Psoriasis – Treatment Options

Transcript

“What treatment options are there for psoriasis? There are many effective psoriasis treatment options. Single therapy options can be considered, or combination therapy as well. Psoriasis treatment includes topical psoriasis creams, such as cleansers and other creams, lotions, ointments, and oral medications, as well as injectables. Treatment options include general skincare recommendations, avoidance of triggers, oral immunosuppressants, or immunomodulators, topical treatments, anti-inflammatory agents. There are newer medications known as biologic similars that address the different inflammatory mediators and cytokines that contribute to the pathogenesis and onset of psoriasis in many individuals. Topical agents are often first line, such as corticosteroids. There are also vitamin D analogs, such as calcipotriene and calcitriol, which are second line. Calcineurin inhibitors may be the first-line for sensitive areas on the body, such as the face or the flexures or skinfolds. Tars also can be used as shampoos or topical medications. Antrolin is a historic tropical treatment that can be used as well as Tazarotene, a topical retinoid or vitamin A derivative that can be used to decrease the size of scaly plaques. Phototherapy and systemic agents can also be used first-line for more diffused disease.

Phototherapy typically includes UVB, narrowband or broadband and PUVA, which is UVA light. This can be done in office, or it can also be performed with light booths, which can be ordered to the home. If there are thick keratotic plaques, it can often be combined with oral retinoids. Methotrexate can be used orally or intramuscularly, and occasionally subcutaneously, as a treatment option. Oral retinoids such as acitretin and isotretinoin can also be used to help decrease the thick and scaly plaques. Second line systemic therapy can also be used. Targeted immunomodulators or biologic agents come in a variety of forms and are typically injectable, although there are certain oral medications. These have a wide variety of names and are typically working on the immune system to help prevent psoriasis plaques, and can be used as maintenance therapy. Cyclosporin is also an immunosuppressant that can be used to prevent psoriasis flares. There are also certain treatment options in patients with comorbidities or in special situations. There are recommended laboratory evaluations for patients that are receiving targeted immunomodulators as well.”