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What is Psoriasis?

December 30th, 2015 | Category: Cosmetic,Dr. Goldenberg,Psoriasis

 

Psoriasis is a multifactorial genetic condition in which inflammation is increased and skin cells turn over at a higher than normal rate. On the outside, the increased scale is caused by rapid growth of skin cells. This in turn causes skin cells to accumulate on the surface of the skin and cause silvery scale. On the inside, there is an increase in inflammation. This inflammation causes the skin to be red and inflamed. This likely causes the itching and burning commonly seen in psoriasis.

The most common type of psoriasis is called psoriasis vulgaris (common psoriasis). These patients have insolvent of the skin extensors, such as knees and elbows, scalp and buttocks. However, every inch of skin can be covered with psoriasis in severe cases. Other types of psoriasis include inverse psoriasis, guttate psoriasis, pustular psoriasis and erythrodermic psoriasis

The inflammation that is seen in the skin of psoriasis may also be occurring in joints, causing psoriatic arthritis.  It’s also been shown that patients with psoriasis are at an increased risk of heart disease, stroke, diabetes, insulin resistance, metabolic syndrome, depression, smoking and alcohol abuse.

Psoriasis is a chronic condition for which there is no cure. However, multiple treatment options exist for patients with a wide range of disease, from mild to severe. These include:

  • Diet and lifestyle modification
  • Topical creams & ointments
  • Light therapy
  • Oral medications
  • Biologics injections

 

Creams and ointments are the most commonly used option by people. Light therapy has been proven to work by slowing cellular growth and nullifying the effects of psoriasis. Oral medications can help with moderate disease with a good safety record. Injectable biologic drugs target specific parts of the immune system effected by psoriasis and are administered through injections. These medicines are safe and effective for both, psoriasis and psoriatic arthritis.

To understand your psoriasis better and to find the right treatment for it, book your consultation today with Dr. Gary Goldenberg at one of his New York dermatology offices.

New Option for Psoriasis Treatment Just Approved!

January 31st, 2015 | Category: Dr. Goldenberg,Media,Psoriasis

 

Good news for those that suffer from psoriasis – a chronic, inflammatory genetic immune condition. A new biologic COSENTYX was just approved by the FDA for the treatment of moderate to severe psoriasis.

This medication works by blocking a specific component of the immune system called IL-17. By doing so, the drug decreases inflammation caused by psoriasis and improves the patients skin. In studies. over 65% of patients were clear or almost clear after 12 – 16 weeks of treatment.

While like all systemic medications, cosentyx has some potential side effects, with careful lab monitoring and follow up, the drug can be used safely.

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Options for patients with psoriasis are getting better!

January 21st, 2015 | Category: Psoriasis

 

Psoriasis is a chronic, genetic condition for which there is no cure. Patients with psoriasis suffer from thick, silvery skin lesions that may get red, scale and become very itchy. About a third of the patients also suffer from psoriasis arthritis – a type of joint disease than can destroy joints over time if not treated. That’s the bad news…

The good news is that there are many medications that can be used to treat psoriasis, and there are about to be more option.

For mild psoriasis, topical creams are the treatment of choice. Most of these are steroids, although non-steroidal creams are also available. Patients used to not like using these because most of the creams were greasy ointments that would stain clothes, feel sticky and take forever to dry. Luckily, there are lots of new formulations that are more cosmetically elegant – lotions, foams, sprays and less greasy creams.

For patients with moderate disease, there is a new oral medication – a pill called OTEZLA. It’s a very good option that’s does not require injection and requires little to no laboratory monitoring. Other options, such as light therapy are also still available.

For patients with severe disease there are biologics – a group of medicines that are injected in a similar way to insulin. Many options are available – ENBREL, HUMIRA, STELARA are currently approved. A new first in class medication called COSENTYX should be approved any day. All these medicines work but may not be the right option for every patient.

But the good news is that we are making improvements and can help more and more psoriasis patients every day.

More information can be found on:

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Dr. Goldenberg quoted on Everyday Health about Psoriasis!

April 22nd, 2014 | Category: Media,Psoriasis

 

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Opening Up to a Psoriasis Support Group: Ninfa’s Story
If you’ve felt hesitant to join a psoriasis support group, meet Ninfa Cantu. She’ll tell you how powerful joining one can be.

By Marie Suszynski
Medically reviewed by Pat F. Bass III, MD, MPH

Every November, San Antonio, Texas, resident Ninfa Cantu has a celebration to commemorate the onset of her psoriasis symptoms in 1979. This November made 34 years. “People ask me why I celebrate an illness,” Cantu says. “I celebrate because it’s a part of my life — it’s a part of me.”

Because of psoriasis, she also has a new family, one that grew after she started a psoriasis support group in 2003. The group meets about every two months. Not only have they exchanged stories and used the time to learn about their disease, but they have also formed strong friendships. One support group member invited Cantu to her to a wedding. Another gives her a Christmas present every year.

