unsigned comment added by 70.29.10.141 (talk) 01:19, 20 June 2013 (UTC)

Shark Cartilage

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004377/#B32 This NIH article uses a Dupont study which examined the use of shark cartilage in treating psoriasis. Here is the Dupont study; should this be added to the article? Dupont É, Savard PE, Jourdain C, et al. Antiangiogenic properties of a novel shark cartilage extract: potential role in the treatment of psoriasis. Journal of Cutaneous Medicine and Surgery. 1998;2(3):146–152. [PubMed] CensoredScribe (talk) 15:23, 14 August 2013 (UTC)

The article wasn't by the NIH, it was just indexed by them—a rather different kettle of fish, but a common mistake. The authors work for a private company which sells shark cartilage products. Here's a direct link to the abstract in PubMed.

The publication is in a low-impact journal (current impact factor is hovering at just less than 1.0), is 15 years old, is a primary study mostly focusing on an animal model of angiogenesis, contains limited clinical data, and uses a model that only loosely approximates aspects of psoriasis. The finding tying the result to psoriasis is described in the abstract as "Anecdotal data suggested that topical AE -941 had a beneficial effect in psoriasis."...which is pretty thin gruel.

So it fails WP:MEDRS on a bunch of different red flags, and isn't suitable for inclusion. TenOfAllTrades(talk) 15:55, 14 August 2013 (UTC)

Kardashians

I thought we dropped a whole bunch of notables with P a few years ago - are celebrities more special?! Just wondering! Jpaulm (talk) 02:41, 12 November 2013 (UTC)

Gluten-free diet

I have just removed a recently-added sentence ([7]) about the possible benefits of a gluten-free diet, based on a single 2003 study: http://www.ncbi.nlm.nih.gov/pubmed/14690336.

While interesting, the study's findings are certainly old enough – 10 years – that they should be covered by relevant review articles (and bolstered by replications) if important and genuine. (From a technical perspective, this study did not have a control/sham/untreated arm, involved a modest number of patients, and appeared in a low-to-middling impact journal.)

If there are newer, better sources on this aspect of psoriasis treatment, they should be evaluated against our usual standards (WP:MEDRS) for inclusion in our article. TenOfAllTrades(talk) 22:22, 18 November 2013 (UTC)

MCOTM

This article is MCOTM. Given its current quality, we might actually be able to get it ready for GA candidacy. The following improvements could be made:

• Remove all content that cannot be sourced to WP:MEDRS-compatible sources.
• Merge "Classification" into "Signs and symptoms", perhaps with a table that compares the various subtypes of psoriasis. Try to get rid of bullet-point lists.
• The "Diagnosis" section is rather brief, and some content from "Signs and symptoms" and "Pathophysiology" might benefit from being moved to this section.
• The "Alternative therapy" section may need trimming, depending on whether we can find good sources for some modalities discussed.
• The "Research" section has to be trimmed.
• The "In children" section should be merged with "Signs and symptoms" and/or "Epidemiology".

I will try to remain involved as much as I can. JFW | T@lk 14:56, 3 December 2013 (UTC)

We should follow the MEDMOS:

• Classification
• Signs and symptoms
• Causes
• Pathophysiology
• Diagnosis
• Prevention
• Treatment
• Prognosis
• Epidemiology
• History
• Society and culture
• Research directions
• Other animals

• Started MEDRS sweep... need to replace many sources here I suspect.
• Although most content in current classification section could be merged to signs and symptoms, I would prefer to retain a clear, brief classification section.
• Started to expand diagnosis section with DDx list from a textbook
• Merged "In children" section. Lesion (talk) 14:53, 7 December 2013 (UTC)

Absence of skin disease

From the lead section, paragraph 2: "Some patients, though, have no dermatological signs or symptoms." Is this really true? The opening sentence states that psoriasis is a skin disease. Certainly it is possible to have associated conditions such as psoriatic arthropathy without any skin disease, but I question whether it is accurate to say that those patients have psoriasis. Axl ¤ [Talk] 21:20, 3 December 2013 (UTC)

Is the content sourced? Lesion (talk) 08:48, 7 December 2013 (UTC)

I put a cn tag on, but agree it probably should go. Lesion (talk) 14:26, 7 December 2013 (UTC)

Stub pages for merging?

Should we merge these 1-2 sentence stubs?

• Psoriatic erythroderma
• Pustulosis palmaris et plantaris
• Annular pustular psoriasis
• Dermatitis repens
• Impetigo herpetiformis
• Drug-induced psoriasis
• Inverse psoriasis
• Napkin psoriasis
• Seborrheic-like psoriasis

The following psoriasis sub-types/related conditions have at least 1 paragraph and I think should stay as stand alone articles:

• Generalized pustular psoriasis
• Guttate psoriasis
• Psoriatic nails
• Psoriatic arthritis

Thoughts? Lesion (talk) 08:40, 7 December 2013 (UTC)

References clean up

1. Johnson, Mary Ann N.; Armstrong, April W. (2012). "Clinical and Histologic Diagnostic Guidelines for Psoriasis: A Critical Review". Clinical Reviews in Allergy & Immunology 44 (2): 166–72. doi:10.1007/s12016-012-8305-3. OK
2. Jobling, R. (2007). "Psoriasis". BMJ 334 (7600): 953–4. doi:10.1136/bmj.39184.615150.802. PMC 1865393. PMID 17478850. Reputable journal, however appears to be a "patient view", a personal account of the condition form someone who suffers from it. Supports "There is currently no cure, but various treatments can help to control the symptoms." I am sure we can find another source for that.
3. "Learn: About psoriasis". National Psoriasis Foundation. Charity website, used to support: "It is not contagious". Prefer to find another source.  Done
4. "Psoriasis Linked to Stroke Risk". BBC. 28 August 2011 BBC press. Prefer a better source for statement about stroke association
5. Ghazizadeh, Ramin; Tosa, Mamiko; Ghazizadeh, Mohammad (2011). "Clinical Improvement in Psoriasis with Treatment of Associated Hyperlipidemia". The American Journal of the Medical Sciences 341 (5): 394–8. doi:10.1097/MAJ.0b013e3181ff8eeb. PMID 21233693. OK, appears to be a review from abstract
6. "University of California, Davis, Department of Dermatology. "Psoriasis". Retrieved 22 April 2013. A US hospital website (?). Used to support "There are five types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic Prefer to find another source for this
7. ^ Committee for Medicinal Products for Human Use (CHMP) (18 November 2004). "Guideline on Clinical Investigation of Medicinal Products indicated for the treatment of Psoriasis" (PDF). European Medicines Agency. OK, used to support psoriatic arthritis incidence. ideally use another source  Done
8. Statistics. Psoriasis.org. Retrieved on 2013-06-08. Same charity website as above. Used to support psoriatic arthritis incidence. Prefer another source  Done
9. Cox, Neil; White, Gary (2000). Diseases of the skin: a color atlas and text. St. Louis: Mosby. ISBN 0-7234-3155-8 OK, but MEDDATE. There is a second edition if anyone has access
10. Zhou, Qiang; Mrowietz, Ulrich; Rostami-Yazdi, Martin (2009). "Oxidative stress in the pathogenesis of psoriasis". Free Radical Biology and Medicine 47 (7): 891–905. doi:10.1016/j.freeradbiomed.2009.06.033. PMID 19577640. Review, OK

Comments

1. There is still lots of unreffed text in the mechanisms section.

•  Done This should be better now.

