THE COAST NEWS
AUG. 21, 2009
TO YOUR HEALTH CONTINUED FROM B4
severe, visible psoriasis may be social embarrassment, job and emotional distress, and other personal issues. Up to 30 percent of those with psoriasis develop psoriatic arthritis. Psoriasis can occur on any part of the body, but commonly affects the skin of the elbows, knees, and scalp. The fingernails, toenails, and genitals may also be involved. Other health conditions, including diabetes, heart disease, hypertension, and depression can accompany psoriasis. Typically diagnosed in the early adult years, it can be seen in babies and seniors alike. It affects both sexes equally and all races, although it is seen most frequently in Caucasians. Not everyone who inherits the genes for psoriasis develops the condition. About one in three persons with psoriasis has a close relative who is also affected. It is not known exactly what causes the T cells to malfunction; however, in those who are genetically predisposed, environmental triggers may start or worsen the condition. These triggers may include infections, such as strep throat, injury to the skin, stress, cold weather, smoking, heavy alcohol consumption, and certain medications — including lithium, which is prescribed for bipolar disorder; and high blood pressure medications such as beta blockers. Psoriasis can be associated with joint problems, which at times may be the only sign of the disorder, although skin symptoms typically occur before the onset of the arthritis. Psoriatic arthritis is an inflammatory, destructive form of arthritis often involving the hands, knees and ankles, and is typically treated with oral medications to inhibit the disease progression. Dermatologists specialize in the diagnosis and
SMALL TALK
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week. My child may only have been gone six months, but she gained years of perspective. She was distressed, but I won’t lie. I relished every, “I have to admit, Mom, you were right.” Meanwhile, I indulged my “Mommy” mode. I schlepped over our rug shampooer, along with a bag full of cleaning products and my heavy-duty rubber gloves. I packed all the kitchen stuff I had pawned off on her and never want to see again. Those boxes will definitely stay in the garage. I did grind my teeth a bit as she ignored my various suggestions on how to wrap and pack, instead tossing things, willy-nilly, into boxes. The really hard part was
treatment of psoriasis, and rheumatologists specialize in the treatment of joint disorders and psoriatic arthritis. Most patients will be treated by one or both of these specialists, or by their family physician or internist. Psoriasis treatments may be topical, light-based therapy, or oral. Treatment is begun with the mildest and safest treatments, usually creams and ultraviolet light, progressing to oral treatments if necessary. Topical treatments may contain corticosteroids, synthetic vitamin D, vitamin A derivatives, calcineurin inhibitors (not FDAapproved for psoriasis, but may be used “off-label”), coal tars, salicylic acid, and other substances. Oral medications may include retinoids (related to vitamin A), immunosuppressant drugs such as methotrexate and cyclosporine, and a class of immunomodulating drugs called “biologics.” Oral drugs may have severe side effects, and are used with caution only when necessary. The goal is to find the most effective medication for each particular patient while minimizing adverse effects. Although not “curable,” psoriasis is usually “controllable.” Patient education and partnership with a concerned and knowledgeable physician will go a long way toward the goal of living well with psoriasis. Finally, whether or not one has psoriasis, it is a good idea to schedule an annual skin exam with either your primary care physician or dermatologist, especially if you have spent years in the sun, used artificial tanning, received light treatments for psoriasis, or have concerns due to a change in your skin. “To Your Health” is brought to you by the physicians and staff at Scripps Memorial Hospital Encinitas. For more information or for physician referral call 1-800-SCRIPPS.
admitting I had become such a fuss-budget. As I stood looking at the half-empty apartment, I was filled with fond memories of my feckless, footloose days when it was me tossing
he was distressed, but I won’t lie. I relished every, “I have to admit, Mom, you were right.”
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things into boxes, willy-nilly. But I always got that deposit back. Jean Gillette is a freelance writer and one-time vagabond. Contact her at jgillette@coastnewsgroup.com.
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reached. Once you have exhausted that number, you will no longer receive a check. However, you may live there for the balance of your life and your husband’s. At the time that both you have passed on, the home will be sold and the mortgage company will recover its advances plus interest. The older you are the more viable a reverse mortgage becomes.
year-old single woman. I only have $15,000 in savings. I wanted to get a Roth IRA for this year but I didn’t understand it and I have missed out. Can I get one for 2010? Reader in Pennsylvania
Dear Reader: You most certainly can. Whether it is wise for you to put your money into a Roth IRA is another question, since you will have to wait for six years to get at the principal. Having said that, a Roth IRA is still a deal since whatever it earns is totally tax-free. If you are in a very Dear Bruce: I’m a 58- low income-tax bracket,
B19 where you are paying no percent, 8 percent, 12 pertaxes anyway, the tax-free cent and so on) into 72. This feature becomes academic. will tell you how many years it will take for those dollars Dear Bruce: Is it possi- to double. ble to figure out how much You can do this each money I would have in 20 year for not only the former years if my wife and I put deposits but the current $5,000 a year into a Roth deposits. IRA every year? At the end of your calReader in Connecticut culation you will have some idea what you will have. If Dear Reader: Because performance does not meet we don’t know the rate of your expectations then the return on your investment it number will drop dramatiis difficult to forecast how cally. This is only a guesstiquickly your money will mate and should be treated grow. as such. What you can do for each year is to divide what- Send questions to Smart Money, P.O. ever rate of return you think Box 503, Elfers, FL 34680, or e-mail you’re going to receive (6 them to bruce@brucewilliams.com. .