Most importantly, they give each other hope. “That’s the power of the support group,” Cantu says.

Why Psoriasis Support Is So Important

Studies have found that psoriasis significantly affects people’s quality of life, says Gary Goldenberg, MD, medical director of the Dermatology Faculty Practice at Mount Sinai Medical Center and an assistant professor of dermatology and pathology at the Icahn School of Medicine at Mount Sinai in New York City. Among the findings is evidence that the bigger the skin area affected by psoriasis, the lower your quality of life, especially among women and young people.

Part of what’s so troubling about psoriasis is that it’s chronic. Once you’re diagnosed, you know you’ll always have it, Dr. Goldenberg says. However, when you spend time around others with psoriasis, you’ll see people who do get better as time goes on, and it can help you understand that you can find effective treatments, too.

Another major issue for many people with psoriasis is the way they’re treated by others who don’t understand the disease. Strangers, even friends and family members, may think psoriasis is contagious, which obviously isn’t true.

“I make sure my patients see me touching their skin with bare hands,” Goldenberg says. “I want to show them I’m not afraid to touch them because it’s not contagious.”

Psoriasis Support Groups: ‘Like a Burden Lifted’

Because Cantu doesn’t cover up her skin, people were often approaching her and asking questions about her psoriasis. She decided to start a bilingual support group because she saw the need for one in her community. There’s a strong Hispanic culture in San Antonio, and her group sometimes holds meetings in Spanish so that everyone feels included.

Twenty people showed up for that first meeting 10 years ago. Many came with questions, like whether their children will have psoriasis and what are the best ways to treat it. Now, members of the group bring family members to meetings so they, too, can learn about psoriasis. Sometimes they break up into pairs to talk to each other and tell their stories. “People can let out their frustrations,” Cantu says.

One man who joined the support group confided that, as a child, his parents left him in the garage because they thought he had something like HIV/AIDS. “He felt the need to talk about his situation,” Cantu says. “It helps to learn you’re not alone and that other people can relate to what you’re going through.”

Cantu’s group once brought in a physician to speak about the social-psychological effects of psoriasis, and it’s hosted psoriasis fairs. She and other members also met with a local congressman to talk about how psoriasis has affected them and the importance of having access to prescription drug coverage for treatment.

Over the years, Cantu’s psoriasis has caused her to be hospitalized three times, and she’s also developed psoriatic arthritis and fibromyalgia. Last year, she was hit by a truck and sustained injuries that have made it difficult for her to walk. But she has good friends — friends through her support group — that she can turn to.

Once in a while, Cantu comes across someone who’s hesitant to join the group. In these situations, she talks to him or her about how empowering support groups can be. “Join one, because you don’t know how much relief you’ll get until you try it,” she says. “It’s like a burden lifted when you know you’re not alone.”

How You Can Find Psoriasis Support

Cantu started her support group on her own, but since then, the National Psoriasis Foundation has picked it up. To find a group in your area, go to the foundation’s Web site at www.psoriasis.org.

Many psoriasis patients go untreated or undertreated. Check out my quotes on Healthday.com.

August 18th, 2013 | Category: Media,Psoriasis

 

According to a study by notional psoriasis foundation, many psoriasis patients go untreated or undertreated. Please see my quotes on healthday.com.

Many Psoriasis Patients Going Without Treatment, Study Finds

More than half surveyed said they are dissatisfied with the level of care
By E.J. Mundell
HealthDay Reporter

 

WEDNESDAY, Aug. 14 (HealthDay News) — The autoimmune skin disorder known as psoriasis affects millions of Americans, but a new study suggests it remains woefully undertreated.

In 2011, between 30 percent and nearly 50 percent of patients said they had no treatment for their psoriasis, depending on the severity of their disease.

One expert unconnected to the study said he wasn’t surprised by the findings.

“Dermatologists, especially those that specialize in caring for patients with psoriasis, are well aware of the fact that many patients are untreated or undertreated,” said Dr. Gary Goldenberg, an assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai, in New York City. “This is especially concerning for those patients with moderate to severe disease and those with psoriatic arthritis, which affects approximately 30 percent of patients with psoriasis.”

Psoriasis is an immune disorder that can cause discomfort and unsightly skin eruptions for patients, another expert explained.

“Psoriasis of the skin is a process where the skin acts as if it’s being wounded and accelerates skin cell turnover, so that new skin cells rapidly rise through layers of the skin without having time to mature properly,” said Dr. Doris Day, a dermatologist at Lenox Hill Hospital, in New York City. “Psoriatic skin sheds in only a few days, which is significantly faster than the approximately 30 day shed cycle of normal skin. This creates thick red plaques on the skin with silvery white scale.”

Day noted that people with psoriasis may also suffer from joint pain or pitting of the nails, especially for those with a subset of psoriasis known as psoriatic arthritis. But she added that these and other symptoms can often be managed with newer drugs. “With many of the newer treatments, namely the biologics, they can avoid and even treat joint destruction and the associated pain and co-morbidities [illnesses],” Day said.