1. Some refs are not properly formatted.

•  Done This should be better now. Please let me know if you find any in particular that are improperly formatted that I may have missed. TylerDurden8823 (talk) 08:57, 22 February 2014 (UTC)

1. Lists should be turned into prose. The signs and symptoms section needs expanding.

•  Done Lists are now prose. Working on the signs/symptoms. TylerDurden8823 (talk) 06:03, 24 February 2014 (UTC)

1. How many people have the condition globally?

Isn't that covered by the 2-4% of the population figure? Do we really need to convert that to an exact number in the millions? I'll see if I can find an exact figure, but that's pretty specific. According to the International Federation of Psoriasis Associations, the figure is 125 million people. I think the figure is an estimate from 2013. I'm not certain if this website would meet WP:MEDRS though, so that's something else to consider. The 125 million figure seems to be pretty consistent with the 2-4% figure quoted in peer-reviewed journal articles. http://www.ifpa-pso.org/web/page.aspx?refid=10TylerDurden8823 (talk) 08:59, 22 February 2014 (UTC)

Maybe James meant does the prevalence vary according to geographic location. Is there more psoriasis in "developed countries" for instance. Lesion (talk) 13:45, 24 February 2014 (UTC)

1. Some of the language is in need of simplification.Doc James (talk · contribs · email) (if I write on your page reply on mine) 17:23, 20 February 2014 (UTC)

Any particular sections you had in mind? I'll comb through the article and try to simplify where I can. TylerDurden8823 (talk) 08:59, 22 February 2014 (UTC)

•  Done This should be better now.

1. TylerDurden8823, not sure if you also had a look through the original references to check they were suitable. I started to do this above, but gave up. From the looks of things there were a lot of issues in the original refs. Lesion (talk) 20:41, 20 February 2014 (UTC)

I'll work on fixing the refs that are improperly formatted and find the answers to the global prevalence question and add that into the epidemiology section if I can find it. I'll start working on that tomorrow since I'm busy today. TylerDurden8823 (talk) 01:23, 21 February 2014 (UTC)

Oh, and Lesion, yes, I did look through the original references to check if they were suitable. I replaced many of them as they were quite old, primary, or I simply found a better source to verify the same information. Jmh is right though that I haven't finished formatting the references from previous editors since some of them are improperly formatted as he mentioned. TylerDurden8823 (talk) 01:25, 21 February 2014 (UTC)

Looking again I see something from emedicine and that can probably be better sourced. I'll fix that. TylerDurden8823 (talk) 20:23, 21 February 2014 (UTC)

GA Review

This review is transcluded from Talk:Psoriasis/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Jfdwolff (talk · contribs) 21:10, 24 February 2014 (UTC)

I will do the GA review to make good on my promise to help out here. It might be a slightly slow process (1-2 sections/day) depending on my timetable. JFW | T@lk 21:10, 24 February 2014 (UTC)

No problem, take your time. Thank you for doing this by the way. TylerDurden8823 (talk) 01:05, 25 February 2014 (UTC)

Generally I am very impressed by the selection of the sources, which are practically all of MEDRS standards. JFW | T@lk 15:45, 26 February 2014 (UTC)

Great, I'll work on all of this in the next few days and after that we can reevaluate the article for GA. TylerDurden8823 (talk) 18:51, 28 February 2014 (UTC)

• Hi Jfdwolff, although I've seen your handiwork in many places, I don't believe we've had the opportunity to interact before; so, greetings! I've offered to help out with this GAN of psoriasis, and will attempt to address your concerns in the signs & symptoms, causes, mechanism & diagnosis sections. --LT910001 (talk) 01:57, 2 March 2014 (UTC)
  • Great, the more the merrier! JFW | T@lk 10:38, 2 March 2014 (UTC)
  • Tyler has respectfully reminded me that everything is ready. I will try to complete my final review before Sunday night, but I can't guarantee anything due to meatspace obligations. JFW | T@lk 21:51, 15 March 2014 (UTC)

TylerDurden8823 and LT910001, I have checked the points from my review, and only two items still require action (marked {{not done-t}}). Everything else looks fantastic and we're very close to GA. Hopefully these last points can be addressed with relative ease.

I plan to have a final readthrough for flow and style in the next 24h. I will spend a few minutes on "mechanism". JFW | [[User_talk:JfdwolffT@lk]] 13:33, 16 March 2014 (UTC)

Ready when you are. TylerDurden8823 (talk) 21:08, 16 March 2014 (UTC)

 Passed! Great work! JFW | T@lk 16:35, 17 March 2014 (UTC)

I am not sure whether the "classification" section is useful. I know WP:MEDMOS expects this, but I personally find that you need to introduce a lot of technical concepts to make these sections understandable. The ICD-10 codes are a bit of a distraction, and I wonder whether they might be better off in a table. JFW | T@lk 11:41, 2 March 2014 (UTC)

Please take another look at the Classification section and let me know if the table I put there is more like what you had in mind. TylerDurden8823 (talk) 20:23, 3 March 2014 (UTC)

That is much better. There is still the option of moving the ICD-10 table to the right margin. JFW | T@lk 21:51, 15 March 2014 (UTC)

Introduction

My comments on the introduction: JFW | T@lk 15:03, 26 February 2014 (UTC)

• Is there a stronger etymological source in any of the publications? The Online Etymology Dictionary isn't bad, but a stronger source would be ideal.

 Done-Replaced it with a book source. TylerDurden8823 (talk) 07:09, 2 March 2014 (UTC)

•  Done Same question about the five types: is the web page cited the only source for this?

These are discussed in more depth later in the article and have much better sourcing in that section. Is that sufficient? Or do we need better sourcing for it in the lead as well since it's discussed more later in the article? TylerDurden8823 (talk) 01:38, 2 March 2014 (UTC)

You're correct that the intro does not need separate referencing. There's the option of removing it altogether. JFW | T@lk 13:33, 16 March 2014 (UTC)

• Not all of the sections of the article are represented in the introduction (e.g. "Prognosis", "History" and "Research").

