November Newsletter
Welcome to Novembers Newsletter.
OCTOBER 29TH WAS WORLD PSORIASIS DAY.
The Irish skin foundation are launching a digital awareness campaign…. #SaySomething.
Psoriasis affects many people in Ireland up to 30% of whom can also develop arthritis. Heart disease and high blood pressure are also more common in those with psoriasis, due the stigma attached to psoriasis depression can also be associated with this skin condition and stress can exacerbate it.
Those with psoriasis should have regular check -ups. There are some useful links at the end of this message.
Your doctor will examine your skin, scalp and nails.
It is related to the immune system – an autoimmune disease
It may run in families (there are several different genes involved in psoriasis)
It is not curable, but treatments are available
It is not contagious
It is sometimes associated with psoriatic arthritis
It is associated with slightly higher risk of diabetes, high blood pressure, high cholesterol and obesity
It is associated with slightly higher risk of cardiovascular disease (angina, heart attack and stroke)
There is a strong association between psoriasis and depression
If you suspect you have psoriasis your doctor will do a general exam but look specifically at your skin hair and nails
There are different types of psoriasis plaque psoriasis is most common
Make the most of your visit with your doctor
Do not be embarrassed about asking your doctor questions. Make a list of questions beforehand so you don’t forget, and take them with you to your appointment
Acknowledge your feelings and emotions about your condition. Share these with your doctor. It will help ensure that you get the most out of your visit
If you feel your mood is very low, you have lost interest in things you used to enjoy, you have changes in sleep patterns or appetite, or feel like life is not worth living – these are symptoms of significant depression and you should talk to your doctor urgently about these. Your doctor can prescribe medication, talking therapy or a combination of both. Depression is very common in psoriasis and is very treatable
Similarly, anxiety can cause disrupted sleep, panicky feelings, palpitations, excessive worrying and a feeling of inability to cope with the day to day tasks of life. Depression and anxiety sometimes occur together in the same person. There are effective treatments available. Do not suffer in silence
Ask your GP and dermatologist about your risks for heart disease. Your GP is an expert in screening for these and treating them if necessary
If you have symptoms of arthritis ask for referral to a rheumatologist
Make sure you understand the information your doctor is giving you. It is acceptable to say, “I don’t understand”
Learn more about psoriasis. This will make it easier to have a conversation with your doctor about treatment options and your treatment progress
Keep a diary of your symptoms and how you feel, and note any times that you forgot to take your medication
Treatment options step one:
Topical treatments
Topical corticosteroid cream
Calcipitriol a form of synthesised Vit D acts similarly to steroid cream but with fewer side effects
Coal tar
Dithranol is a cream that helps in plaque psoriasis to reduce cell turnover
Combinations of the above Eg: dovobet
Step two, Phototherapy or light treatment UVB or PUVA:
Uvb Ultraviolet light B (UVB), which is also present in natural sunlight, penetrates the skin and slows rapid growth of cells associated with psoriasis
There are two types of UVB treatment: broadband and narrowband. Most hospitals now use narrowband as it is more effective. Narrowband exposes the skin to a more specific range of UV wavelength
PUVA is an acronym for psoralen combined with ultraviolet light A (UVA). UVA, like UVB, is found in sunlight. UVA must be combined with a light – sensitizing medication such as psoralen to be effective. PUVA slows down the rapid cell growth of psoriasis
Step 3 systemic oral therapy (Tablets):
Methotrexate effective in psoriatic arthritis it is an anti-proliferative drug which improves the abnormal activity of the immune system in the skin
Cyclosporin A drug that suppresses T-cells in the immune system
Acitretin a vitamin A analogue also used in acne helps reduce abnormal cell growth rate
Step 4 Biological therapies:
An anti-TNF monoclonal antibody (TNF-alpha is a molecule which increases immune activity in your skin)
Adalimumab A TNF-alpha receptor blocker
Etanercept An anti-TNF monoclonal antibody given by infusion (“drip”)
Infliximab A monoclonal antibody that blocks interleukins 12/23. (These interleukins are involved in the abnormal immune responses in psoriasis).
These medications are also used in other conditions such as Cohn’s Disease or rheumatoid arthritis
Useful links include:
Irish Skin Foundation, www.irishskinfoundation.ie
Irish Association of Dermatologists, www.irishdermatologists.ie
British Association of Dermatologists, www.bad.org.uk
Psoriasis and Psoriatic Arthritis Alliance, www.papaa.org/self-help/etips
National Psoriasis Foundation, www.psoriasis.org
Our NEW “FREE WEE LIBRARY”
Free smear tests for women aged 25 to 60.
Cervical Check’s aim is to find changes in the cervix before they become cancerous.
Results take just 4 weeks.
Most smear tests are normal.
For information or details on Cervical Check visit: www.cervicalcheck.ie or Freephone 1800 45 45 55.
To arrange your free cervical smear test, please contact us here at The Medical Centre on 074 93 63611 and ask for Michelle.
Vascular Screening
We were delighted to welcome Mr. Sultan the professor of Vascular Surgery, Galway University Hospital to Buncrana Medical Centre last Tuesday.
He is offering male patients over 70 the opportunity to have a lifesaving ultrasound of the aorta, the carotid arteries and femoral arteries which is a unique opportunity to have a full vascular screening test.
This is also more important if you are a smoker or have high blood pressure
Any man over 70, if they are interested in screening please contact Anne Brogan (074 93 63611) as there will be another screening clinic in December
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