Psoriasis

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What is Psoriasis?

Psoriasis is a chronic, autoimmune disease that appears on the skin. It occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. Genetics and environmental triggers both play a part in developing the disease.

There are five types of psoriasis: plaque, guttate, inverse, pustular and erythrodermic. The most common form, plaque psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells, called scale. Psoriasis can occur on any part of the body and is associated with other serious health conditions, such as diabetes, heart disease and depression.

According to the National Institutes of Health, as many as 7.5 million Americans have psoriasis.

Treatment

There are a number of different treatments for psoriasis. Unfortunately, there is no cure-all. What works for one person, may not work for another, so we know how important it is to work with you to find the right treatment regimen to help you manage your psoriasis.

Topical Treatments

Medications applied to the skin are usually the first line of defense in treating psoriasis. Topicals slow down or normalize excessive cell reproduction and reduce inflammation (redness) associated with psoriasis.

Over-the-counter topicals

• Salicylic acid: Also known as “sal acid,” salicylic acid helps remove scales and is often combined with topical steroids, anthralin or tar to enhance effectiveness. Available in both OTC and prescription forms.
• Coal tar: Coal tar is available in topical, shampoo and bath solution forms. Tar can help slow the rapid proliferation of skin cells and help reduce inflammation, itching and scaling. It can also be used in combination with phototherapy.

Prescription topicals

• Anthralin: This prescription topical can be very effective in treating plaque psoriasis. It does not work as quickly or as thoroughly as superpotent topical steroids, but unlike steroids, it has no known long-term side effects.
• Dovonex: A form of synthetic vitamin D3 that slows down the rate of skin cell growth, flattens psoriasis lesions and removes scale. Dovonex also can be used on the scalp and for nail psoriasis.
• Taclonex: This prescription ointment contains calcipotriene (the active ingredient in Dovonex) and the potent steroid betamethasone dipropionate. The calcipotriene slows down the rate of skin cell growth, flattens psoriasis lesions and removes scale, while the steroid helps reduce inflammation and itch. For treating scalp psoriasis, Taclonex Scalp is available.
• Tazorac: Available as a presciption gel or cream (also known by its generic name tazarotene), Tazorac is a vitamin A derivative and is also known as a topical retinoid. It can be used on the face, scalp and nails.
• Vectical: This prescription ointment contains calcitriol, a naturally-occurring, active form of vitamin D3, and has shown in clinical trials to be well-tolerated even when used on sensitive skin fold areas.
• Topical steroids: Corticosteroids, ordinarily called “steroids” by doctors and patients, are routinely used to treat psoriasis. Topical steroid medications can be very effective in controlling mild to moderate psoriasis lesions. They are easy to use and work relatively quickly. Most are available by prescription.

Light Therapy

Light therapy involves exposing the skin to wavelengths of ultraviolet light under medical supervision.

• UVB phototherapy: UVB treatment involves exposing the skin to an artificial UVB light source for a set length of time on a regular schedule
• PUVA: PUVA is an acronym for psoralen (a light-sensitizing medication) combined with exposure to ultraviolet light A (UVA). UVA, like UVB, is found in sunlight. By itself, however, UVA is not usually used to clear psoriasis. It is relatively ineffective unless used with a light-sensitizing medication such as psoralen.
• Lasers: Targeted UVB treatment using excimer lasers and pulsed dye lasers can be used to treat chronic localized plaque lesions.

Prescription Medications

Currently, there are five FDA-approved biologics (i.e., medicines made from human or animal proteins as opposed to chemicals), Amevive, Enbrel, Humira, Raptiva and Remicade, that are being used for psoriasis treatment, all of which are delivered via injection. These biologics target and suppress the genetic information that triggers the skin to go into immune-response overload. These are generally reserved for patients with moderate to severe psoriasis who are not responsive to or eligible for conventional topical treatments or light therapy.

Other Resources

• StopHiding.org –This public education campaign is brought to you by The American Academy of Dermatology and the National Psoriasis Foundation and features singer LeAnn Rimes, a psoriasis sufferer.
• Psoriasis.org – Established in 1966, the National Psoriasis Foundation is the largest psoriasis patient advocacy organization in the world.
• Psoriasis-cure-now.org – Established in 2005, Psoriasis Cure Now is a nonprofit dedicated to raising awareness – and funds – in order to find a cure for psoriasis and psoriatic arthritis.
• Psoriasis.org/forum/ – The online message forum of the National Psoriasis Foundation.
• AAD pamphlet on Psoriasis
• PsoriasisNet – This is an information resource from the American Academy of Dermatology.