 Done Basically done-not quite sure how to work the history part in there, but the prognosis and research parts are now represented. TylerDurden8823 (talk) 22:01, 3 March 2014 (UTC)

• The sentence "The disorder is a chronic, recurring condition that varies in severity from minor localized patches to complete body coverage" seems out of place and repeats points made elsewhere in the introduction. I would suggest moving it upwards.
  •  Done This should be better now. TylerDurden8823 (talk) 02:22, 2 March 2014 (UTC)
• I'm not sure if rebound effect of steroids is common enough to warrant discussing in the introduction.
  •  Done This should be better now. TylerDurden8823 (talk) 02:22, 2 March 2014 (UTC)

Signs and symptoms

My comments on this section: JFW | T@lk 15:03, 26 February 2014 (UTC)

• The table is useful in some ways, but for skin conditions it might be appropriate to describe the lesions in prose.
  •  Done Agree. --LT910001 (talk) 01:57, 2 March 2014 (UTC)
•  Done It might be appropriate to describe the different recognised subtypes of psoriatic arthritis (there's four).

Wouldn't that be more appropriate on the psoriatic arthritis page? They do have a discussion of psoriatic arthritis subtypes there and if we do it here as well, we run the risk of redundancy. TylerDurden8823 (talk) 22:09, 3 March 2014 (UTC)

• The "gallery" makes it possible to squeeze a number of images in a small space, which is great for the purposes of the article. I do wonder if one of them should be brought to the side and made slightly larger as a "close-up".
  •  Done Agree. --LT910001 (talk) 01:57, 2 March 2014 (UTC)

Causes

My comments on this section: JFW | T@lk 15:03, 26 February 2014 (UTC)

• The section should ideally be divided in discussion about possible underlying causes of the condition (and I would place "Genetics" before "HIV") and triggering/provoking factors.

 Done Partially done-switched order of genetics and HIV sections so far. Regarding dividing it into cause and triggering/provoking factors, wouldn't we say that the mechanism section is really what discusses the cause (which isn't fully understood)? We might consider renaming the mechanism section as causes and the current causes section as triggers or exacerbating factors or something to that effect. TylerDurden8823 (talk) 02:02, 2 March 2014 (UTC)

• The discussion about pathogenesis in HIV is quite technical, and may need a little bit more elaboration or explanatory terms.

 Done I think it's better now. Have another look when you're ready. TylerDurden8823 (talk) 02:16, 2 March 2014 (UTC)

• I don't know if the sources are clear on this, but are the medications listed considered "cause" or "trigger"? In other words, are they a sine qua non for the development of psoriasis or are they just one of numerous possible triggers?

 Done When I was looking through papers, it looked like it could be either one-exacerbating factor or a trigger. I don't know if any of them say it caused the first episode of the chronic disease and that it persisted afterward. My overall impression is that the medications are viewed as something that can precipitate the disease or perhaps induce a relapse in a psoriatic patient who is in a state of remission. TylerDurden8823 (talk) 02:16, 2 March 2014 (UTC)

If the sources are unclear then we should not be trying to create a distinction. Clinically it is difficult to say whether a particular exposure is a "sine qua non". JFW | T@lk 11:41, 2 March 2014 (UTC)

Mechanism

My comments on this section: JFW | T@lk 15:03, 26 February 2014 (UTC)

• "Compromised skin barrier function has a role in the pathogenesis of psoriasis." Does this mean that the disease compromises the skin barrier with an increased risk of skin infection, or is the disease thought to be caused by the fact that the skin a priori is unable to keep out bacterial nasties, leading to an exuberant immune response and increased keratinocyte production?

 Done Looking at the referenced papers again, it looks like altered skin barrier function is considered a marker of susceptibility for psoriasis development. TylerDurden8823 (talk) 02:17, 2 March 2014 (UTC)

• In the second paragraph, the fragment "immune cells move from the dermis to the epidermis" is repeated. Consider rephrase.
  •  Done This should be better now. TylerDurden8823 (talk) 02:23, 2 March 2014 (UTC)
• "Psoriasis does not seem to be a true autoimmune disease" seems out of place. It seems to address a presumption that it is an autoimmune disease; perhaps this presumption should be spelled out.

Okay, so I do have access to the NEJM paper and here is what it says: "A key question concerns the autoimmune nature of psoriasis and the contribution of autoreactive T cells to the disease process. Currently available data do not support the notion that psoriasis is a bona fide autoimmune disease. Psoriasis is prob- ably best placed within a spectrum of autoim- mune-related diseases characterized by chronic inflammation in the absence of known infec- tious agents or antigens.58" This seems like a contrast from other (including more recent) papers that I've seen that do seem to say that it is regarded as an autoimmune disease. I certainly respect the expert opinion of NEJM review articles and I know they're normally regarded as the gold standard, but I'll see if I can confirm with newer reviews if psoriasis is now regarded as autoimmune or not. TylerDurden8823 (talk) 02:27, 2 March 2014 (UTC)

There seems to be some disagreement in the literature about how to describe psoriasis (as autoimmune or as an immunoinflammatory dermatosis) Here are some review articles from various journals that are newer than the 2009 NEJM review article that classify psoriasis as autoimmune: 1. http://www.ncbi.nlm.nih.gov/pubmed/24434359 2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771250/( this one specifically says psoriatic arthritis is autoimmune) 3. http://www.ncbi.nlm.nih.gov/pubmed/23420016 4. http://www.ncbi.nlm.nih.gov/pubmed/24101875 5. http://www.ncbi.nlm.nih.gov/pubmed/22428855 6. http://www.ncbi.nlm.nih.gov/pubmed/22044352 However, these are some other review articles that use terms like immunoinflammatory dermatosis or chronic relapsing immune-mediated disorder or similar terms, but do not specifically say "autoimmune" 1. http://www.ncbi.nlm.nih.gov/pubmed/22348323 2. http://www.ncbi.nlm.nih.gov/pubmed/22754278 3. http://www.ncbi.nlm.nih.gov/pubmed/23197207

Most articles seem to say autoimmune, but we could say that there is some degree of debate as to whether psoriasis is actually an autoimmune disease rather than use the 2009 article only and simply say it appears not to be since newer literature reviews have differing opinions on the matter. Let me know what you think. TylerDurden8823 (talk) 22:28, 3 March 2014 (UTC)

 Done I would revise the statement in "Mechanism" to reflect the controversy. JFW | T@lk 13:33, 16 March 2014 (UTC)

As it stands, I believe it is alright to put two MEDRS-sources side by side and state what they both say. Unfortunately there is no "head to head" source that examines both perspectives. JFW | T@lk 20:01, 16 March 2014 (UTC)

Yeah, I know. I just wanted to put a few sources for each to make sure both sides are well-represented and to show that this has been an ongoing debate for a number of years. TylerDurden8823 (talk) 20:34, 16 March 2014 (UTC)

• The section does enumerate the recognised immunological and pathological abnormalities, but at the moment the exact chain of events seems unclear. This may reflect a genuine lack of understanding in dermatological science, but I am wondering if there is any way the section could be made to stick together a little bit better.

