It is a skin disease with rash and silvery scaly patches. It is a disease with ups and downs, good time and bad time, due to chronic inflammation. At present, there is no complete cure of the disease but recent advances in medicine has helped to much better control it. It is not related to allergy and is not considered transmissible. It is not life-threatening but can be detrimental to psychological well being and causes a lot of stress.
Itchy rash, with rough scaly patches, skin appear dry and are covered in scales, often appears first in scalp, elbows, knees and back. Severe cases can affect whole body with pustules and infection. Pitting nails, separation of nails and sometime affect sexual organs.
Depends on the severity of the lesion, no of lesions, affected areas and most importantly how it affects the daily living of the patient
Topicals
Mainly steroids and Vitamin D derivatives creams or ointment or a mixture of both. Suitable for small area, small no of lesions and can be used on scalp and finger nails
Phototherapy
Less used nowadays, patients need to commit more time for this treatment. Usually, treatment schedule is 2-3 times a week (about 15-45min) for UVB/ UVA. However, the treatment effect takes 2-3 months to be noticeable. Moreover, due to the radiation involved, the exact dosage of UVB/UVA needs to be precise as excess in radiation may increase risk of skin cancer.
Systemic Oral Drugs
They are used to suppress the whole immune system, thereby reducing the inflammation of psoriasis. Before starting the drugs, one need to be screened for underlying inflammation, infection and cancer risk. While on treatment, patients still need to be monitored for its side effects and blood taken for some inflammatory markers.
Biologics for Psoriasis
There are now various types of injections for Psoriasis, depending on disease severity, affected areas and no of lesions. Similar to systemic oral drugs, screening for underlying infection and cancers needs to be done, especially for Hepatitis B, C and tuberculosis. If found, they need to be treated before biologics treatment. While on treatment, patient cannot receive live vaccine. Thus, some planning are needed before initial treatment.
As biologics focus on specific inflammatory pathways and mediators for Psoriasis, it will not affect the whole immune system per se, and thus, have much less side effects compared with systemic oral drugs. The choice is many and we need to consider patient’s value, commitment, economic resources and disease severity to choose the best suitable biologics.
If you would like to learn more or need treatment for Psoriasis, please make an appointment to meet our specialists.
