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• Well off use more drugs than the jobless
  Published 01 February 2010
• Ministers aim to halve number of people smoking by 2020
  Published 01 February 2010
• Male breast op numbers 'growing fastest'
  Published 01 February 2010
• York's 2010 Race For Life launched
  Published 01 February 2010

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Living with psoriasis

Taking charge of psoriasis is about finding an effective treatment and gaining control of your life.

Here are some practical tips to help you manage the effect of psoriasis on your life.

• Learn more about psoriasis, so you can explain what it is to others. Talking comfortably about psoriasis will help you open up to the outside world.
• Try sharing your feelings about psoriasis and how it impacts your life. It could be easier than you think and could make a big difference in how you feel.
• Understand that some people will react inappropriately to your condition. These reactions usually result from misunderstanding. Try not to dwell on comments that seem hurtful or negative.
• Focus on the positive things in your life like friends and family, activities you enjoy and accomplishments you are proud of.

Psoriasis and stress

Studies show that, in some instances, stress can make psoriasis worse. Learn to limit the stress in your life. Try keeping track of the situations you find stressful, then find practical ways of reducing them.

Different people have different ideas about what stress is. Stressful situations can vary from the death of a relative to a cracked coffee cup.

No matter what causes you to become stressed, there are some simple things you can do to control your stress levels.

• Accept your psoriasis coming to terms with your condition will allow you to move forward.
• Ask your family and friends for support. Share your frustrations with others instead of keeping them to yourself.
• Relax and take time for yourself, especially during outbreaks or times of the year when you know your psoriasis is likely to be worse.
• Exercise regularly or practice yoga or meditation to help you relax.
• Eat healthy and get enough sleep to generate positive benefits for both your body and mind.
• Join a psoriasis support group to meet people with similar experiences.

Co-morbidities associated with psoriasis and their potential impact on disease management

It is now increasingly evident that psoriasis can be associated with other diseases which may have a major impact on patient health. The more common co-morbidities include psoriatic arthritis and anxiety/depression disorders. More recently, psoriasis has also been associated with cancers and metabolic disorders including obesity, dyslipidemia and diabetes. Major factors that may contribute to the unfavourable risk profile include: cigarette smoking, obesity, physical inactivity, hyperhomocysteinemia and psychological stress that have a higher prevalence among patients with psoriasis.

Increased mortality from cardiovascular diseases in patients with severe psoriasis has been documented and this may confer an independent risk of myocardial infarction. Severe psoriasis is associated with a number of cardiovascular risk factors and a higher risk of mortality for cardiovascular events. Patients with psoriasis should be carefully evaluated for cardiovascular diseases and associated risk factors. They should also be encouraged to aggressively correct their modifiable cardiovascular risk factors. Improved management of psoriasis may also positively affect some cardiovascular risk factors.In effect, any management of the psoriasis co-morbidity (e.g. obesity) is management of psoriasis.

Many traditional systemic therapies may also worsen cardiovascular risk factors such as hyperlipidemia (retinoids, ciclosporin) and hyperhomocysteinemia (methotrexate). The adverse effects of drugs on co-morbidities should be taken into account when selecting a therapy for psoriasis.

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