I definitely think that's a part of it. It does appear to me that there are certainly gaps in understanding of the sequence of events in the pathogenesis of psoriasis. I'll see if I can find review articles that fill in some of these gaps. TylerDurden8823 (talk) 02:30, 2 March 2014 (UTC)

Often, a single major article is needed to form the backbone of these sections. NEJM is often good for this, but sometimes you will find the review in a core specialty journal. JFW | T@lk 11:41, 2 March 2014 (UTC)

I will review this in my final readthrough and try to weld it together a little bit. JFW | T@lk 13:33, 16 March 2014 (UTC)

Diagnosis

My comments on this section: JFW | T@lk 15:03, 26 February 2014 (UTC)

• "Skin from a biopsy will show clubbed rete pegs if positive for psoriasis." It bears pointing out that this is the microscopic appearance. I think understanding might be improved by elaborating on "rete pegs" and the clubbed appearances.

It should be clearer now that this is a microscopic finding. Working on clarifying what rete pegs are so that it's clearer for readers. TylerDurden8823 (talk) 08:06, 2 March 2014 (UTC)

We probably need a fairly comprehensive discussion (probably available in a single source, e.g. NEJM) that lists the cardinal findings on histology. Currently we are saying little about an inflammatory infiltrate. JFW | T@lk 11:41, 2 March 2014 (UTC)

 Done I hope the additions I made are sufficient. If not, let me know and I'll add more. TylerDurden8823 (talk) 01:46, 4 March 2014 (UTC)

• Auspitz's sign should probably be mentioned before discussing the histological appearances.

 Done TylerDurden8823 (talk) 07:27, 2 March 2014 (UTC)

• "Severity" - body surface area doesn't have a unit - is this meant to be a percentage? At the risk of being too verbose, it might be appropriate to say how the DLQI is derived.

Yes, from a brief search it appears that BSA is measured as a percentage of body surface area affected by psoriatic lesions to determine severity. I'll see if I can find out how DLQI is calculated or derived. TylerDurden8823 (talk) 08:11, 2 March 2014 (UTC)

 Done-This is fixed and now elaborated on. TylerDurden8823 (talk) 08:27, 2 March 2014 (UTC)

• "Classification" - the term "morphologic" might need to be explained. It is not quite clear what "This section" refers to. Is it a self-reference, and if so it seems the ICD-10 codes were removed.

I removed those because I did not know those were ICD-10 codes. That was unclear from how it was written before. I'll bring them back. TylerDurden8823 (talk) 07:30, 2 March 2014 (UTC)

 Done ICD-10 codes were replaced. TylerDurden8823 (talk) 08:04, 2 March 2014 (UTC)

See my comments above about the ICD-10 codes in the text. JFW | T@lk 11:41, 2 March 2014 (UTC)

 Done TylerDurden8823 (talk) 22:46, 3 March 2014 (UTC)

•  Done Subsection "nonpustular" seems to repeat some characteristics already covered elsewhere in the article.

Can you be more specific? Which parts are repetitive? TylerDurden8823 (talk) 22:30, 3 March 2014 (UTC)

Dealt with as a result of reorganisation. JFW | T@lk 13:33, 16 March 2014 (UTC)

• In general I am wondering if the clinical descriptions from the "classification" section wouldn't be more appropriate as subsections of "Signs and symptoms".

 Done A very reasonable suggestion; have made this change. --LT910001 (talk) 01:58, 2 March 2014 (UTC)

Management

My comments on this section: JFW | T@lk 15:03, 26 February 2014 (UTC)

• "A 2013 review concluded that [...]" can probably be omitted; the same applies to the discussion about the Cochrane review.
  •  Done This should be better now. TylerDurden8823 (talk) 02:23, 2 March 2014 (UTC)
• In "phototherapy" (in the sentence on PUVA+acitretin), I cannot find the Hankin CS et al (2010) source on Pubmed and I am not sure from the title whether it is a secondary source.
  •  Done This is fixed now. I replaced it with two PubMed-indexed review article sources. TylerDurden8823 (talk) 23:35, 3 March 2014 (UTC)
• In "systemic agents", the first paragraph has no references. Is it primarily a summary of what follows?
  •  Done Added a review article source to verify that non-biologic systemic therapy is reserved for psoriasis sufferers who have failed topical therapies and phototherapy treatments and that liver/blood monitoring is important in individuals on these systemic treatments. The bit about pregnancy is discussed later in the same section with a reference, so I don't think we need to put a reference there twice for the same thing since it's really more of an introductory paragraph. TylerDurden8823 (talk) 06:07, 4 March 2014 (UTC)
• I would elaborate on "post-surgical events". Does it mean that it can cause complications if someone taking metrotrexate requires surgery?
  •  Done-I removed it instead. This was just a case report of ulcerations and eventration possibly associated with methotrexate use (but no definitive link was established in the paper). I think it's not really noteworthy enough to be in the Psoriasis article. It might be more appropriate in the Methotrexate article. I also came across a review article (the one I added to the beginning paragraph of the section) that states methotrexate is okay before surgery. TylerDurden8823 (talk) 23:45, 3 March 2014 (UTC)
• I would link to monoclonal antibody somewhere to give readers a chance to figure out how they are produced.

 Done It was wikilinked in this sentence: Efalizumab is a monoclonal antibody (MAb) that specifically targets the CD11a subunit of LFA-1.[62], but I moved it earlier. TylerDurden8823 (talk) 06:08, 4 March 2014 (UTC)

• "The severity of psoriasis symptoms may also be influenced by lifestyle habits related to alcohol, smoking, weight, sleep, stress and exercise" doesn't strike me as particularly controversial. Is there a particular reason why it was placed here (apart from the title of the reference that supports it)?
  •  Done. Agreed, this is already mentioned elsewhere in the article and is not controversial. TylerDurden8823 (talk) 02:23, 2 March 2014 (UTC)
• There is no mention of climatotherapy. There are regular tours to the Dead Sea for people with psoriasis and other cutaneous conditions; there are some secondary sources that discuss this (doi:10.1016/j.clindermatol.2007.10.023, doi:10.1016/j.semarthrit.2012.02.006)
  •  Done-this is definitely incorporated into the article now. TylerDurden8823 (talk) 09:06, 7 March 2014 (UTC)

Prognosis

My comments on this section: JFW | T@lk 15:45, 26 February 2014 (UTC)

• The opening paragraph seems duplicative in its description of disease severity and distribution. Could it be moved to (or integrated with) "signs and symptoms"?

 Done I just removed it. As you said, it's repetitive and not really necessary. I don't think it contributed much to the article. TylerDurden8823 (talk) 03:32, 2 March 2014 (UTC)

• The second paragraph currently doesn't have a source.

