Psoriasis appears as a small bump, a papule, surmounted by scale. When these papules coalesce, a plaque is formed that is often covered by thick layers of horny scale. When this scale is shed, it appears as dandruff, which can be quite unsightly. Scratching these plaques, either because of itching or because of the impulse to remove it, is a very poor idea because of what is called the Koebner phenomenon (also known as the Koebner response or isomorphic response). This may cause psoriasis to develop in areas of inflammation and trauma. Scratching off the scale will only make things worse. Although most patients do not note hair loss, there can be extensive alopecia hair loss (alopecia) in severe cases.
Another treatment for moderate to severe psoriasis is fumaric acid esters (FAE) which may be similar in effectiveness to methotrexate.
FIGURE 2. Acitretin can be very harmful to a developing baby, so it's important that women use contraception and do not become pregnant while taking this drug, and for at least 3 years after they stop taking it. However, it's safe for a man taking acitretin to father a baby.
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Vitamin D analogues. These synthetic forms of vitamin D slow skin cell growth. Calcipotriene (Dovonex) is a prescription cream or solution containing a vitamin D analogue that treats mild to moderate psoriasis along with other treatments. Calcipotriene might irritate your skin. Calcitriol (Vectical) is expensive but may be equally effective and possibly less irritating than calcipotriene.
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Psoriasis is a common condition. Studies from different developed countries have reported that it affects between 1 and 4% of the total population. InAustraliaprevalence is estimated to be between 0.3–2.5% of the population. It is the reason for some 0.3–0.6% of doctor visits overall and 2.6% of all skin-related doctor visits.
Nail. The nails of fingers and toes become pitted. They can grow abnormally with discoloration. Psoriatic nails may become loose and fall off.
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In randomized controlled trials, super-potent CP in various formulations has been shown to be the most efficacious topical treatment for scalp psoriasis. In a recent vehicle-controlled, randomized, double-blind study involving 81 patients with moderate-to-severe scalp psoriasis, 85% of patients using CP spray were clear or almost clear of their disease after 4 weeks of twice daily application compared with only 13% in the vehicle control group (P<0.001).28 Another recent study involving 168 patients with moderate scalp psoriasis evaluated the efficacy of once daily CP 0.05% shampoo. This study demonstrated similar results, with 42% of patients using CP shampoo found to be clear or almost clear of their disease after 4 weeks of treatment compared with only 2% in the vehicle control group (P<0.001).21 Continued twice weekly use of the CP shampoo provided continued benefit to the treatment group, significantly prolonging the time to first relapse, and increasing the total percentage of patients without relapse.21 Importantly, both studies stated similar adverse event profiles between the treatment and vehicle arms, with no significant differences in scalp atrophy, telangiectasias, hypothalamic-pituitary-adrenal axis suppression or other adverse events. A recent Cochrane review found the most evidence for the use of CP in the treatment of scalp psoriasis, with four high-quality clinical trials demonstrating a combined 1.9-point change in participants’ psoriasis on a six-point global improvement scale (Investigators Global Assessment of Improvement).18
CHANGE-MAKERS Dose varies from 10 mg three times weekly to 50 mg daily.
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Salicylic acid is a medication that helps the skin peel. It may also remove psoriasis scales and help the body heal psoriasis patches faster. The higher the percentage of salicylic acid a product contains, the stronger it will be. People should try starting with a relatively weak form of salicylic acid and gradually increasing the strength based on their skin's reaction.
Learn about skin cancer Jump up ^ Robinson A, Van Voorhees AS, Hsu S, Korman NJ, Lebwohl MG, Bebo BF, Kalb RE (2012). "Treatment of pustular psoriasis: From the Medical Board of the National Psoriasis Foundation". J Am Acad Dermatol. 67 (2): 279–88. doi:10.1016/j.jaad.2011.01.032. PMID 22609220.
Environmental factors such as smoking, sunburns, streptococcal sore throat, and alcoholism may affect psoriasis by increasing the frequency of flares. Injury to the skin has been known to trigger psoriasis. For example, a skin infection, skin inflammation, or even excessive scratching can activate psoriasis. A number of medications have been shown to aggravate psoriasis.