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Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult. Share a Case Psoriasis is an autoimmune disorder where rapid skin cell reproduction results in raised, red and scaly patches of skin. It is not contagious. It most commonly affects the skin on the elbows, knees, and scalp, though it can appear anywhere on the body.
armpits OTC = over-the-counter; – = not an observed side effect; + = mild effect; ++ = moderate effect; +++ = severe effect. Kaplan RP
Show fewer languages Figure 1 Histology of psoriasis Possibly absence of scales About Galderma
Hematology and Oncology May affect up to 55 per cent of patients with psoriasis Mason AR, Mason J, Cork M, Dooley G, Hancock H
The risk of psoriasis is increased in individuals with type 2 diabetes or metabolic syndrome and those who are obese.
Disease modifying anti-rheumatic drugs (DMARDs) Dry skin Topical agents: Medications applied directly to the psoriatic skin lesions are the safest approaches to treatment but are only practical if treating localized disease. The most popular topical treatments are corticosteroids (in vehicles such as foams, creams, gels, liquids, sprays, or ointments), calcium modulators, coal tar extracts, and anthralin. There isn't one topical drug that is best for all people with psoriasis. Because each drug has adverse effects or limited efficacy, it may be necessary to rotate them. Sometimes topical preparations are combined together. For example, keratolytics (substances used to break down scales or excess skin cells) are often added to these preparations to enhance their penetration into the skin. Some preparations should never be mixed together because they interfere with each other. For example, salicylic acid inactivates calcipotriene cream or ointment. On the other hand, drugs such as anthralin (tree bark extract) may require the addition of salicylic acid to work effectively.
Tazarotene gel, a recently developed topical retinoid for psoriasis, is available in 0.05% and 0.1% gels and creams. Topical retinoids may reverse some of the cutaneous atrophy caused by topical corticosteroids12 but are associated with local cutaneous irritation. Thus, they are often prescribed in combination with topical corticosteroids.13
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