Psoriasis

From Biohacking Wiki

What Is It

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Severe psoriasis on back and arms

Unpredictable and irritating, psoriasis is one of the most baffling and persistent of skin disorders. It's characterized by skin cells that multiply up to 10 times faster than normal. As underlying cells reach the skin's surface and die, their sheer volume causes raised, red plaques covered with white scales. Psoriasis typically occurs on the knees, elbows, and scalp, and it can also affect the torso, palms, and soles of the feet.
The symptoms of psoriasis vary depending on the type you have. Some common symptoms for plaque psoriasis — the most common variety of the condition — include:

  • Plaques of red skin, often covered with loose, silver-colored scales; these lesions may be itchy and painful, and they sometimes crack and bleed. In severe cases, the plaques of irritated skin will grow and merge into one another, covering large areas.
  • Disorders of the fingernails and toenails, including discoloration and pitting of the nails; the nails may also begin to crumble or detach from the nail bed.
  • Plaques of scales or crust on the scalp


Psoriasis can also be associated with arthritis, which leads to pain and swelling in the joints. The National Psoriasis Foundation estimates that between 10% to 30% of people with psoriasis also have psoriatic arthritis.

 

What Causes It

Psoriasis is a common skin disease which is characterized by the proliferation and abnormal differentiation of keratinocytes, coupled with complex immune disturbances[1]

Jun/Ap-1 proteins have been shown to be closely linked to the control systems for skin inflammation.[2][3]  

Traditional Treatments

Traditional medicine views Psoriasis as "incurable." Most doctors will therefore only attempt to treat it on a symptomatic basis, prescribing a variety of topical treatments. These include: [test|test1]

  • Steroid-based creams - the most common treatment, effective for quick relief for a flare-up
  • Salicylic acid - helps to shed the build-up of dead skin cells. Can have negative side effects.
  • Calcipotriene -containing topical ointment 
  • 'Coal-tar ointments and shampoos'
  • Prescription retinoids 
  • Light therapy
    • PUVA - drug psoralen + UVA light, uncommonly prescribed due to cancer concerns
    • UVB
  • Oral Drugs

Note: even with traditional drugs, if efficacy of treatment begins to diminish then it has been shown that switching compounds can have a beneficial effect.[4]

Applicable Biohacks

Psoriasis is essentially excessive inflammation of the skin cells. Many of the treatments therefore are focused on reducing inflammation.

Diet

Avoid sugar, carbohydrates, and personal food sensitivities (these often include foods such as eggs, milk, and legumes). 

Gut Health / Probiotics

In recent years we have begun to understand that a large number of autoimmune disorders are intrinsically linked with the microbiome of the gut. 

In one study the oral administration of a particular therapeutic microbe, Bifidobacteria infantis (B. infantis) 35624, for 6-8 weeks showed significantly decreased plasma levels of C-reactive protein (CRP) and the pro-inflammatory cytokines tumor necrosis factor α (TNF-α) in patients with psoriasis (as well as two other inflammatory diseases, ulcerative colitis  and chronic fatigue syndrome).[5]

Supplements

Glutathione

"Glutathione supplementation saw improvements in patients being treated for skin disorders and autoimmune disease such as psoriasis, due to the effect glutathione has on decreasing immune reactivity and supporting immune function. Additional support in the cell happens due to the fact glutathione helps to reduce the cell proliferation seen in psoriasis."[6]

Vitamin D

Psoriasis is characterised by the proliferation and abnormal differentiation of keratinocytes, coupled with complex immune disturbances. Vitamin D derivatives such as calcipotriol and/or tacalcitol (applied topically so as to limit their effect on calcium metabolism) have the capacity to inhibit proliferation of, and induce normal differentiation in keratinocytes as well as help modulate the immune system.[7] [8][9]

Compared with 1,25(OH)2D3, calcipotriol is about 200 times less potent in its effect on calcium metabolism although similar in receptor affinity.[10]

Vitamin D values have been found to be significantly lower in patients with psoriasis (and with obesity).[11][12][13]

A group of patients treated with 35,000 IU once daily for six months in association with a low-calcium diet (avoiding dairy products and calcium-enriched foods like oat, rice or soya “milk”) and hydration (minimum 2.5 L daily). All patients shows a significantly improved PASI score after treatment (Psoriasis Area and Severity Index). Serum urea, creatinine and calcium (total and ionized) did not change and urinary calcium excretion increased within the normal range. [14]

Zinc

Zinc pyrithione was shown to be a safe and effective treatment for psoriases when applied topically. [15] [16]The benefit was attributed to the antiproliferative effect.

