Athina Matekovits Dalamaga - Dermatologist - Venereologist

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Psoriasis treatments

Psoriasis is a common skin disease caused by chronic inflammation in the skin. It is not contagious.

Psoriasis is one of the most intensively studied skin disorders. Recent scientific research has unraveled the pathogenetic mechanism causing psoriasis. It is believed that an aberrant immune response in the skin causes inflammation which triggers epidermal cells to grow rapidly and mature incompletely. For further information on this topic click here.

Understanding the mechanism of the disease has led to the development of new, targeted drugs for the treatment of psoriasis. Despite the impressive control of the disease obtained with the available treatment options, there is not yet any therapy that can cure psoriasis.

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Treatment of psoriasis can ensure clearing of skin lesions, alleviation from symptoms such as itch and pain and can significantly improve quality of life.

Medical treatment modalities for psoriasis include:

1. Topical treatments – creams, lotions, gels, shampoos – that contain active ingredients such as corticosteroids, calcipotriol, retinoids,urea, tar, salicylic acid. These are medications applied to the skin. They are recommended for the treatment of mild psoriasis or, in combination with systemic therapies, for more severe forms of the disease.

2. Phototherapy (light therapy) – Usually narrow band UVB (311 nm). The whole body surface is exposed for a few minutes two to three times a week, for a series to about 15 – 20 sessions. A specific type of laser called Excimer Laser has the same wavelength and is used for the treatment  of small areas of localized psoriasis lesions, Another form of phototherapy is PUVA (psoralen and UVA) but it is rarely used for psoriasis nowadays. In general, light therapy is a very effective treatment. In the same time, it has an excellent safety profile (nbUVB), therefore it can be applied to children and pregnant women alike. Nevertheless, phototherapy units are not widely available,. Furthermore, treatment is time-consuming, since it requires numerous sessions.

3. Conventional systemic drugs – Cyclosporin, methotrexate, acitretin – in the form of pills that are ingested orally. They are recommended for moderate to severe forms of psoriasis. They have various effectiveness. The most severe drawback is their well characterized organ toxicity (from kidneys and liver), especially if they are taken for long periods of time. Therefore it is necessary to have a close follow up and to perform blood tests regularly.

4. Otezla (Apremilast) – a newly approved small- molecule drug for psoriasis. It is on the market in Greece from 3/2016 and it is recommended for patients with moderate to severe psoriasis and/or psoriatic arthritis. It is ingested twice daily, it has a relatively good safety profile and does nor require regular blood tests. The effectiveness of the treatment varies from case to case.

5. Biologic agents – Enbrel (Etanercept), Humira (Adalimumab), Remicade (Infliximab), Stelara (Ustekinumab), Cosentyx (Secukinumab). They are injectable drugs that are produced with highly advanced biotechnological methods. Recommended for patients with moderate to severe psoriasis and/ or psoriatic arthritis. These drugs target specific immunologic pathways that play a central role in the inflammatory response in psoriasis. They are highly effective and have a reasonable safety profile.

Treating your psoriasis is critical to good disease management and overall health. Sometimes, it might not be easy. Talk to your Dermatologist to find a treatment—or treatments—that reduce or eliminate your symptoms. What works for one person with psoriasis might not work for another. So it’s important to know the different treatment options and decide which is the right regimen for you.