Psoriasis

Psoriasis is a very common skin disease. It has been estimated that between six and eight million people in this country have some form of psoriasis. Psoriasis is not contagious and can be controlled with a variety of treatments. Each case is treated on an individual basis.

Skin cells in certain areas of the body grow at a much faster rate that is normal, resulting in patches of tough, dry, scaly skin. It most often affects the elbows, knees, shins, nails and the scalp. Psoriasis of the scalp may be mistaken for dandruff, because as the patches get thicker and tougher, they begin to flake off.

Psoriasis can affect any age group. Although it usually begins in young adults, it can also start in childhood or first appear in old age.

Psoriasis may or may not be a chronic condition. Some patients suffer from this their entire life. For them, this disease may disappear for a while and then return. Many things can trigger the symptoms of psoriasis, including physical trauma (burns, cuts, surgery), infections (strep throat), drugs, severe sunburn, and periods of emotional stress.

Additional information can be obtained from the national psoriasis foundation website www.psoriasis.org.

Therapeutic treatment options for Psoriasis

3 types of therapies are available for treating psoriasis:

1.  Topical therapies
2.  Phototherapies
3.  Systemic therapies

Topical Therapies: topical steroids (creams, lotions, foams, ointments, gels, solutions and sprays) that are used to treat mild to moderate psoriasis. For severe psoriasis, these therapies may be used in combination with other forms of therapy, such as systemic (oral or injection) and/or phototherapy. Anthralin, Dovonex, and Tazorac are other topical therapies that can be used.

Phototherapies: PUVA, Broadband UVB, Goeckerman (UVB + Tar) or Narrowband UVB.
PUVA consists of the use of Methoxsalen (Oxsoralen) prior to UVA radiation (320-400nm). This is used for moderate to severe psoriasis. One danger of this therapy is its increased risk of skin cancers.
Broadband UVB is the most commonly used phototherapy for moderate to severe psoriasis. This can be used alone or combined with topical and/or systemic therapies.
Narrowband UVB utilizes UV radiation in a narrow range at 311nm. This treatment is found to be superior to UVB and is safer than PUVA. It is believed to be less carcinogenic (cancer-producing) than the other forms of therapies. This is particularly useful in treating psoriasis that is refractory to broadband UVB.

Systemic Therapies: include Soriatane, Neoral, Methotrexate, and tumor necrosis factor inhibitors (a new class of drugs) including Etaneracept (Enbrel), Infliximab (Remecaide) and Alefacept (Amevive).