010 Sep; 3(9): 3740. Commonly used topical medications for psoriasis include corticosteroids, Vitamin D analog, keratolytics, anthralin, coal tar, and tazarotene. 17th Revision. 16. Roelofzen J, Aben K, Khawar A, et al. Treatment policy for psoriasis and eczema: a survery among dermatologists in the Netherlands and Belgian Flanders. Psoriasis is a common dermatosis, affecting from 1 to 3 percent of the population. Until recently, the mainstays of topical therapy have been corticosteroids, tars, anthralins and keratolytics. Recently, however, vitamin D analogs, a new anthralin preparation and topical retinoids have expanded physicians’ therapeutic armamentarium. Coal tar for treatment of cutaneous conditions was described by the Greek philosopher Dioscorides nearly 2,000 years ago,10 and it continues to be used today in the treatment of psoriasis (Table 2). Limited, or mild-to-moderate, skin disease can often be managed with topical agents, while patients with moderate-to-severe disease may need phototherapy or systemic therapy. Alternatives include vitamin D analogs, such as calcipotriene and calcitriol, tar, and topical retinoids (tazarotene). Other topical therapies used for psoriasis (eg, tazarotene, coal tar shampoo, anthralin) and intralesional corticosteroid injections also may be beneficial for scalp involvement, though data on efficacy specifically in scalp disease are limited 10.
Medications for scalp psoriasis include those to be left on the scalp and the wash off products. The second phase is the clearing phase in which topical corticosteroids, vitamin D analogs, tar, dithranol, antifungal treatment, ultraviolet B light therapy or systemic treatment are used. Salicylic acid 5-10 is often added as a keratolytic. These are vitamin D 3 derivatives used for chronic, moderately severe psoriasis of the scalp. Traditional topical treatments for palmoplantar psoriasis include tar, salicylic acid and corticosteroids. Salicylic acid 5-10 is often added as a keratolytic. Topical therapies include corticosteroids, vitamin D analogs, tazarotene, anthralin, 5-fluorouracil, cyclosporine, keratolytics/debridement agents (urea-propylene glycol) and combination therapies. Psoriasis is a common dermatosis, affecting children in North America. Signs and symptoms of psoriasis include erythema, scaling, skin thickening, and pruritus. Topical treatments, e.g., corticosteroids (mild, mid and high potency agents), keratolytics, anthralins, coal tars, vitamin D analogs, retinoids, ureas, and emollients., corticosteroids (mild, mid and high potency agents), keratolytics, anthralins, coal tars, vitamin D analogs, retinoids, ureas, and emollients.1,9,11,15 Many of these are available as ointments (cutaneous plaques), creams (intertriginous areas) and lotions (scalp) (see Table 1).
5 East 98th Street, New York, NY 10029-6574, USA; lebwohlaol.com. Topical therapies such as corticosteroids, vitamin D analogues, and retinoids are used for localised disease. Older topical remedies of psoriasis such as anthralin and coal tar are still in use. In the few years that narrowband UVB phototherapy has been used, no increase in cutaneous malignancies has been reported. Vitamin D3 is known to inhibit keratinocyte proliferation, enhance cellular differentiation, and possess immunomodulating activities. 8 The disease is seen in all ethnic groups but is most common in people of European ancestry. Topical treatment of psoriasis is usually the first line of therapy. Topical treatments consist of emollients and keratolytic agents, anthralin, coal tar, corticosteroids, vitamin D 3 analogues, topical retinoids, and topical psoralens plus ultraviolet A (UVA) light. The markers of epidermal proliferation the keratins (K6, K10, K16, and K17), epidermal growth factor (EGF) receptor, and ornithine decarboxylase are usually increased in psoriasis.
Newer Trends In The Management Of Psoriasis At Difficult To Treat Locations: Scalp, Palmoplantar Disease And Nails Handa S
Background: Chronic plaque psoriasis is a common papulosquamous skin disorder, for which a number of topical agents are being used including coal tar, topical steroids and more recently topical calcipotriol/betamethasone dipropionate. Several topical modalities have been found effective in limited chronic plaque psoriasis including, topical steroids, coal tar, anthralin, tazarotene and the vitamin D analogue calcipotriol (calcipotriene) alone or in combination with betamethasone dipropionate. J Dermatolog Treat 2006;17:327-37. Generally, it is more common in individuals living at higher latitudes or in colder locales, and is less common in individuals who have greater sun exposure. It is also known as psoriasis vulgaris.16 The lesions are often symmetrical. The oldest one is coal tar. 3. Koo JYM, Siebenlist J. Vitamin D analogues in the treatment of psoriasis. Flexural or inverse psoriasis is commonly found in the skin folds, particularly the axillae, submammary regions, groin, and natal cleft. 2 It is often caused by current infection and abrupt withdrawal of systemic and topical corticosteroids.2 Many smaller pustules may form from an erythematous base and join up to form a lake of pus. Calcitriol is an active metabolite of vitamin D3, while used twice daily. The Ingram regimen includes the application of anthralin following coal tar and light therapy. Treatment can include emollients, vitamin D analogs, topical retinoids, tar, anthralin, corticosteroids, phototherapy, and, when severe, methotrexate, oral retinoids, immunomodulatory agents (biologics), or immunosuppressants. Peak onset is roughly bimodal, most often at ages 16 to 22 and at ages 57 to 60, but the disorder can occur at any age. Use topical treatments (eg, emollients, salicylic acid, coal tar preparations, anthralin, corticosteroids, vitamin D3 analogs, retinoids, calcineurin inhibitors, tazarotene), particularly for mild disease. Plaque psoriasis is the most common presentation of the disease.