Replacement Skin

Biologics effective as weapon against psoriasis.

Since Paul Day was a teen, he suffered with an irritating disorder that caused flaky patches to form on his body that were both uncomfortable and unsightly. His doctor diagnosed his condition as the skin disease psoriasis.

Jason Welch, MSN, NP-C, at Blue Ocean Dermatology in Port Orange treats Paul Day for psoriasis with the biologic COSENTYX®.

“I love the way my skin looks. My wife says my elbows are beautiful, and my knees are looking excellent.” – Paul

Psoriasis occurs when an overactive immune system produces too many new skin cells to replace skin cells that are damaged or die. As a result, the extra skin cells pile up on top of one another, forming tough, flaky patches.

“My psoriasis started as areas about the size of a lemon, with big, white flakes on my knees, elbows and the top of my head,” describes the former carpenter. “They didn’t hurt. It was more embarrassing than anything, so I always wore jeans and long-sleeve shirts to cover up my elbows and knees.”

As Paul grew older, his psoriasis became progressively worse. Eventually, the Maryland native sought treatment for his condition from several skin specialists.

“I went to one dermatologist for nine months, and they gave me creams to treat my psoriasis,” Paul recalls. “Another dermatologist tried lotions and ultraviolet light, but none of that worked. For six months they did that and nothing helped.”

When those practitioners failed to find answers for Paul’s uncomfortable symptoms, his wife decided to research other providers in the area. Her search led her to Blue Ocean Dermatology in Port Orange, where her husband met with Jason L. Welch, MSN, NP-C, a certified nurse practitioner specializing in dermatology.

“I really like Jason,” Paul states. “He’s very knowledgeable and answered all my questions. The first thing he told me was, Get rid of that cream. You’ve got to treat psoriasis from the inside out instead of the outside in.”

Cancer and Precancer

According to the latest estimates, 6.7 million people in the United States are afflicted with some form of psoriasis, Jason reports. It’s caused by a disconnect in the body’s protein chain that tells the skin to stop making new cells.

“The process is similar to that of fixing a pothole in a highway,” Jason describes. “In that case, workers hurry to fill in the hole before a car gets damaged. When there’s a break in the skin, the body hurries to repair it before bacteria get in. To do the repair work, the body produces a protein that tells it to make layers of skin cells to fill in the wound.

“Once the wound is healed, that cell-making mechanism stops. But with psoriasis, it doesn’t stop. The skin continues to produce skin cells on top of skin cells, then plaques form. Further, the skin around the plaques itches intensely. When that occurs, most people scratch, which breaks the skin again. It’s a continuous cycle.”

Traditionally, the mainstays of psoriasis treatment have been topical steroids, tar treatments and light therapy. Unfortunately, light therapy also poses a risk of skin cancer, so using it is a double-edged sword. A little more than a decade ago, however, a new type of treatment became available that revolutionized psoriasis management.

“About thirteen years ago, biologic medications such as ENBREL® and HUMIRA® were introduced to treat psoriasis,” Jason observes. “Protein-based biologics work by targeting specific types of immune system cells that are involved in the development and progression of psoriasis.

“These treatments are especially important because psoriasis is not just a skin disorder. It also causes psoriatic arthritis, which can attack the joints and the tissue lining the organs and damage them. Psoriatic arthritis causes inflammation, and chronic inflammation can also lead to heart attacks and cancer.”

At Blue Ocean Dermatology, Jason and the rest of the staff have access to a full complement of therapy options for treating patients with psoriasis.

“We’ve got all the tools available,” he verifies. “In addition to a phototherapy cabinet and excimer laser, which is another therapy for psoriasis, we also have an extensive knowledge and expertise in the use of biologics.

“There are a number of biologics available to prescribers, and based on my experience, I chose the one for Paul that reacted for him as I expected, which is COSENTYX®, and gave him an injection on November first.”

Beautiful Elbows

Jason explains that with COSENTYX, he gives the first injection to the patient in the office. The patient then returns to the office four weeks later for a second dose. After that, dosing is once a month. Eventually, patients are able to give themselves the injections. That’s how Paul receives his medication now, and he’s thrilled with the results.

“I noticed a real difference in the appearance of my skin about two months after I started to receive the injections, and now, I love the way my skin looks,” Paul raves. “My wife says my elbows are beautiful, and my knees are looking excellent. I’m not embarrassed to show my skin anymore. I wear short-sleeve shirts and shorts now.

“I recommend Jason and Blue Ocean Dermatology to anybody.”

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    • Blue Ocean Dermatology

      Blue Ocean Dermatology provides outstanding medical and aesthetic dermatology to people of all ages. All services are performed with integrity and honesty, and with high regard to humane concerns.... Read More

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    • Nitra H. Welch, MSN, NP-C

      Nitra H. Welch, MSN, NP-C, received her Bachelor of Science degree in Nursing from Troy State University in Troy, AL. She was an ICU nurse for eight years. She earned her Master of Science degree in Nursing and her family nurse practi... Read More

    • Jason L. Welch, MSN, NP-C

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    • Alina Collins, ARNP

      Alina Collins, ARNP, received her Bachelor’s degree from Walsh University in North Canton, Ohio and her Master’s degree in Nursing from the University of Central Florida in Orlando. Prior to earning her Master’s degree, she worked as a registere... Read More