First sentence already does, but I agree that it would probably benefit from some more. TylerDurden8823 (talk) 03:30, 2 March 2014 (UTC)

 Done It would be preferable to have a source, however logical it sounds. JFW | T@lk 13:33, 16 March 2014 (UTC)

Not sure I understand since the second paragraph does have sources now. Did you mean the first paragraph of the prognosis section? If so, I've added them. TylerDurden8823 (talk) 18:44, 16 March 2014 (UTC)

Indeed. The Parrish source is excellent for this. Sorry for the confusion. JFW | T@lk 19:23, 16 March 2014 (UTC)

• The sections "Autoimmune comorbidities" and "Cancer" are very short, and perhaps the content on comorbidities could be covered in a single section.

 Done -These are merged now. TylerDurden8823 (talk) 20:35, 3 March 2014 (UTC)

• In "cancer", "mildly increased risk" is not very specific. Might it be an idea to give some relative risks from the source?

 Done -This should be specific enough now. TylerDurden8823 (talk) 21:03, 3 March 2014 (UTC)

• In "cardiovascular comorbidities", the words "Metabolic syndrome" occur without further elaboration, followed by the Raychaudhuri SK et al (2014) reference. I'm sure there's something you wanted to say there.
  •  Done-this should be better now. TylerDurden8823 (talk) 02:25, 4 March 2014 (UTC)
• In "cardiovascular comorbidities", it is ambiguous whether treatment for hypercholesterolaemia improves the cardiovascular risk or the cutaneous symptoms. The source implies that it's only the latter.
  •  Done-this should be better now. It appears to improve both cutaneous symptoms and cardiovascular risk (or at least cardiovascular risk factors-the paper did not specifically address if treatment of hyperlipidemia results in fewer cardiovascular events or mortality due to cardiovascular events). TylerDurden8823 (talk) 06:25, 7 March 2014 (UTC)

Epidemiology

My comments on this section: JFW | T@lk 15:45, 26 February 2014 (UTC)

• I wonder whether the prevalence figure should be mentioned earlier in the section.
  •  Done TylerDurden8823 (talk) 03:38, 2 March 2014 (UTC)
• The sentence "Psoriasis is more common [...]" is quite long and strings together a lot of technically unrelated facts. It might be better to break it up a bit.

 Done This should be better now. I put it that way with the link being the various factors that make it more likely for a given individual to have psoriasis, but I suppose I can see how it would be better to break it up. TylerDurden8823 (talk) 03:37, 2 March 2014 (UTC)

History

My comments on this section: JFW | T@lk 15:45, 26 February 2014 (UTC)

•  Done Does the Gruber et al source state who speculated that tzara'ath was the same as psoriasis? Just curious - might be worth including. Does the Benedek source mention this at all?

The Benedek source does not discuss this aspect of the history. This book source that I added to the beginning of the article (http://books.google.com/books?id=RN-B2g2YjmAC&pg=PA4&lpg=PA4#v=onepage&q&f=false) discusses that it is well-accepted that the Hebrew term "tzara'ath" was used for a spectrum of dermatological diseases in addition to leprosy and probably included psoriasis. There are two papers referenced in this book for the statement that tzara'ath refers to these conditions-a 1986 paper from Glickman, FS and the 1955 Meenan paper we have in the history section. Unfortunately, I'm unable to access the full text of either of these papers, so I am unable to verify what these papers say about the topic. TylerDurden8823 (talk) 06:35, 4 March 2014 (UTC)

Unfortunately, the Glickman source also does not specify who speculated that zaraath was the same as psoriasis. It actually says (in a matter of fact tone) that zaraath in Hebrew stands for leprosy and that it has been suggested that this archaic Hebrew word for leprosy may have been used for people with a variety of skin disorders including psoriasis. However, regarding who is doing this suggesting? This is never specifically mentioned and it is unclear to me if biblical scholars, medical scientists, or both communities put forward this suggestion. TylerDurden8823 (talk) 06:37, 7 March 2014 (UTC)

If the sources can't confirm who postulated this, no worries. JFW | T@lk 13:33, 16 March 2014 (UTC)

• Similarly, does Benedek provide any information on historical therapies? I would be surprised if it didn't!

 Done Benedek part II does have some discussion of historical treatments and I've incorporated that into the history section. TylerDurden8823 (talk) 06:52, 7 March 2014 (UTC)

Society and culture

My comments on this section: JFW | T@lk 15:45, 26 February 2014 (UTC)

•  Done The references are somewhat weak, but then this is usually verifiable content in an area where sources are not abundant.

Agreed, I really didn't mess with that section much, but I'll see if I can scare up some better sources. TylerDurden8823 (talk) 01:28, 2 March 2014 (UTC)

This might be a better source, but I don't have access to it. http://www.ncbi.nlm.nih.gov/pubmed/21362781 TylerDurden8823 (talk) 06:55, 4 March 2014 (UTC)

Not a breaking point. JFW | T@lk 13:33, 16 March 2014 (UTC)

Research

My comments on this section: JFW | T@lk 15:45, 26 February 2014 (UTC)

• The first paragraph is unsourced. I think this content does require a source.
  •  Done TylerDurden8823 (talk) 02:57, 4 March 2014 (UTC)
• The content focuses on immunological therapy. Do the sources discuss any other emerging theories and/or treatments under development?
  •  Done-Yes, it looks like most of the research out there targeted at therapies seems to be focusing on targeting different aspects of cellular signaling or the immune system. I did add brief mention of research into the role of insulin resistance in the pathogenesis of psoriasis and investigation of antioxidants as treatment. TylerDurden8823 (talk) 02:57, 4 March 2014 (UTC)

This page sucks

I think we can do much better. Let's start by admitting that basically now one knows anything. Also, can we remove the historic old testament reference. This should be merged with lepers? I don't know where we can go here. WTF happens to the human body. Is this contagious? 74.71.199.128 (talk) 09:32, 2 July 2014 (UTC)

very nicely written article

I just added 1 more reference related to the identification of new drug targets for treatment in research section.

Bekiaris V, edý John R, Macauley Matthew G, Rhode-Kurnow A, Ware Carl F. The Inhibitory Receptor BTLA Controls ³´ T Cell Homeostasis and Inflammatory Responses. Immunity. 2013;39(6):1082-94. — Preceding unsigned comment added by Kirtimaansyal (talk • contribs) 01:37, 5 March 2014 (UTC)

If you find a review article that discusses this topic, that could be incorporated into the article. TylerDurden8823 (talk) 06:52, 21 March 2014 (UTC)

Histological slide

I've been looking into getting an image of psoriasis for a little while, no major success yet. I'd like to point to two Plosone papers with images of psoriasis. They aren't top of the line quality, but I'd like to know what you think, if there is any point in uploading them and adding them to the article? I'm not sure the stains are the most common either, but its something at the very least.

