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Hide comments A principal source of advice, support and information on psoriasis and psoriatic arthritis
Other non-biological medications Relatively small, localised patches of psoriasis may improve with occlusion (eg, using waterproof adhesive dressings).
one or more joints. This can be very debilitating. In most cases, the first treatment used will be a topical treatment, such as vitamin D analogues or topical corticosteroids. Topical treatments are creams and ointments applied to the skin.
According to the WHO, males and females are affected equally. Caucasians are affected disproportionately. People of color make up a very small proportion of psoriasis diagnoses.
In about one third of patients, physical trauma to the skin, such as a cut, scrape, insect bite, or burn, can cause psoriasis to develop at the site of the injury. This occurrence was first described by a doctor named Koebner in 1872, and was subsequently called the Koebner phenomenon.
In recent years, a wide range of treatment options has been established for psoriasis, including a variety of local therapies, phototherapy, traditional systemic antipsoriatic medications, and biologicals.6-11 The clinical goal is to find the most efficient treatment, associated with the fewest possible adverse effects (AEs), at a reasonable cost. What can result is a process of treatment trial and error and inefficiencies in identifying an effective and patient-acceptable therapy.12 Specifically, the processes and AEs associated with recommended treatments may not fit well with patients' social and work context and preferences.13 Poor fit of a recommended treatment could contribute to the high level of dissatisfaction with5,14 and low adherence to psoriasis treatments.15-17 Nonadherence to prescribed treatment has been reported18 in up to 40% of individuals with psoriasis.
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Potential future treatments Site Special problem Treatment options Patient age and general health
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Jump up ^ Benoit S, Hamm H (2007). "Childhood Psoriasis". Clinics in Dermatology. 25 (6): 555–562. doi:10.1016/j.clindermatol.2007.08.009. PMID 18021892.
This article describes an algorithmic treatment approach for primary care physicians. The algorithm is based on treatment guidelines for psoriasis published by the American Academy of Dermatology,3 supplemented by a review of the medical literature. There currently are no evidence-based guidelines for the treatment of psoriasis. Because localized plaque psoriasis is the most common form, the algorithm focuses on the treatment of this type of psoriasis.
Dedicated to providing practical information and research to those working in psoriatic disease care. Picture of severe plaque psoriasis. Note the classic red color and scales or plaque. Image courtesy of Hon Pak, MD.
What causes them, and what you can do about them.
Rosenberger AD Schaarschmidt M, Schmieder A, Umar N, et al. Patient Preferences for Psoriasis TreatmentsProcess Characteristics Can Outweigh Outcome Attributes. Arch Dermatol. 2011;147(11):1285–1294. doi:10.1001/archdermatol.2011.309
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Petroleum Gelfand JM, Weinstein R, Porter SB, et al. Prevalence and treatment of psoriasis in the United Kingdom: A population-based study. Arch Dermatol. 2005; 141(12): 1537-41. [Abstract | Full text]
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Scalp psoriasis is one of the scalp conditions that you should never ignore. “Unfortunately a lot of the topical treatments are thick, gooey ointments that need to be rubbed on the scalp, and this can be a non-starter for some,” Dr. Farber says. The main ingredients in these products are tar or salicylic acid. “I recommend that people massage the lotion or foam into their scalp at night and then put on a shower cap to sleep,” he says. “The key thing is to be using something that fits with routine and lifestyle,” he says. “The good news is that once the scalp psoriasis is under control you can decrease frequency to every other day or twice a week, Dr. Bagel adds. If OTC topical products don’t do the trick, your dermatologist may prescribe Dovonex (a form of vitamin D that slows skin cell growth and removes scales), Taclonex (vitamin D-steroid combo), Tazorac (a topical retinoid that slows skin cell growth) or Anthralin, which reduces the rapid growth of skin cells.
Update on Noninvasive Body Contouring Techniques Physical therapy Genetic predisposition: : most likely determined via polygenic inheritance
Science & Society Find a local Doctor in your town Our new What you need to know about psoriasis booklet has been prepared by people with psoriasis, dermatology nurses and consultant dermatologists to help you understand your condition, talk with your doctor, learn about available treatments and find useful tips for living with psoriasis.
Recommendations for the initial management of psoriasis — Primary Care Dermatological Society and the British Association of Dermatologists
The cost of treatments varies widely, and is typically based on your insurance and where you live. Using an app like GoodRx can help you figure out the cost of different medications in your area.
Use cover-ups when you feel it necessary. On those days when you feel particularly self-conscious, cover the psoriasis with clothing or use cosmetic cover-up products, such as body makeup or a concealer. These products can mask redness and psoriasis plaques. They can irritate the skin, however, and shouldn't be used on open sores, cuts or unhealed lesions.
Irritation from rubbing and sweating can make it worse, because of its location in skin folds and tender areas. It is more common in people who are overweight and in those with deep skin folds. It can affect the genital area.
PUVA: PUVA is the therapy that combines a psoralen-containing oral medication with ultraviolet A (UV-A) light therapy. Psoralens make the skin more sensitive to long-wave UVA (320-400 nm). Methoxsalen (Oxsoralen) is a psoralen that is taken by mouth before UV-A light therapy. More than 85% of patients report relief of disease symptoms with 20-30 treatments. Therapy is usually given two to three times per week on an outpatient basis, with maintenance treatments every two to four weeks to maintain remission. Adverse effects of PUVA therapy include nausea, itching, and burning. Long-term complications include increased risks of sensitivity to the sun, sunburn, skin cancer, skin aging and cataracts. Protective glasses must be worn during and after treatment to prevent cataracts. PUVA therapy is not used for children younger than 12 years of age.
A Word From Verywell Management of psoriasis may involve topical and systemic medication, phototherapy, stress reduction, climatotherapy, and various adjuncts such as sunshine, moisturizers, salicylic acid, and other keratolytics such as urea.
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FIND A FREE SPOTme® SKIN CANCER SCREENING Although doctors choose treatments based on the type and severity of psoriasis and the areas of skin affected, the traditional approach is to start with the mildest treatments — topical creams and ultraviolet light therapy (phototherapy) — in those patients with typical skin lesions (plaques) and then progress to stronger ones only if necessary. Patients with pustular or erythrodermic psoriasis or associated arthritis usually need systemic therapy from the beginning of treatment. The goal is to find the most effective way to slow cell turnover with the fewest possible side effects.
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Scopus (202) Canada 21212 (any) Nov 2011 33. Bonafede M, Johnson BH, Fox KM, Watson C, Gandra SR. Treatment patterns with etanercept and adalimumab for psoriatic diseases in a real-world setting. J Dermatolog Treat. 2013;24:369–373. [PMC free article] [PubMed]
We updated our searches of the following databases to February 2011: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library (2011, Issue 2), MEDLINE (from 1948), EMBASE (from 1980), Science Citation Index (from 2008), Conference Proceedings Citation Index - Science (from 2008), BIOSIS (from 1993), Dissertation Abstracts via DialogClassic (all publication years), and Inside Conferences (all publication years).
Last Updated:9/27/2017 Avoiding triggers 4. Menter A, Gottlieb A, Feldman SR, et al. Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;58(5):826–850. [PubMed]
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