Tim Gunn’s Fashion Therapy for Psoriasis (psoriasis treatment)

Psoriasis Treatment
Fashion mentor Tim Gunn.

Tim Gunn may be best known as the exacting mentor to the stressed-out designers of “Project Runway,” but he is also a self-described “fashion therapist,” offering counseling and kindness to style-challenged women on his television show, “Tim Gunn’s Guide to Style.”

Mr. Gunn says it’s the pleasure of helping people “find their fashion” that sparked his interest in his latest role, spokesman for a new awareness campaign directed at the 7.5 million Americans with psoriasis. Psoriasis is a chronic disease of the immune system that appears on the skin, usually as thick, red, scaly patches. This week I spoke to him about his new role and how fashion can help people with the isolating and embarrassing skin condition.

Why did you decide to become a spokesman for psoriasis treatment?

My sister has psoriasis, but it wasn’t primarily because of her. I became very interested when I learned that one of the biggest impacts that this disease has on people is that it affects their perceptions of what they can wear. So many people who have psoriasis feel like their wardrobe options are very limited and their own fashion voice is seriously compromised. I want to spread the word that there are now many effective treatments out there. It was the fashion cheerleader in me, the quasi-fashion therapist who stepped in and said, “I’d love to be part of this message.’’

Many psoriasis patients are focused on covering up their skin. What difference can fashion make for them?

My role is to help people look at this from a positive point of view and bring some practical suggestions about how they can get their fashion right. It’s still about silhouette, proportion and fit. The closer your clothes follow your natural silhouette, the slimmer and more polished you will look.

I know most people with psoriasis are understandably inclined to cover it up. I would never say to someone, “Just show it off. Don’t worry about it.” If one’s personality is like that, that’s great. But all you need is one bad experience and right away wouldn’t the sleeves come back on? It’s complex. It’s inextricable from someone’s emotional health. But there is no reason why you can’t be the chicest person in the entire city covered up.

But in the case of psoriasis, with the right treatment, one can have the lifestyle one aspires to. My message really has been, “Go to a dermatologist, then go to Saks Fifth Avenue!” But it’s not going to happen overnight. While you’re waiting for your treatment to kick in, what are you going to do during that intermediate period? One of the issues with people with psoriasis is the scaling and flaking of skin. People say, “I can’t wear dark colors.” If your skin is flaking, there are treatments that can stop that. Until then, a person might consider wearing lighter colors.

And it’s not just about the clothing itself, but what’s between your psoriasis and the clothing. Undergarments can be a wonderful partner in helping with all this. Ointments and lotions and topical treatments can be sticky or oily. If you have a proper undergarment, you can wear a silk shirt or whatever you want.

What’s the purpose of the fashion show you’re hosting in September?

The people who will walk the runway are people with moderate to severe plaque psoriasis who have an inspiring story to tell, who have not been beaten down by this. We want them to be our role models about how you can live with this disease and have a fabulous life. A high percentage of people say this really erodes their morale, gives them low self-esteem and creates levels of shyness and embarrassment that they wish they didn’t have.

Do you see a larger connection between fashion and health?

It has everything to do with one’s self confidence. When you know you look good and you feel good in your clothes, you navigate the world with an erect posture and great carriage and bearing, and you feel fantastic. Clothes do that for you; they definitely do. That’s how what we want everyone with psoriasis to feel. It’s about self-esteem. The clothes we wear send a message and affect how the world perceives us. What is more profound than that? For anyone who says, “I can’t be who I want to be,” I want to help that person.

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Scientists find genes linked to psoriasis (psoriasis treatment)

[Top: A man suffering from psoriasis.]

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By Amresh Gunasingham

SCIENTISTS here may be a step closer to finding a cure for psoriasis, a disease that causes red scaly patches on the skin and affects 80 million people worldwide.

A study led by researchers at the Genome Institute of Singapore (GIS) has made a vital breakthrough in identifying genes that play a significant role in the development of the disease.

The team found that a certain cluster of genes - called Late Cornified Envelope - create proteins around cells located in the outer layers of the skin, which act as a barrier against psoriasis.

The findings were published in the prestigious journal Natural Genetics yesterday.

'This is an important finding, as it advances our understanding of the genetic basis of psoriasis,' said Associate Professor Liu Jianjun of the GIS, who led the research effort.

