Q. What are the different types of treatments available for psoriasis?

Hi, welcome to icliniq.

It's very sad to hear that you are having this skin issue since 3years, I can totally sense your frustration. Psoriasis is a chronic inflammatory skin disease, with some genetic, environmental influence. If there is family history of psoriasis, then the chance of getting psoriasis ranges from 10-20%. Psoriasis is a common skin disease, seen in upto 3% of general population in the world. This is not contagious, doesn't spread from one person to another. There will be increase skin proliferation (growth) that forms new skin every 4 days in psoriasis instead of every 4 weeks(which is normal), resulting in premature skin cells which appear as scales. There is no exact cause for psoriasis, if the exact cause was known then there would have been permanent cure for this disease. It is a chronic T cell mediated inflammatory disease with lot of triggering factors- immunological, physical trauma, stress, infections, genetics, seasonal variation, obesity, alcohol, smoking, certain drugs.

There are many types of psoriasis, Broadly there are

1. Pustular psoriasis (pus filled lesions) and
2. Non pustular psoriasis (common)-red scaly lesion

Non pustular psoriasis Futher has types,

1. Guttate psoriasis-rain drop like small lesions, usually follow infections,seen commonly in children
2. Chronic plaque psoriasis(most common of all) - involves elbows, knee, back, scalp
3. palmoplantar psoriasis-limited to palms and soles
4. scalp psoriasis- limited to scalp
5. Inverse psoriasis-involving skin folds
6. Erythrodermic psoriasis-involving more than 90% body surface area.

Psoriasis is known to involve nails and joint over a period of time. You are receiving the right treatment from your Dermatologist. Topical corticosteroids, calcipotriene-vitamin D analogue, omega 3 fatty acids,coal tar, Salicylic acid are the initial line of treatment. Other options include,

1. Oral Methotrexate- there are criteria to start this tablets, you will have to undergo blood test before starting it. and you need to be under monthly monitoring.
2. PUVA- Psoralene UVA therapy
3. Narrow Band UVB
4. Oral Cyclosporine
5. Oral Retinoids
6. Biologicals- adalinumab(humera), infliximab,
7. Apremilast (otezla)

Psoriasis can be well controlled, but unfortunately there is no permanent cure for this. To prevent recurrence,

• should avoid stress, emotional stress- yoga, medications are helpful
• regular physical exercise, atleast 40mins a day, 6days a week- overweight/obesity makes the treatment less effective, Obesity and psoriasis have been linked to heart problems.
• avoid trauma/ injuries to skin- after the wound heals, there will be psoriasis lesion at the site of trauma, it is called Koebnerization.
• Donot scratch- lead to Koebnerization, new lesions appear along the line of scratch.
• use good moisturisers- keep the skin hydrated
• No alcohol and no smoking.
• Avoid taking pain killers without consulting your doctor, certain pain killers, Diclofenac, ibuprofen are known to exacerbate psoriasis.
• It is known to get worse during winters, use moisturiser at the time
• Any infection like cold fever can increase psoriasis- meet your physician and treated in time.

You can discuss all these treatment options with your Dermatologist, and choose which suits you better. Hope I have addressed all your concerns. Take care Dear.

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Dr. Ashwini. V. Swamy

Experience: 10 + Yrs

Venereology

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