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pustular psoriasis what the best treatment for it.
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Anon -
Thanks for your question. There are several treatments available for psoriasis. Treatment is based on:
* The severity of the disease
* The extent and location of the areas involved
* Responsiveness to the treatment
Many patients respond very well to treatments applied directly to the skin. Topical treatments include:
* Corticosteroid creams and ointments (most common treatment)
* Synthetic forms of vitamin D and retinoids (calcipotriene ointment 0.005)
* Retinoids (tazarotene gel 0.05 and 0.1%)
* Coal tar preparations
* Bath solutions and moisturizers
* Tacrolimus and pimecrolimus (especially for inverse psoriasis)
If psoriasis covers more than 30% of the body it is difficult to treat with topical medications alone, and photo (light) therapy can help. Daily, short, nonburning exposure to sunlight clears or improves psoriasis in many people. Sunlight is often included among initial treatments. A more controlled form of artificial light treatment (UVB phototherapy) is often used in more widespread cases. Althernatively, psoriasis can be treated with ultraviolet A (UVA light) and psoralen. Psoralen is an oral or topical medication that makes the body more sensitive to light. This treatment is known as PUVA.
Phototherapy can be very effective in controlling psoriasis but it requires frequent treatments. It may cause side effects such as nausea, headache, fatigue, burning, and itching. Both UVB and PUVA may increase the person's risk for squamous cell and, possibly, melanoma skin cancers . It is unclear whether UVB increases the risk of skin cancer.
Systemic Treatment
For more severe types of psoriasis, doctors may prescribe a number of other powerful medications, which can be effective, but are associated with more serious side effects. These include:
* Methotrexate—should not be taken by pregnant women, women planning to become pregnant, or by their male partners.
* Cyclosporine—suppresses the immune system to slow the turnover of skin cells.
* Hydroxyurea—less toxic than methotrexate or cyclosporine, but may be less effective
* Systemic retinoids—Compounds with vitamin A-like properties taken internally (such as methotrexate) may be prescribed in severe cases. Retinoids can cause birth defects, and women must diligently protect themselves from pregnancy for several years after completing treatment. Systemic retinoids are often combined with phototherapy for increased effectiveness and for their property of being protective against squamous skin cancer.
Newer systemic immunomodulators, or biologicals—so called because they affect some aspect of the body’s natural immune response—may also be quite effective. These treatments are generally the most expensive, though, and some can cause serious toxicity when given systemically (intravenously or by injection). Topical preparations of immunomodulators are currently being tested and seem to have benefits. Other drugs called thiazolidinediones may show promise as future treatments for psoriasis, but are not currently recommended.
July 20, 2010 - 5:43pmThis Comment