Unfortunately, many patients are going without treatment, according to the new study, which appears online Aug. 14 in JAMA Dermatology.

In the study, researchers led by Dr. April Armstrong of the University of California-Davis, in Sacramento, collected surveys from more than 5,600 patients with psoriasis or psoriatic arthritis. The surveys were conducted by the National Psoriasis Foundation (NPF) and collected between 2003 and 2011.

“Nontreatment and undertreatment of patients with psoriasis and psoriatic arthritis remain a significant problem in the United States,” Armstrong’s group concludes. “Specifically, in 2011 almost half of the patients with mild psoriasis, one-quarter of the patients with moderate psoriasis, and almost 10 percent of patients with severe psoriasis were not receiving any treatment.”

They add that because respondents to the survey were members of the NPF, and were therefore more likely to be engaged in their health care, the actual number of untreated patients is likely to be even higher.

Many patients were also found to be what the researchers called “undertreated” — for example, they might be using only a topical cream to ease their psoriasis, when the addition of a systemic drug might help even more.

Patient dissatisfaction with treatment was common. More than half (52.3 percent) of those with psoriasis said they were dissatisfied with their care, as did 45.5 percent of people with psoriatic arthritis, the study authors said.

Discontinuation of therapy was also widespread among patients, according to the study. The most common reason that patients stopped therapy was unwanted side effects. However, “the inability to obtain adequate insurance coverage was [also] among the top reasons for discontinuation,” Armstrong’s team wrote.

Goldenberg agreed that there are probably many missed opportunities to help patients fight psoriasis.

“Great advances have been made in psoriasis care, especially with the use of biologics, but a lot of patients are still unaware of these treatments,” he said.

“While these new treatments do have potential side effects, with careful monitoring biologics can be used to help many patients with psoriasis and psoriatic arthritis,” Goldenberg added. “Disease and treatment awareness are key to improve lives of patients with psoriasis and psoriatic arthritis.”

 

Dr. Goldenberg on CBS.COM – Psoriasis and Systemic Disease

August 10th, 2013 | Category: Media,Psoriasis

 

“It’s a mistake to think that psoriasis is just a skin disease,” said Dr. Gary Goldenberg, a dermatologist at Mount Sinai Medical Center in New York City, adding to Everyday Health the findings aren’t new. “We now know that it’s a disease of systemic inflammation… Similar inflammation likely occurs throughout the body, which can lead to diabetes, heart disease and even cancer.”

Psoriasis isn’t just a skin disease. This  comes as a surprise to many patients. In fact, psoriasis is associated with multiple internal problems, such as lymphoma, heart diseases, cardiovascular disease, diabetes and metabolic syndrome, obesity, arthritis, depression, smoking, alcohol abuse, and lung disease.

The inflammation you see on your skin is happening under the skin as well. Therefore, I counsel all my patients about these risks. Systemic treatments, such as with biologics, can help decrease some of these risks as well.

Psoriasis and Systemic Disease – Dr. Goldenberg quoted on everydayhealth.com

August 08th, 2013 | Category: Psoriasis

 

Dr. Goldenberg Discusses the Link Between Psoriasis and Systemic Disease

Did you know that psoriasis isn’t just a skin disease? It comes as a surprise to many patients. In fact, psoriasis is associated with multiple internal problems, such as lymphoma, heart diseases, cardiovascular disease, diabetes and metabolic syndrome, obesity, arthritis, depression, smoking, alcohol abuse, and lung disease.

The inflammation you see on your skin is happening under the skin as well. Therefore, I counsel all my patients about these risks. Systemic treatments, such as with biologics, can help decrease some of these risks as well.

Here are my quotes:

“The findings aren’t new, said Gary Goldenberg, MD, medical director of the dermatology faculty practice at Mount Sinai Medical Center in New York City, but they confirm that the worse psoriasis gets, the more likely a patient is to have other, potentially deadly, conditions.”

“It’s a mistake to think that psoriasis is just a skin disease,” Dr. Goldenberg said. “We now know that it’s a disease of systemic inflammation.  On the skin, psoriasis shows as red, inflamed patches. Similar inflammation likely occurs throughout the body, which can lead to diabetes, heart disease and even cancer.”

“Goldenberg said he makes sure to warn all his patients who are diagnosed with psoriasis that they need to take steps to avoid these diseases, and informs their doctors.”

“Lots of psoriasis patients are overweight,” he said, “so I encourage them to lose weight. I also write a letter to their primary doctor to let them know that psoriasis is associated with these other conditions, and that they should screen for them.”

“Informing their doctor allows physicians to test for diabetes, heart disease and other conditions more frequently, which is the best way to combat them, Goldenberg added. Many people with psoriasis will develop another deadly condition, and it’s important to get screened frequently, eat a proper diet and exercise.”

“It’s really about catching these diseases early so it’s not too late when they do occur,” Goldenberg said.

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