• http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0005227

• http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0045509

-- CFCF (talk · contribs · email) 11:17, 2 March 2014 (UTC)

Hey CFCF, I actually liked the ones in the first paper. I agree they're not optimal quality, but it's certainly better than not having a histological slide depicting the characteristic features of psoriatic skin lesions. Is there a way to get it on to here? Do we have access somehow? TylerDurden8823 (talk) 07:45, 13 April 2014 (UTC)

Everything from Plosone is CC-BY-SA, so all you need to do is upload it. I'm currently not at home, but I can see if I can do it from here. Otherwise feel free to upload to commons if you know how to. CFCF (talk · contribs · email) 09:33, 14 April 2014 (UTC)

I'm not exactly sure how to do it from the paper, but it would be ideal to have an image that points out the histological features. I don't know if Lancet would let us use a histological slide of theirs, and it is in black and white, but this is another slide for consideration: http://www.thelancet.com/journals/lancet/article/PIIS0140673697052574/images?imageId=gr1&sectionType=green This might also be a good one if UCSF would be willing to let us use it: http://missinglink.ucsf.edu/lm/dermatologyglossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/psoriasis_mid_power.jpg What do you think? TylerDurden8823 (talk) 18:36, 15 April 2014 (UTC)

I think the bottom image is very good, and my experience is that with a courteous mail many non-profit organizations or single professors with web-sites are willing to license image for Wikipedia. Your best bet would be to send an e-mail. I will be back at home in 2-3 days time, and I can upload the plosone images then. CFCF (talk · contribs · email) 10:23, 20 April 2014 (UTC)

Images uploaded

I've been very slow on doing this, but there are now two images on commons for use in this article:

• 
• 

Check their pages for info on what they show.
-- CFCF (talk · contribs · email) 11:25, 21 June 2014 (UTC)

Prognosis section

The "prognosis" section currently says:

“ Most people with psoriasis experience nothing more than mild skin lesions that can be treated effectively with topical corticosteroid cream.[citation needed] The following applies to severe cases. ”

The citation request is a bit of an eyesore. Could anyone find a reference to support this claim? Do any of the current references make the distinction? JFW | T@lk 15:52, 23 July 2014 (UTC)

Well, I put the tag there because I felt that statement needed to be verified. How long do we normally leave an unverified statement (if we're unable to find a reference) before removing it? TylerDurden8823 (talk) 04:19, 24 July 2014 (UTC)

There's no deadline. But on a Good Article there should ideally be no "citation needed" tags at all. JFW | T@lk 11:15, 24 July 2014 (UTC)

I agree, but this was a new addition to the article. Haven't had time to find a suitable reference to support this statement that was added. TylerDurden8823 (talk) 18:18, 24 July 2014 (UTC)

So, what I'm finding in review sources I can access is basically saying (to address this unverified statement) that about 20% suffer from a moderate-severe form of psoriasis (per this reference: http://www.ncbi.nlm.nih.gov/pubmed/24790410) and 30% of psoriatics get psoriatic arthritis (there would clearly be a good amount of overlap in these two statistics) per this reference (http://www.ncbi.nlm.nih.gov/pubmed/23569359). The statement as written is a bit vague since it says that most people with psoriasis end up with the mild form with inflammatory skin lesions and nothing else, but what are we considering most? Half? Two-thirds? More? Without quantification, this is a bit vague. I think the statement should either be removed or rewritten. What do you think Jfd? TylerDurden8823 (talk) 01:59, 25 July 2014 (UTC)

I suppose we could use this reference as support, right? http://www.ncbi.nlm.nih.gov/pubmed/23413913 It seems to verify the statement. I'm going to put it there as a reference unless there are any objections. TylerDurden8823 (talk) 02:00, 25 July 2014 (UTC)

I'm happy with the above. Sorry for the sluggish response. JFW | T@lk 19:14, 27 July 2014 (UTC)

Goeckerman therapy

Mhandler, who is also the creator of the article Goeckerman therapy, added a paragraph about this treatment protocol. It was supported with a single reference that was basically a case report. The protocol is not mentioned in doi:10.1111/bjd.12276. At the moment I can therefore not think of a good reason to discuss it in much detail. JFW | T@lk 22:50, 10 August 2014 (UTC)

VTE

doi:10.1093/qjmed/hcu073 - meta-analysis in QJM. Probably worth mentioning. JFW | T@lk 22:04, 27 September 2014 (UTC)

Agreed, I'll work on incorporating it into the article soon unless someone beats me to it. TylerDurden8823 (talk) 22:27, 27 September 2014 (UTC)

Cardiovascular comorbidity

... was discussed in a conference and reviewed here: doi:10.1016/j.amjmed.2014.08.008. Worthy of inclusion. JFW | T@lk 09:12, 4 December 2014 (UTC)

I agree and would add it but unfortunately I don't have access. TylerDurden8823 (talk) 00:04, 5 December 2014 (UTC)

Proposed Merge with Antipsoriatic

I'm not sure exactly why this is being proposed because the antipsoriatic article doesn't really say anything that isn't said here (the only exception to this is the mention of tazarotene). Can someone clarify why we need to do this please? TylerDurden8823 (talk) 16:36, 25 February 2015 (UTC)

• Merge Very little has been done at antipsoriatic and it could easily be covered under treatments here. BakerStMD T|C 04:01, 15 March 2015 (UTC)

The Medical Letter 2015

Drugs for Psoriatic Arthritis (online only)
http://secure.medicalletter.org/TML-article-1470d
The Medical Letter on Drugs and Therapeutics. 57(1470):e88. June 8, 2015

Drugs for Psoriasis
http://secure.medicalletter.org/TML-article-1470a
The Medical Letter on Drugs and Therapeutics. 57(1470):81. June 8, 2015
Mild to moderate psoriasis generally treated with topical corticosteroids. Vitamin D analogs or tazarotene can be added. Phototherapy and systemic therapy recommended for moderate to severe disease. For moderate to severe psoriasis, methotrexate (most serious adverse effect hepatotoxicity) or cyclosporine (most serious AE hypertension and nephrotoxicity).
Biologic agents are most effective and most expensive. Kim IH found 12-week PASI75 infliximab 78.6%, adalimumab 70.5%, etanercept 48.1%. Ustekinumab (IL-12/23 antagonist) more effective than etanercept, but serious infections, malignancies, etc. Secukinumab (IL-17A inhibitor) also more effective than etanercept. Prices of biologicals for 12 weeks tx ~$9-10,000, except for infliximab ($5842) and ustekinumab ($7661).--Nbauman (talk) 05:23, 19 June 2015 (UTC)

Rapamycin

Is an anti proliferative drug, has it been investigated for treating Psoriasis? — Preceding unsigned comment added by 71.9.22.214 (talk) 19:58, 2 April 2015 (UTC)

Lancet Seminar 2015

Boehncke W-H, Schön MP
Seminar: Psoriasis
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2961909-7/fulltext
The Lancet. Online: 26 May 2015, DOI: 10.1016/S0140-6736(14)61909-7
Main difference from this Wikipedia article: "life expectancy of patients with psoriasis is substantially reduced, with cardiovascular diseases contributing most." Cites Abuabara, Br J Dermatol 2010; 163:586-92. --Nbauman (talk) 05:42, 2 June 2015 (UTC)

It also says that adalimumab is the "most widely used biological for this indication." Table 1 gives a nice comparison of anti-psoriatic therapies, with efficacy and safety concerns.

