Topical Medications

Anthralin

• Can produce skin irritation
  May cause brown stains on skin, clothing and everything it contacts, including bathroom fixtures

Coal Tar

• When used with UV light therapy, requires daily visits to treatment center

• Possible skin irritation

• Unpleasant odor

• Can stain skin and clothing

Corticosteroids

• Not recommended for long-term use

• Overuse may cause thinning of the skin, dilated blood vessels, stretch marks, infection and excess body hair

• Must be used with caution around the eyes

• May suppress growth in children

May become ineffective with continued use

Retinoid: Tazarotene

Skin irritation (can be reduced with topical corticosteroids)

Vitamin D3: Calcipotriene

• Can cause skin irritation

• Other topicals, such as salicylic acid, can inactivate it

• May affect growing bone when used in large amounts so special care should be used when treating children

Excimer Laser

How it works: The ultraviolet (UV) light produced by excimer lasers induces biologic reactions in the skin’s cells that decrease the number of skin cells that grow too quickly and reduce inflammation.

• Cannot treat entire body

• Treatment may be painful

• Darkening of the skin can occur

• Scarring possible

Psoralen + Ultraviolet Light A (PUVA)

How it works: Combining the photosensitizing agent (psoralen) and UVA slows the rapid growth of skin cells and kills T cells in the skin.

• Requires numerous treatments in medical office or clinic

• Patients must wear UVA-blocking sunglasses when exposed to sunlight after treatment

• Increased risk of skin aging, freckling and skin cancer with long-term treatment

Side effects may include nausea, headache, fatigue, burning skin, itching and irregular skin pigmentation
 

Ultraviolet B (UVB) Phototherapy

How it works: Ultraviolet (UV) light induces biologic reactions in the skin’s cells that decrease the number of skin cells that grow too quickly and kills T cells in the skin, which can result in the clearing of psoriatic lesions.

• Requires 2 – 5 weekly visits to a clinic or medical office until lesions clear

• May require follow-up treatments once lesions clear

Long-term treatment may increase risk of developing skin cancer
 

Acitretin

How it works: Acitretin normalizes skin cells’ growth, which prevents the rapid growth of and piling up of cells on the skin’s surface.

• Many side effects possible, some significant

• Patients must be monitored during therapy

Cannot be prescribed to women who plan to become pregnant within 3 years
 

 Systematic  Medications
How they work: Alefacept interferes with the migration as well as the activation and proliferation of T cells (a type of white blood cell). This is what gives patients relief from the signs and symptoms of psoriasis.

• Expensive, cost may be prohibitive for some

• Long-term effects not known

• Not effective for all patients

Alefacept requires weekly visits to patient’s dermatologist
 

Cyclosporine

How it works: Cyclosporine inhibits T cell activity, which decreases the rapid growth of skin cells.

• Possibility of severe side effects, including kidney damage
  Patient must be carefully monitored during therapy

Methotrexate

How it works: Methotrexate blocks certain parts of the immune system, which decreases skin cell proliferation (rapid growth and multiplication) and suppresses inflammation.

• Potentially serious side effects, including liver damage Patients must be carefully monitored during therapy These medicines available today are acting at the level of basal cell layer of epidermis to stop their division and hyperkeratinisation or at the lavel of horn cells to remove them smoothly.
  They treat the effects of Psoriasis. Keep one thing in mind - the skin is not the cause of Psoriasis, it is just where the end result appears.

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