Psoriasis

Treatment

Treating psoriasis can improve a patient’s quality of life by decreasing the appearance of plaques and the associated scaling and itch. There are many different ways to treat psoriasis. The extent of the skin involvement and the presence of arthritis will determine a patient’s appropriate therapy. It is important to keep in mind that individual patients can respond differently to certain therapies.

Treatment options for psoriasis include:

• Biologic Medications— medications that target specific components of the immune system. They are used for moderate to severe psoriasis in patients that have not responded to or cannot take other systemic treatments, or if there is joint involvement. They are given by subcutaneous (just below the surface of the skin) injection or intravenous (IV) infusion. There are risks and side effects associated with the use of biologics which will need to be discussed with your dermatologist.
• Systemic Medications— like biologic medications, systemic medications work by targeting the immune system. They are either oral or injectable prescription drugs that work throughout the body. They are usually used for individuals with moderate to severe psoriasis and psoriatic arthritis. Systemic medications are also used when a patient has failed or cannot use topical medications or UV light therapy.
• Ultraviolet B (UVB) Phototherapy— also referred to as light therapy. This treatment involves consistent exposure of the skin to ultraviolet light under medical supervision. Treatments are done in a doctor's office or at home with a phototherapy unit.
• Excimer Laser Therapy — was recently approved by the Food and Drug Administration (FDA) for treating chronic, localized plaque psoriasis. It emits a high-intensity beam of ultraviolet light B (UVB). The excimer laser can target select areas of the skin affected by mild to moderate psoriasis, and research indicates it is a particularly effective treatment for scalp psoriasis.
• Pulsed dye laser— is approved for treating chronic, localized plaque psoriasis. Using a dye and different wavelength of light than the excimer laser or other UVB-based treatments, pulsed dye lasers destroy the tiny blood vessels that contribute to the formation of psoriasis lesions.
• Topicals— come in many forms: creams, ointments, shampoos, etc. Topical medications are applied to the affected skin and are usually first-line treatment. They can be used in addition to systemic medications. Topicals can be purchased over the counter or by prescription and include substances such as corticosteroids, salicylic acid, coal tar, zinc pyrithione and capsaicin.
• Complementary and Alternative Treatments —Always talk to your doctor or consult with a licensed health care professional before adding any complementary and alternative treatments to your treatment plan for psoriasis and psoriatic arthritis.

Prevention

Living with psoriasis has unique challenges, but health care providers are becoming more aware of the impact psoriasis can have on a person's quality of life. The best way to prevent flares is to avoid and treat known triggers, such as infections and specific medications.

*Source:

American Academy of Dermatology National Psoriasis Foundation

What Is Psoriasis?

Psoriasis is a skin disease that causes scaling and inflammation (pain, swelling, heat, and redness). Skin cells grow deep in the skin and slowly rise to the surface, a process called cell turnover, which normally takes a month can occur in just a few days because the cells rise too fast and pile up on the surface.

Most psoriasis causes patches of thick, red skin with silvery scales. These patches can itch or feel sore. They are often found on the elbows, knees, other parts of the legs, scalp, lower back, face, palms, and soles of the feet. Signs of psoriasis can be seen in the nails and genitals.

Who Gets Psoriasis?

Anyone can get psoriasis, but it occurs more often in adults. In many cases, there is a family history of psoriasis. Certain genes have been linked to the disease. Men and women get psoriasis at about the same rate.

What Causes Psoriasis?

Psoriasis begins in the immune system, mainly with a type of white blood cell called a T cell. T cells help protect the body against infection and disease. With psoriasis, T cells are put into action by mistake. They become so active that they set off other immune responses. This leads to swelling and fast turnover of skin cells. Things that can cause the psoriasis to get worse include:

• Infections
• Stress
• Changes in weather that dry the skin
• Certain medicines

How Is Psoriasis Diagnosed?

Psoriasis can be hard to diagnose because it can look like other skin diseases. The doctor might need to take a biopsy, or sample, of the skin to confirm the diagnosis.

How Is Psoriasis Treated?

Treatment depends on:

• How severe the disease is, determined by the size of the psoriasis patches and the site of the skin involvement.
• The type of psoriasis.
• How the patient reacts to certain treatments.

All treatments don't work the same for everyone. Doctors may switch treatments if one doesn't work, if there is a bad reaction, or if the treatment stops working.

Topical Treatment: Treatments applied right on the skin (creams, ointments) may help. These treatments can:

• Help reduce inflammation and skin cell turnover.
• Suppress the immune system.
• Help the skin peel and unclog pores.
• Soothe the skin.

Light Therapy: Natural ultraviolet light from the sun and artificial ultraviolet light are used to treat psoriasis. One treatment, called PUVA, uses a combination of a drug that makes skin more sensitive to light and ultraviolet A light.

Systemic Treatment: If the psoriasis is severe, doctors might prescribe medication by mouth or in the form of an injection. This is called systemic treatment. Antibiotics are not used to treat psoriasis unless bacteria make the psoriasis worse.

Combination Therapy: When you combine topical (medication put on the skin), light, and systemic treatments, you can often use lower doses of each. Combination therapy can also lead to better results.

What Are Some Promising Areas of Psoriasis Research?

Doctors are learning more about psoriasis by studying:

• Genes
• New treatments that help calm the immune system’s response in the skin
• The association of psoriasis with other conditions such as obesity, high blood pressure, and diabetes

*Source: