Fissuring within plaques can occur when lesions are present over joint lines or on the palms and soles. First-line therapy which includes traditional topical therapies – eg, corticosteroids, vitamin D analogues, dithranol and tar preparations. Methotrexate is usually the first choice of systemic agent for people with psoriasis who fulfil the criteria for systemic therapy. Keywords: Alpha-hydroxy acids, Emollients, Keratolytic agents, Keratolysis, Poly-hydroxy acids, Psoriasis, Salicylic acid, Skin-peeling agents, Skin peeling, Urea. Current guidelines recommend keratolytics such as topical preparations containing urea and salicylic acid as adjuvant therapy for psoriasis and state that these represent an internationally recognized standard in the treatment of all severity states of psoriasis 10. Commonly used topical medications for psoriasis include corticosteroids, Vitamin D analog, keratolytics, anthralin, coal tar, and tazarotene. Coal tar 2 foam was effective as monotherapy for both palmoplantar and intertriginous psoriasis and was effective in combination with topical clobetasol emollient foam for scalp psoriasis. 6 While coal tar is not used commonly in the United States, in other parts of the world, such as the Netherlands, it is considered to be first-line therapy.
Treatments currently available are: topical agents used predominantly for mild disease and for recalcitrant lesions in more severe disease; phototherapy for moderate disease; and systemic agents including photochemotherapy, oral agents, and newer injectable biological agents, which have revolutionised the management of severe psoriasis. The first sign of nail psoriasis is usually pitting of the fingernails or toenails. Doctors combine UVB treatments with topical medications to treat some patients and sometimes prescribe home phototherapy, in which the patient administers his or her own UVB treatments. Skin injury (such as from scratching or surgery) or inflammation (as from overexposure to ultraviolet light) can lead to the development of more lesions. Recommended topical agents include moisturizers, keratolytics, coal tar, anthralin, steroids, and vitamin D derivatives. For example, bullous pemphigoid typically affects those in the fifth through seventh decades of life. Mild therapies are preferable for older patients with limited plaque psoriasis; start with emollients and keratolytics, topical corticosteroids, and vitamin D analogues. For Grover disease, moderate-strength topical corticosteroids are the first line of treatment; increase the strength if there is no response.
Topical treatment of psoriasis is usually the first line of therapy. First-line therapy of psoriasis usually consists of topical agents, such as emollients, tar, dithranol, and vitamin D3 analogs. In cases of severe, extensive psoriasis, where topical therapy is either impractical or not sufficiently effective, systemic treatment may be warranted at the outset. This invention relates to topical compositions, such as creams and lotions, that comprise or consist essentially of Telmesteine, or a pharmaceutically acceptable salt thereof, as the active ingredient, and methods for their use in treating a variety of dermatological diseases and disorders, including atopic, dermatitis (eczema), allergic contact dermatitis, seborrheic dermatitis, radiation dermatitis, psoriasis, xerosis and atopy. The composition of claim 1, 2, 3, 4, or 5, further comprising an antibacterial agent, disinfectant agent, antifungal agent, analgesic, emollient, or a local anesthetic. Topical treatments are first- line therapy for patients with mild to moderate plaque psoriasis.
Current And Future Management Of Psoriasis
Topical corticosteroids are the recommended first-line therapy for short-term use. The choice of preparation such as ointment, cream, gel, lotion, foam, spray or shampoo is mostly patient driven. Corticosteroids, when combined with vitamin D analogs, minimize the irritation while the total amount of corticosteroids required is low.