The Lancet also had a head-to-head study by Pfizer of tofacitinib vs. etanercept. A commentary said that there were no significant serious adverse effects in the trials, but we can't know whether drugs are safe until they've been in widespread use with safety monitoring.

--

Lebwohl M

Comment: Do we need more psoriasis therapies?

The Lancet. Online: 4 June 2015 DOI: 10.1016/S0140-6736(15)60205-7

--

Bachelez H, van de Kerkhof PDM, Strohal, et al.

Tofacitinib versus etanercept or placebo in moderate-to-severe chronic plaque psoriasis: a phase 3 randomised non-inferiority trial

The Lancet. Online: 04 June 2015 DOI: 10.1016/S0140-6736(14)62113-9

Tofacitinib is a janus kinase inhibitor, etanercept is a tumor necrosis factor inhibitor. Tofacitinib is administered orally, etanercept subcutaneously. They were non-inferior. --Nbauman (talk) 21:54, 7 June 2015 (UTC)

Bachelez H

Comment: Interleukin-17 inhibition: a route to psoriasis clearance?

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960857-1/fulltext

The Lancet. Online: 10 June 2015. DOI: 10.1016/S0140-6736(15)60857-1

IL-17 inhibitors can reach 90% skin clearance, and may offer complete skin clearance for many patients. IL-17 blocking has superior efficacy to etanercept, although the risk of infection with ixekizumab is higher.

--

Griffiths CEM, Reich K, Lebwohl M, et al. for the UNCOVER-2 UNCOVER-3 investigators

Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis (UNCOVER-2 and UNCOVER-3): results from two phase 3 randomised trials

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960125-8/fulltext

The Lancet. Online: 10 June 2015. DOI: 10.1016/S0140-6736(15)60125-8

The efficacy of ixekizumab, an IL-17 blocker, was superior to etanercept. Ixekizumab (q 2 weeks) sPGA 83%, PASI75 90%; Etanercept sPGA 36%, PASI75 42%. --Nbauman (talk) 03:19, 12 July 2015 (UTC)

Note to TylerDurden

Sorry -- you are the one who is confused. Doc James's edit summary plainly referred to the section heading "Bibliography." It seems the doctor prefers the heading "Further reading." So be it. The See-also section was also removed at the same time, possibly by mistake and in any case without explanation. I have restored it. Wahrmund (talk) 19:21, 1 March 2016 (UTC)

See also sections are not generally recommended per WP:MEDMOS. The link you provide is only tangentially related IMO. Doc James (talk · contribs · email) 21:33, 1 March 2016 (UTC)

I can assure you I'm quite up to speed. =) TylerDurden8823 (talk) 02:19, 2 March 2016 (UTC)

penis imagery not necessary.

The Image of the penis with psoriasis on this article seems to be unnecessary and offensive given the article topic. Under WP:GRATUITOUS the image should be removed because the removal of the image would not cause the article to be less informative or less relevant.--207.74.26.1 (talk) 19:39, 18 February 2016 (UTC)

I agree. Penile psoriasis is uncommon and the image is not illustrative. JFW | T@lk 11:24, 22 February 2016 (UTC)

It is not uncommon but I agree with you about the unnecessary image.Vorticus (talk) 21:58, 1 May 2016 (UTC)

Note

Am moving this note here. A popular press article is not good for updating Wikipedia. We need to go with high quality reviews. Doc James (talk · contribs · email) 19:26, 18 June 2016 (UTC)

We mention IL17 inhibitors already of which this is one. Doc James (talk · contribs · email) 19:32, 18 June 2016 (UTC)

A simple factual edit being unnecessarily blocked

I made a simple 100%-proven factual edit by adding Apremilast to the list of FDA-approved, non-biologic treatment modalities for psoriasis. The editor, calling himself Doc James modified it and moved to the paragraph describing the biological treatment modalities. I am fine with his modification but not with moving my edit to the "biologicals" section, because Apremilast is not a biologic. So I moved it back where it belongs. However, it was not only immediately moved back to the wrong section, but I was told that I started an edit war!

I don't think this kind of editorial supervising is in the best interest of Wikipedia. Experts in the field shouldn't be prevented from making 100% fact-proven edits by overzealous editors, who are obviously not experts in the field. Since it appears that I am prohibited from doing it myself by Doc James, I request that some authorized person place my edit back where it belongs - in the "non-biologics" section of the Psoriasis article.

Thank you very much in advance,

Dr. K. Bojanowski — Preceding unsigned comment added by Kbojanowski (talk • contribs) 23:38, 8 November 2016 (UTC)

Would you please read just above, and respond there? Thanks Jytdog (talk) 00:04, 9 November 2016 (UTC)

Frequently used

Were does this ref say apremilast is frequently used User:Kbojanowski? [8] Doc James (talk · contribs · email) 18:52, 6 November 2016 (UTC)

Do you have evidence that it is a "first line" agenet? Doc James (talk · contribs · email) 09:41, 7 November 2016 (UTC)

I don't have a problem with you modifying the verbiage of my edit so it does not suggest that apremilast is frequently used. However, why "apremilast may also be used" sentence was placed in the "biologicals" section. Could we put it in the "non biologicals" section and move on with our lives? Why my placement of this sentence in the "biologicals" section was undone and apremilast was put back in the section discussing antibodies? Kbojanowski (talk) 01:25, 9 November 2016 (UTC)kbojanowski

Okay so you added it to the sentence that says it is frequently used when evidence does not support frequent use.

