Types and Treatments for Psoriasis

Are you experiencing bumpy red patches with white scales on your skin? A skin condition known as Psoriasis effects many individuals today ranging in type and severity. This disorder is caused by the body’s over production of skin cells and the inability to shed normally. The good news is that there are several effective treatments for psoriasis. Unfortunately, this complication is the result of an over active immune system and can cause irritation and itchiness.

Types of Psoriasis

  1. Plaque Psoriasis: Often times, physicians mistakenly diagnose Plaque Psoriasis as dermatitis or eczema because of its red and scaly appearance. It is the most common form of psoriasis as 90% of the individuals diagnosed with this condition suffer from this type. Although this disorder can appear all over the body, it is commonly noticed in areas such as the elbows, knees, lower back and scalp.
  2. Erythrodermic Psoriasis: Despite the fact that Erythrodermic Psoriasis is rare, it still disturbs the life of 3% of those with psoriasis. This bright red rash is considerably more aggressive than other types and spreads quickly. Because of the fact that it can spread to over 60% of the body and is typically accompanied by chills or a fever, it is critical to see a physician immediately. This case of psoriasis could be considered a medical emergency.
  3. Guttate Psoriasis: This type of psoriasis is not as common as plaque psoriasis but is considered the second most common type. It reveals itself as small, red, and scaly droplet-shaped patches. It is typically seen in areas on the chest, back, arms and legs. Streptococcus (strep throat), a bacterial infection, is the common cause of a Guttate outbreak.
  4. Inverse Psoriasis: As its name would suggest, Inverse Psoriasis occurs in the skin folds of the body. These areas would include under the arms, in the groin, or even under the breast. This condition tends to be very painful and manifests itself as flat red patches. Generally, yeast is also present.
  5. Pustular Psoriasis: The name given to this disorder also gives insight on the nature of it. The word pustule represents a small blister that contains pus. Pustular Psoriasis commonly appears on the palms of the hand and soles of the feet as little blisters filled with fluid. This form of psoriasis can potentially be disabling due to its location and is the hardest to treat.
  6. Psoriatic Arthritis: This type of arthritis only occurs in individuals with psoriasis. It causes pain and swelling in joints. Every case of Psoriatic Arthritis is different, ranging from slow development with mild symptoms to more severe cases that develop quickly. In more serious cases, an individual may experience increased difficulty to perform common, every day activities.  Some people suffering with this disorder may experience periods of remission, but it is important to remain aware and to visit a dermatologist when symptoms emerge. A small number of individuals will experience joint pain before skin abnormalizes. If left untreated or unidentified for some time, joint changes may be permanent.

Psoriasis Treatments

There are several treatments for Psoriasis available.

Topical Therapy: The two types of Topical treatments include steroidal creams and nonsteroidal creams. Steroidal creams contain a drug known as cortisone that works towards reducing the swelling and inflammation of the body. Physicians instruct their patients in ways to prevent damaging the skin. Failing to follow direction could result in stretch marks, easily bruised skin, or thinning of the skin. Over the counter, non-steroidal medications include tar and salicylic acid. Both of these products are proficient in either reducing the growth of cells or shed scales on the skin. To increase the effectiveness of these drugs, they are sometimes prescribed with the addition of other topical therapies. Other medications that aid in the removal of scales and work towards flattening lesions are topical retinoids and vitamin D products. This type of treatment is offered through a variety of forms such as lotion, gel, foam, spray, ointment and cream. Typically, lotion and foams provide patients an easier application of the product.

Phototherapy: This procedure is effective in reducing the skin’s cell growth. It works through the use of light treatments that are usually administered in doctor’s offices. However, occasionally, a physician will allow usage of the unit at the patient’s home. The first type of light, Broadband UVB, is composed of 290-320 nanometers of wavelength. Because a common side effect of phototherapy is a sunburn reaction, this type of treatment is conducted through shorter treatment times. A more modern UVB treatment is known as Narrowband, which is composed of 311-312 nanometers of wavelength. With this newer type of treatment, patients are able to experience longer remission times and tend to have less sunburn type reactions.

PUVA, an alternative kind of phototherapy, exercises the use of medication alongside UVA light. Oxsoralen is the prescribed medication that should be taken as a capsule 90 minutes before the light therapy. This type of therapy poses a risk for developing a multitude of side effects such as headaches, burning, itching, nausea, vomiting, dizziness. The chance on developing skin cancer also increases.

If the psoriasis covers less than 10 percent of the body’s skin, an alternative form of treatment is an option. Pharos excimer laser is a unique treatment because of its ability to concentrate on localized areas of the body. It applies a NB UVB light to these regions. Comparable to the side effects of other therapies, it also causes itchiness, dry skin, and poses as an increased risk for skin cancer.

Medications: There are a variety of medications available for patients suffering with Psoriasis. If a physician notices that the use of topical treatments or light therapies have become ineffective, they may prescribe an oral medication. Methotrexate and Acitretin are the most common systemic oral medications implemented today. Although this kind of remedy requires numerous office visits and a continued commitment of the patient, it holds the greatest success rate.

  • Methotrexate: This is one of the original treatments for psoriasis dating back to the 70’s. Methotrexate is filtered through the liver and affects the immune system by preventing the rapid turnover of skin cells. Because of its effect on the liver, it is important for patients to undergo a liver biopsy to determine if it is the right treatment for them. Patients not advised to receive this medication include people with a history with alcohol abuse or renal, hepatic or other hematological irregularities. Methotrexate is frequently used in combination with light therapy, but the two should not be administered within 48-72 hours of each other. This drug can cause patients to become hypersensitive to light. Therefore, it is crucial to be cautious and monitor the body.
  • Acitretin: Also known as Soriatane, this drug is derived from vitamin A and works to control cell growth and produce shedding. Just like Methotrexate, Soriatane also discourages its use for particular individuals such as women in their child bearing ages and individuals suffering from depression. However, it is very effective in men and women of non-childing bearing potential. It is also advised for the physician to administer blood tests to monitor cholesterol and triglycerides due to the fact that the drug can affect lipid levels. Long term use of this kind of therapy also calls for bone density scans or x-rays.

Biologic Drugs: Biologic drugs control the growth of cells by blocking specific immune cells. In contrast to other treatments, this type of drug works through the injection and infusion of proteins, rather than chemicals. Because this medication was developed fairly recently, the long-term effects are unfamiliar to physicians currently. However, they do not display very many side effects. The value in using biologic drugs is its ability to target a specific area of the immune system, without imposing on the rest. Every individual receiving this type of treatment will get an individualized strategy depending on their situation. Additionally, it accommodates individuals and gives them the convivence of performing the injection at home.

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Dr. Gurgen offers proven, powerful treatment techniques that reduce pain associated with psoriasis and encourage your body’s overall health. Schedule an appointment today.