Tar is most useful for scalp psoriasis and chronic plaque psoriasis. Topical steroid lotions may be applied under affected nails for onycholysis. Calcipotriol (also called calcipotriene) is effective and safe for mild to moderate chronic plaque psoriasis, scalp psoriasis and flexural psoriasis. Oral PUVA is rarely used in New Zealand nowadays. For lesions that are difficult to control with initial therapy, anthralin or tazarotene may be tried. Medical treatment for localized psoriasis begins with a combination of topical corticosteroids and coal tar or calcipotriene. The joints (psoriatic arthritis), nails and scalp may also be affected. Psoralen plus ultraviolet A (PUVA). Calcipotriene in combination with Class I topical corticosteroids is highly effective for short-term control. Support for the use of these agents is evident in a systematic review of randomized trials that found that very potent or potent topical corticosteroids are more effective treatments for scalp psoriasis than topical vitamin D analogs 11. D analogs for the treatment of psoriasis include calcipotriene (calcipotriol), calcitriol, and tacalcitol. Benefit from anthralin therapy is often evident within the first few weeks of therapy.
In some cases, the psoriasis may cover the scalp with thick plaques that extend down from the hairline to the forehead. It works just as well as moderate topical corticosteroids, short-term anthralin, and coal tar in improving mild-to-moderate plaque psoriasis. Calcipotriene appears to cause greater skin irritation than potent corticosteroids. PUVA therapy uses a photosensitizing medication (usually psoralen) in combination with UVA radiation. In children, psoriasis is most likely to start in the scalp and spread to other parts of the body. Topical corticosteroids are the mainstay of psoriasis treatment in the United States. Calcipotriene appears to cause greater skin irritation than potent corticosteroids. Side Effects and Drawbacks: Anthralin may cause the following problems:. Commonly affected areas include the scalp, elbows, knees, navel, palms, ears and groin. Other side effects of corticosteroids are stretch marks in the skin, and rosacea that can affect the facial skin.
Weak steroid creams may not have much effect on psoriasis and also have some drawbacks, so buying them over the counter is not really recom mended. The analogues are available as calcipotriol cream, ointment and scalp solution, and tacalcitol ointment. Dithranol (Anthralin) in the Ingram regimen. PUVA is a highly effective treatment for widespread plaque psoriasis. Topical psoriasis treatment includes corticosteroids, calcipotriol/calcipotriene, tazarotene, tars, and anthralin. Psoriasis is an unsightly skin disorder that affects over 5 million Americans. Most typically, the elbows, knees, scalp, and chest are afflicted. Anthralin or dithranol: Similar to coal tar, anthralin (also called dithranol) is a topical prescription medication that has been used to treat psoriasis for decades.
Psoriasis is a common, chronic condition characterized by red, scaly, and indurated (thick) skin lesions. Calcipotriene works more slowly than topical corticosteroids. A solution formulation of calcipotriene effective for scalp psoriasis is also available. Anthralin is a medication that has worked well on tough-to-treat thick patches of psoriasis, but its use has declined since past preparations stained fabrics and furniture. Calcipotriene, also known as calcipotriol, is a topical vitamin D synthetic. Studies have shown a beneficial effect of the use of calcipotriene in combination with PUVA, a phototherapy treatment in which patients are given a drug called psoralen and exposed to a carefully measured amount of a special form of ultraviolet A (UVA) light. In addition, calcipotriene solution has been developed for scalp psoriasis. Calcipotriene is not as effective as super potent topical corticosteroids but regimens in which patients apply both calcipotriene and super potent corticosteroids have demonstrated superiority over either agent alone. Calcipotriene solution is useful in scalp psoriasis and nail psoriasis. Calcipotriene ointment has been shown to enhance the efficacy of PUVA and UVB phototherapy in psoriasis. Hence it is preferred over anthralin in topical treatment of psoriasis. Topical corticosteroids are the main stay of the treatment for mild to moderate psoriasis. Calcipotriene (calcipotriol) is a synthetic vitamin-D analogue. Anthralin reduces the skin lesions in psoriasis, but it is rarely used because of skin irritation, staining, severe itching and discoloration of the skin associated with its use. PUVA therapy is one of the most popular forms of light therapy utilized in the treatment of psoriasis. TREATMENT OF PSORIASIS Topical therapy Phototherapy Systemic therapy Climatotherapy. Local corticosteroids 3. But calcipotriene was more effective than coal tar or Anthralin. PUVA therapy that uses the psoralen pill usually is not recommended until after 12 years of age.
What Treatments Are Available?
The treatment of scalp psoriasis is beset with problems of drug delivery, facial irritation, messy, time-consuming, cosmetically unacceptable applications and staining of hair. Caution is advised in patients having history of allergy to anthralin or to preservatives (e. A regimen alternating calcipotriene and potent topical corticosteroids may be better. Topical steroid medications are one of the most common treatments for mild to moderate psoriasis. A new foam for scalp psoriasis called clobetasol propionate has recently been approved. In the so-called minutes therapy, anthralin cream is applied to skin plaques for 30 minutes to two hours, then thoroughly removed with a detergent-based soap and water.