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RENEE MONTAGNE, host:

This is MORNING EDITION from NPR News. I'm Renee Montagne. Today in Your Health, we have two reports on skin disease. We take a look at triggers that can cause flare-ups. We start with psoriasis. It's painful, and it has the added discomfort of being embarrassing. NPR's Patti Neighmond begins her report on how patients cope at a fashion event.

(Soundbite of applause)

PATTI NEIGHMOND: A fashion show in New York City. Cindy McGowen walks the catwalk. Like the other models, McGowen wears a custom-designed outfit: a spaghetti-strap dress, showing off her arms, which are covered with psoriasis, thick, dry red patches of skin.

Ms. CINDY MCGOWEN (Model): I have it on both my elbows, both my knees, both my ankles. I have large patches up the back of my triceps, some patches that go down to my wrist and on all of my knuckles. And I also have a different pattern. They kind of call it the raindrop pattern, where it just sprinkles little dots on different parts of your body.

NEIGHMOND: All the models, including one man, have severe cases of plaque psoriasis, the most common form of the disease. It's not contagious, although uneducated strangers often think it is. At its most severe, it can be very painful and itchy. It comes and goes. No one knows exactly why outbreaks occur. Psoriasis is a chronic, lifelong disease.

(Soundbite of music)

Unidentified Man: Let's welcome to the auditorium…

NEIGHMOND: McGowen says events like this, co-sponsored by drug manufacturers and the National Psoriasis Foundation, among others, aim to demystify the disease so strangers don't gawk. For Isabel Estevez, this kind of support was literally lifesaving, she says. Estevez was diagnosed at five years old. At nine, she had an experience that shaped her life. She was at a water park.

Ms. ISABEL ESTEVEZ (Model): My skin was pretty bad broken out, and a young girl approximately my age with her mother saw my skin and immediately freaked out and tugged on her mother, oh, my God, what's wrong with that girl? And the mother looked at me, shocked, equally in terror, pulled her daughter away from me, and, you know, she said, stay away.

And it was at that point that I never went back to a water park, or that's when I really began hiding my skin from the world, because just the look on their faces really just sent me into shame.

NEIGHMOND: So Estevez wore pants and long sleeves, no matter how hot. She never wore her hair up. She wore jackets all the time. Then, she did an Internet search on psoriasis and found the National Psoriasis Foundation, which happened to be having a conference in Chicago, near her home.

Ms. ESTEVEZ: I genuinely thought I was going to show up to this conference and I would be the only one there. And imagine my eyes when I walked in and there was a room full of 500 people, all with psoriasis, all who knew what I was going through. I saw people exposing their skin and not afraid, and it, in turn, gave me the inspiration to do the same.

NEIGHMOND: Support from other patients, says Estevez, has helped to bring her out of hiding.

Ms. ESTEVEZ: You know what? I wear whatever I went.

(Soundbite of laughter)

Ms. ESTEVEZ: I mean, if it's cold, I wear long sleeves. If it's hot, I'll wear sleeveless. I'll wear shorts. If someone wants to go to the beach, OK, what time should I be there? I'll bring my sunscreen.

NEIGHMOND: There is no cure for psoriasis, And treatments often fail or wear off over time. Some people use anti-itch creams, which often contain cortisone or other steroids. There are ointments that contain tar, creams that reduce scaling, dandruff shampoos, moisturizers, vitamin D or A. Oatmeal baths can soothe and ultraviolet light treatments can help.

For severe psoriasis, there are medicines to suppress the body's immune response, because psoriasis is thought to be an autoimmune disease where the body's immune system turns on itself.

But the most promising treatments, say dermatologists like Mark Lebwohl from Mount Sinai School of Medicine in New York, are drugs called biologics, which came on the market about five years ago.

Dr. MARK LEBWOHL (Dermatologist, Mount Sinai School of Medicine): Most of the biologics available are forms of antibodies that are directed against specific parts of the immune system.

NEIGHMOND: Because the drugs suppress the immune system, patients may be more vulnerable to certain infections and even malignancies. Lebwohl says there's a dramatic new biologic waiting federal approval.

Dr. LEBWOHL: For the first time, we actually have an injection where you get four shots a year and it clears the majority of patients with just four shots a year. And that is a true breakthrough.

NEIGHMOND: About three-quarters of patients with severe psoriasis saw dramatic improvement. For half of the patients, the psoriasis cleared completely.

Patti Neighmond, NPR News.

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