The GIS aims to find cures for diseases through genetic research.

The research team, which included researchers from the Anhui Medical University in China, studied more than 2,000 people.

The study was significant as it was the first to be performed on a Chinese population. Previous studies focused only on Western populations.

Prof Liu said the findings will have important implications in early detection and predicting an individual's risk of developing the disease.

The condition is caused by a mix of genetic and environmental factors such as climate, stress and hormone levels.

'With a comprehensive understanding of the risk factors involved, early diagnosis and even prevention of the disease is possible with proper treatment,' he said.

But he added that more research needed to be done before a cure could be developed.

According to the Psoriasis Association of Singapore, at least 13,000 people here suffer from the disease.

Dr Colin Pheng, president of the association, said the disease is a complicated one and linked to more than just a person's genetic makeup.

'The causes of psoriasis are multi-factorial, involving a combination of genetic and environmental factors,' he said.

'(But) research efforts can now be targeted in this area to ultimately find a cure for the disease.'

amreshg@sph.com.sg

This story was first published in The Straits Times on Jan 26, 2009.

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Biologic therapies:Safety of biologics for psoriasis examined through multiple lines of analysis (psoriasis treatment)

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Kohala Coast, HI — In weighing the safety of biological therapies for psoriasis, one of the most fundamental concepts to consider is that psoriasis itself is unsafe, said Kim A. Papp, M.D., Ph.D., at the Winter Clinical Dermatology Conference.

"That has ramifications for helping guide our treatment decisions and our patients who are deciding what treatments they will accept," said Dr. Papp, assistant professor of dermatology, University of Western Ontario, Canada.

In discussing the safety of biological therapies, Dr. Papp first provided a definition of safety, but by inverting the issue. He proposed anything may be considered "unsafe" if it compromises an individual’s well-being.

"We know that psoriasis impacts patients physically and emotionally and as much as such serious diseases as arthritis, cancer, chronic lung disease, among others," said Dr. Papp.

Further putting the safety of psoriasis treatment with biologics in perspective, he cited statistics about the risks of accidental death from various causes, including being an occupant of an automobile.

"Perhaps the biggest risk we are going to impose on our patients is asking them to come into our clinics for regular follow-up," he said.

Data from a recent population-based study has also identified that psoriasis may be an independent risk factor for myocardial infarction. In that analysis, younger patients with severe psoriasis were four to six times more likely to suffer a myocardial infarction than controls without psoriasis, and there was even an elevated risk of myocardial infarction in younger individuals with mild psoriasis.

"Looking at health-adjusted life expectancy after adjustment for other comorbidities, patients with moderate- to-severe psoriasis live on average three to four years less than a population without psoriasis," noted Dr. Papp.

Although there is no data available to characterize the relative risks of mortality and serious diseases associated with biologic treatment of psoriasis, relevant information can be gleaned from studies in the rheumatoid arthritis population.

Citing one study comparing populations of patients treated with nonbiologics (NSAIDs and DMARDs) versus those treated with biologics (TNF-alpha antagonists), Dr. Papp noted that the patients in the biologic group had lower relative risks for cardiovascular events and solid tumors. Treatment with the biologics was not associated with any increase in mortality.

"Although these data are not specifically from patients with psoriasis, rheumatoid arthritis is a chronic inflammatory disease like psoriasis and is associated with similar patterns of comorbidity. The bottom line is that biologics as a whole appear to be beneficial to our patients. They reduce hazards and they improve many aspects of our patients’ lives," Dr. Papp concluded.

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4 Genetic Hotspots Associated With Psoriasis Identified By Researchers (psoriasis treatment)

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A genomewide scan of millions of genetic mutations has revealed four new DNA "hotspots" that affect the risk for psoriasis, a national group of researchers led by the University of Michigan and including several from the University of Utah School of Medicine has shown in a just-published study. 

Appearing Jan. 25 in Nature Genetics online, the study also confirmed that two other previously identified DNA sites, discovered by researchers at the University of Utah and Celera Group, have a high association with psoriasis, an automimmune disease that can affect the joints and cause sore, itchy patches of skin in an estimated 7.5 million people in the United States. 

