Clinical Immunology focuses on the immune system’s health. Learn about the diagnosis and treatment of allergies, autoimmune diseases, and immunodeficiencies.
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The management of psoriasis has evolved significantly, offering patients numerous options to achieve clear skin. The goal of treatment is to stop the skin cells from growing so quickly and to remove scales. Treatment plans are highly individualized, often depending on the severity of the disease, the size of the psoriasis patches, and the patient’s response to previous treatments. Management usually involves a “ladder” approach, starting with topical treatments and escalating to systemic or biologic therapies for more resistant cases.
These are the most frequently prescribed medications for treating mild to moderate psoriasis. They reduce inflammation and relieve itching. They range in strength from mild hydrocortisone to potent betamethasone.
Vitamin D Analogues
Synthetic forms of Vitamin D slow down the growth of skin cells. They can be used alone or in combination with corticosteroids to minimize side effects and improve efficacy.
Controlled exposure to ultraviolet B (UVB) light slows the growth of affected skin cells. Treatment involves consistent sessions using artificial light sources.
PUVA Therapy
This combines a light-sensitizing medication (psoralen) with UVA light. It is used for more severe cases but requires careful management due to increased sensitivity to sunlight.
An oral medication that suppresses the immune system and slows down skin cell turnover. It is also effective for psoriatic arthritis.
Cyclosporine
A strong immunosuppressant used for severe psoriasis. It offers rapid relief but is typically used for short periods due to potential side effects on blood pressure and kidney function.
Biologics are protein-based drugs derived from living cells. They target specific parts of the immune system, such as TNF-alpha, IL-17, or IL-23, which fuel the inflammation.
Administration
These are administered via injection or intravenous infusion. They are generally reserved for moderate to severe psoriasis that has not responded to other treatments.
A newer class of oral treatment (e.g., apremilast) that works by inhibiting an enzyme involved in inflammation. It regulates the immune response within the cells.
JAK Inhibitors
These block the Janus kinase pathways, which play a role in the body’s immune response. They offer an alternative for patients who prefer oral medication over injections.
While not a cure, keeping the skin moist is crucial. Creams and ointments help reduce scaling, dryness, and cracking, improving the skin’s barrier function.
Salicylic Acid
This peeling agent helps cause the outer layer of skin to shed. It acts as a scale lifter, often used in shampoos for scalp psoriasis.
To minimize side effects and prevent the body from becoming resistant to a treatment, doctors may rotate therapies.
Combination Therapy
Using two or more treatments together (e.g., phototherapy plus a topical retinoid) often yields better results than using one treatment alone, allowing for lower doses of each.
Management requires regular blood tests to monitor liver and kidney function, especially with systemic medications.
Adapting to Flares
Treatment is dynamic. During flare-ups, therapy may be intensified, while during remission, maintenance doses may be lowered to the minimum practical level.
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Biologic drugs are currently considered among the most effective treatments for severe psoriasis, as they target the specific immune pathways causing the disease.
Long-term use of potent steroid creams can cause skin thinning and other side effects. Doctors usually recommend using them in cycles or alternating with non-steroid treatments.
Light therapy, or phototherapy, uses ultraviolet light to penetrate the skin and slow down the rapid growth of skin cells, effectively reducing inflammation and scaling.
While a healthy diet can help manage inflammation and triggers, it rarely replaces medical treatment entirely. It is best used as a complementary approach alongside prescribed therapies.
Biologics are advanced medications made from living sources that block specific parts of the immune system, driving the psoriasis. They are usually given as injections.
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