That paragraph is about first line treatments. I am not seeing a ref that says it is a first line treatment. Doc James (talk · contribs · email) 11:27, 9 November 2016 (UTC)

Ayurvedic content

User:59.96.160.156 the content you added, then edit warred to restore:

• diff at 10:23, 14 February 2017
• diff 17:10, 14 February 2017
• diff 17:24, 14 February 2017
• diff 17:51, 14 February 2017

Is based on sources that don't satisfy MEDRS, as you have been told several times. Please do read WP:MEDRS and if you have questions, please ask. Jytdog (talk) 19:33, 14 February 2017 (UTC)

Emphasis on pustular psoriasis

Why is so much emphasis being put on pustular psoriasis? It is a merely a rare subtype of psoriasis. The page should be reorganized with less emphasis on pustular psoriasis symptoms. IIIBALESIII 19:02, 26 March 2017 (UTC)

Anti-IL17 Treatments

Probably deserve mention in the treatment section of the article if someone has the time. TylerDurden8823 (talk) 06:06, 27 March 2017 (UTC)

Proposed role of Rac1

A paper published here in JCI, and reported by Stanford University here suggests a role for Rac1 in psoriasis; I don't know enough to add this to the article, but it looks to merit a mention both here and under Rac1. Hv (talk) 09:17, 15 July 2017 (UTC)

how to cure — Preceding unsigned comment added by 117.227.38.205 (talk) 17:44, 9 March 2018 (UTC)

Vitamin D therapy in psoriasis.

Araugo OE, Flowers FP, Brown K.

Vitamin D therapy in psoriasis.

DICP. 1991 Jul-Aug;25(7-8):835-9. Review.

PMID 1659041

Abstract : The use of vitamin D3 in the treatment of psoriasis is discussed with emphasis on positive and negative results of many clinical trials. Investigations indicate the treatment with topical vitamin D3 provides consistently more rapid clinical improvement than its oral counterpart, with no reported adverse effects. Studies have shown that 68 of 83 patients exhibited significant improvement of their psoriatic lesions with the topical application of vitamin D3 analogs, including 1,24-dihydroxycholecalciferol, calcitriol, and MC 903. Clinical trials involving 35 patients treated with oral vitamin D3 analogs resulted in moderate improvement in 24 of the patients. Adverse effects can be minimized by bedtime dosing and possibly the use of new noncalciotropic analogs. Vitamin D3 analogs appear to provide one more promising treatment option for psoriasis.

Morimoto S, Yoshikawa K.

Psoriasis and vitamin D3. A review of our experience.

Arch Dermatol. 1989 Feb;125(2):231-4.

Abstract

Psoriasis is associated with abnormally exaggerated epidermal cellular turnover. Recent studies showed that calcitriol (1,25-dihydroxyvitamin D3) a calcitrophic hormone, regulates terminal differentiation of basal cells of epidermal keratinocytes. We administered active forms of vitamin D3 in both oral and topical ways in an open-design study to patients with psoriasis vulgaris. Significant improvement was observed at the end of the study periods in these patients, especially in those treated with topical application of calcitriol. We also found a significant negative correlation between the severity of psoriasis and the basal serum level of 1 alpha,25-dihydroxyvitamin D but not with those of other calcium-related parameters in psoriatic patients. These data suggest that exogenous active forms of vitamin D3 are effective for treatment of psoriasis and that the endogenous 1,25-dihydroxyvitamin D level also may be involved in the development of this skin disease.

PMID 2536537

Kamangar F, Koo J, Heller M, Lee E, Bhutani T.

Oral vitamin D, still a viable treatment option for psoriasis.

J Dermatolog Treat. 2012 Jan 21. [Epub ahead of print]

PMID 22103655

Abstract : Vitamin D as a topical treatment has become one of the mainstays for treatment of psoriasis vulgaris. Oral vitamin D on the other hand has for the most part become a forgotten option. But a review of the literature on oral vitamin D as a treatment for psoriasis reveals that this treatment is efficacious. The main side effect of this therapy is hypercalcemia, which appears to be easily monitored and avoidable with proper dosing and monitoring. The literature also suggests a correlation between low levels of serum vitamin D in this patient population associated with increased severity of disease involvement. In addition, oral vitamin D improves psoriatic arthropathy. Moreover, vitamin D has been proven to have many health benefits such as prevention of cancer, improved cardiovascular health among many others. Psoriatic patients as a population are at increased risk of developing adverse health complications such as cardiovascular disease, and oral vitamin D may prove to be of benefit in this population. Oral vitamin D is inexpensive and easily available. It is still a viable option and should not be forgotten as a possible treatment for psoriasis.

Grace K. Kim, DO

The Rationale Behind Topical Vitamin D Analogs in the Treatment of Psoriasis; Where Does Topical Calcitriol Fit In?

J Clin Aesthet Dermatol. 2010 August; 3(8): 46–53.

PMC 2945865

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945865/ </ref>

"The therapeutic use of vitamin D dates back to the 1930s when it was used as an oral agent for osteoporosis on a psoriasis patient who subsequently experienced clearing of psoriatic skin lesions.10 Dermatological application of topical vitamin D3 centers on the fact that the skin is both a site of initial vitamin D biosynthesis and a target for vitamin D3 activity causing modulation of keratinocytes and inflammatory mediators.11" [1]

Cites in above block quote:

10: Nagpal S, Lu J, Boehm MF

Review Vitamin D analogs: mechanism of action and therapeutic applications.

Curr Med Chem. 2001 Nov; 8(13):1661-79.

PMID 11562285

11: Wolverton SE.

Comprehensive Dermatologic Drug Therapy. 2nd Edition.

Philadephia, PA: Saunders Elsevier; 2007.

Interesting that the first 3 references above mention experience with oral vitamin D - Should cover in article ? - Rod57 (talk) 11:27, 20 July 2017 (UTC)

2018 : [9] says 2/3 of patients helped with Vitamin D. "... found strong evidence for a link between higher vitamin D levels and lower psoriasis severity. Researchers used something called the Psoriasis Area and Severity Index (PASI) to gauge the severity of psoriasis symptoms. And as vitamin D levels went up, PASI scores went down. This inverse relationship held true for people with vitamin D levels up to 125 nmol/L." - Rod57 (talk) 07:38, 2 May 2018 (UTC)

Strange that the discussion of UV phototherapy does not mention vitamin D

especially considering the UVB will produce vitamin D, and vitamin D is known to help psoriasis symptoms and help regulate immune system. - Rod57 (talk) 07:44, 2 May 2018 (UTC)

Permanent cure from psoriasis

I was suffering from plaque psoriasis for many years. Who was in my foot, but now I am fine. I took the root of white Abrus precatorius for 5 days and psoriasis was cured forever. I took the medicine as follows - Abrus precatorius root 1 cm long, 3 mm smooth / thick. Rise at 6 o'clock in the morning and chew and eat before leaving the foot from the bed. I took the medicine. I did this for 5 days. And I was freed from psoriasis. WHICH PERSON that he had given me medicine, he had asked me to take this 15 days and told that if I had diarrhea, then I would have eaten KHICHADI of MUNG BEAN AND RICE. This was the story of being free from my psoriasis. https://en.wikipedia.org/wiki/Abrus_precatorius

Your account is encouraging but it is also anecdotal. Such claims can only be included on Wikipedia if they are supported by high-quality medical sources (see WP:MEDRS). JFW | T@lk 10:54, 12 August 2018 (UTC)