Zinc sulphate was found to be effective when taken orally for treating psoriatic arthritis[17]  but not for plaque psoriasis.[18]

Textiles formulated with ZnO were shown to be effective in treating atopic dermatitis (AD), another chronic inflammatory skin diseas. The garments were shown to have both antioxidative and antimicrobial properties, and improved both the skin and overall sleep quality[19] . While this study did not look at patients with psoriases, given the other studies showing zinc's effectiveness as a psoriases treatment sorts of textiles could be an easy, effective biohack.

Therapies

UVB

UVB exposure (light at 280-320nm) is known to induce synthesis of hormonally active calcitriol (1alpha,25-dihydroxyvitamin D(3]].[20]

Contrary to popular belief, the ideal time to get a healthy dose of UVB from sun exposure is around noon. This is because the atmosphere scatters the shorter wavelengths more than the longer ones of UVA (320-400nm), and UVA is what is more strongly linked to cancer. [21]

The overall risk of skin cancer in patients treated with UVB was not found to be greater than that of the general population.[22]

When using specialized bulbs to produce UVB rather than sun exposure, narrow-band UVB has been found to be effective (311–312nm).[23][24] {addreference biblio_code="sigmun2005"} 

UVB radiation has been shown to be one of the most effective overall treatments for psoriasis, but the specific mechanism of its operation is still being explored. Three of the more well-researched pathways in which it operates are as follows:

  1. Alteration of cytokine profile 
  2. Induction of apoptosis
  3. Promotion of immunosuppression

As biohackers we often tend to be more results focused, but if you care about the underlying complicated biology, this paper by Wong et. al. is a fantastic resource.[25]

Anecdotes

 

--- Name - Joe Shmoe

Experience with the issue - What were your symptoms? How did you get it? How did it impact your life?

Treatment History - What did you try? What worked? What didn't?

 

---  


 

This article uses material from the Wikipedia article Psoriasis, which is released under the Creative Commons Attribution-Share-Alike License 3.0