The study was led by James T. Elder, M.D., Ph.D., a dermatologist who heads a group at the University of Michigan with long-standing interest in and an international reputation for its work in the genetics of psoriasis, and Goncalo Abecasis, Ph.D., a biostatistician at the University of Michigan. They elected to make the study a collaboration with researchers at Washington University in St. Louis and the University of Utah. Gerald G. Krueger, M.D., professor of dermatology and Benning Presidential Endowed Chair holder at the U of U, and his colleague Kristina Callis Duffin, M.D., assistant professor of dermatology, led the Utah portion of the study.

Krueger and Duffin said the study is important for several reasons. 

"First, it shows the efficacy of using this (genomewide) approach to further understand this disease," Krueger said. "Second, it confirmed findings we reported in 2007 of polymorphisms (mutations) in the IL-12/23 pathways. Third, we now find a third polymorphism in this same cluster, IL-23A. Fourth, a treatment that knocks down IL-12 and IL-23 recently has been shown to be a very effective treatment for psoriasis." 

This, plus the clustering of polymorphisms the IL-12/23 pathways, makes it apparent that this pathway is important to the pathogenesis of psoriasis, according to Krueger. 

The researchers took advantage of a new technology called genomewide association studies (GWAS). At the heart of this is selecting from the more than10 million polymorphisms (mutations) in the human genome a group of polymorphisms that are predicted to be informative of association with disease, in this case psoriasis. The platform used in this experiment contained 438,670 polymorphisms. To assess for psoriasis-associated polymorphisms each of the 1,359 subjects with psoriasis and a control group of 1,400 people without the disease had their DNA probed for each of the 438,670 polymorphisms. After identifying 18 DNA sites with the highest associations with psoriasis, the researchers expanded the study to include 5,048 people with psoriasis and 5,051 without the disease. From that, the researchers identified seven potential genetic hotspots for psoriasis. 

Three of those sites - IL-12B, IL-23R and IL-13 - were first identified in earlier studies by Krueger and other University of Utah and Celera Group researchers. A third gene, HLA-C, has the strongest association with psoriasis and has been found numerous times by many investigators. Most recently, the Elder group showed this association appears to be linked to an allele of HLA-C called *0602, and the latest study confirms this, once again. Three new polymorphisms reported in the Nature Genetics study - IL-23A, TNFAIP3, and TNI1 - had not been linked to the skin and joint disorder, and in addition there has been confirmation of IL-13 and a closely linked partner IL-4. 

The researchers concluded that IL-12B and IL-23-R encode proteins that bind to IL-23A and that mutations in any of those genes may predispose people to immune responses that lead to psoriasis. The study also showed that genetic signals from two regulatory elements, TNFAIP3 and TNI1, of TNF-alpha, may be faulty regulating the TNF-alpha induced inflammation of psoriasis and psoriatic arthritis. Polymorphisms of TNFAIP3 and TNI1 are also associated with two other autoimmune diseases, lupus and rheumatoid arthritis. 

The number of DNA sites discovered to have strong associations with psoriasis has increased from one to 10 in the past 18 months. But many more polymorphisms probably are associated with the disease, according to Krueger. He believes the number that ultimately will be associated with psoriasis could be close to 300. 

Once all the gene mutations connected to psoriasis have been indentified, researchers may be able to develop a genetic profile to predict the risk of developing the disease, the type of disease, and response to treatment. Krueger expects that quite soon a gene chip containing psoriasis-associated genetic mutations will be available to aid in the study of the disease. 

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Article adapted by Medical News Today from original press release.

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Other University of Utah researchers involved in the study are: David E. Goldgar, Ph.D., research professor of dermatology; and research fellow Bing-Jian Feng, Ph.D. 

Psoriasis is a chronic skin disease of scaling and inflammation that affects up to 2 percent of the U.S. population. It causes red, scaly patches that itch or are sore to occur on the skin. Ten percent to 30 percent of people with psoriasis also develop a painful inflammation of the joints called psoriatic arthritis. The disease is strongly connected to genetics. If both parents have psoriasis, their offspring have a 50 percent chance of developing the disease. In its most acute form, psoriasis leaves people feeling socially isolated and sometimes unable to hold meaningful employment or develop social relationship.

Source: Phil Sahm
University of Utah Health Sciences    

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