  1. The therapeutic effects of vitamin D3 and its analogues in psoriasis. Guilhou JJ 1998 https://www.ncbi.nlm.nih.gov/pubmed/15991920
  2. Wagner EF, Bone development and inflammatory disease is regulated by AP-1 (Fos/Jun). 2010. https://www.ncbi.nlm.nih.gov/pubmed/19995753
  3. Uluçkan Ö, Guinea-Viniegra J1, Jimenez M1, Wagner EF. Signalling in inflammatory skin disease by AP-1 (Fos/Jun), 2015, https://www.ncbi.nlm.nih.gov/pubmed/26458100
  4. Ganzetti G, Campanati A, Bettacchi A, Brandozzi G, Brisigotti V, Bugatti L, Cataldi I, Filosa G, Giacchetti A, Lemme G, Morresi L, Nicolini M, Postacchini V, Ricotti G, Rosa L, Simonacci M, Offidani A. (2016) The switching from a biological therapy to another biologic agent in psoriatic patients: the experience of PsOMarche group.https://www.ncbi.nlm.nih.gov/pubmed/27845513
  5. David Groeger, Liam O’Mahony, Eileen F. Murphy, John F. Bourke, Timothy G. Dinan, Barry Kiely, Fergus Shanahan, and Eamonn M.M. Quigley (2013) Bifidobacterium infantis 35624 modulates host inflammatory processes beyond the gut https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744517/
  6. Biohacker Labs http://www.biohackerlabs.com/nutrition-hacking/glutathione-important-nutrient
  7. Guilhou, JJ(1998) The therapeutic effects of vitamin D3 and its analogues in psoriasis. https://www.ncbi.nlm.nih.gov/pubmed/15991920
  8. Lehmann B(2005).The vitamin D3 pathway in human skin and its role for regulation of biological processes.https://www.ncbi.nlm.nih.gov/pubmed/16162035
  9. Morimoto S1, Yoshikawa K. (1989) Psoriasis and vitamin D3. A review of our experience. https://www.ncbi.nlm.nih.gov/pubmed/2536537
  10. Kragballe K (1992)Vitamin D3 and skin diseases.https://www.ncbi.nlm.nih.gov/pubmed/1337425
  11. Orgaz-molina J, Buendía-eisman A, Arrabal-polo MA, Ruiz JC, Arias-santiago S. Deficiency of serum concentration of 25-hydroxyvitamin D in psoriatic patients: a case-control study. J Am Acad Dermatol. 2012;67(5):931-8.
  12. Gisondi P1, Rossini M, Di Cesare A, Idolazzi L, Farina S, Beltrami G, Peris K, Girolomoni G. (2012) Vitamin D status in patients with chronic plaque psoriasis. https://www.ncbi.nlm.nih.gov/pubmed/22013980
  13. Barrea L, Savanelli MC, Di somma C, et al. Vitamin D and its role in psoriasis: An overview of the dermatologist and nutritionist. Rev Endocr Metab Disord. 2017;18(2):195-205.
  14. Danilo C Finamor, Rita Sinigaglia-Coimbra, Luiz C . M. Neves, Marcia Gutierrez, Jeferson J. Silva, Lucas D. Torres, Fernanda Surano, Domingos J. Neto, Neil F. Novo, Yara Juliano, Antonio C. Lopes, and Cicero Galli Coimbra (2013) A pilot study assessing the effect of prolonged administration of high daily doses of vitamin D on the clinical course of vitiligo and psoriasis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897595/
  15. Crutchfield CE 3rd, Lewis EJ, Zelickson BD.(1997) The highly effective use of topical zinc pyrithione in the treatment of psoriasis: a case report. https://www.ncbi.nlm.nih.gov/pubmed/9141364
  16. Sadeghian G, Ziaei H, Nilforoushzadeh MA (2011) Treatment of localized psoriasis with a topical formulation of zinc pyrithione. https://www.ncbi.nlm.nih.gov/pubmed/22367374/
  17. Clemmensen OJ, Siggaard-Andersen J, Worm AM, Stahl D, Frost F, Bloch I (1980) Psoriatic arthritis treated with oral zinc sulphate.
  18. Burrows NP, Turnbull AJ, Punchard NA, Thompson RP, Jones RR Cutis. (1994) A trial of oral zinc supplementation in psoriasis. https://www.ncbi.nlm.nih.gov/pubmed/7956335/
  19. wiegand1997
  20. Lehmann B (2005) The vitamin D3 pathway in human skin and its role for regulation of biological processes. https://www.ncbi.nlm.nih.gov/pubmed/16162035
  21. Moan J, Dahlback A, Porojnicu AC. (2008) At what time should one go out in the sun? https://www.ncbi.nlm.nih.gov/pubmed/18348449
  22. Osmancevic A, Gillstedt M, Wennberg AM, Larkö O.(2014) The risk of skin cancer in psoriasis patients treated with UVB therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736829/
  23. Leanne M. Johnson-Huang, Mayte Suárez-Fariñas, Mary Sullivan-Whalen, Patricia Gilleaudeau, James G. Krueger, and Michelle A. Lowes (2010) Effective narrow-band ultraviolet B radiation therapy suppresses the IL-23/IL-17 axis in normalized psoriasis plaques https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955161/
  24. Sigmundsdottir H, Johnston A, Gudjonsson JE, Valdimarsson H. (2005) Narrowband-UVB irradiation decreases the production of pro-inflammatory cytokines by stimulated T cells. https://www.ncbi.nlm.nih.gov/pubmed/15889264
  25. B.S. Tami Wong, B.A. Leon Hsu, and M.D. Wilson Liao (2013) Phototherapy in Psoriasis: A Review of Mechanisms of Action https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736829/