Numerous topical and systemic therapies are available for the treatment of the cutaneous manifestations of psoriasis. 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. Management of psoriasis may involve topical and systemic medication, phototherapy, stress reduction, climatotherapy, and various adjuncts such as sunshine, moisturizers, salicylic acid, and other keratolytics such as urea. Transition from conventional systemic therapy to a biological agent may be done directly or with an overlap if transitioning is needed because of lack of efficacy, or with a treatment-free interval if transitioning is needed for safety reasons. New developments in the topical therapy and phototherapy of psoriasis have greatly improved our ability to safely and effectively treat this debilitating disease. Part 2 will deal with systemic treatments.
Treatment of psoriasis includes topical, systemic, biological, and phototherapy 3. Topical therapies such as corticosteroids, vitamin D analogues, and retinoids are used for localised disease. Phototherapy including broadband ultraviolet B (UVB), narrowband UVB, PUVA, and climatotherapy are effective for more extensive disease. Systemic therapies such as methotrexate, retinoids, and ciclosporin are effective for patients with refractory or extensive cutaneous disease. Practice of phototherapy in the treatment of moderate-to-severe psoriasis. PubMed journal article Psoriasis treatment: traditional therap was found in Unbound MEDLINE. Even before the recent development of biological agents, a long list of effective treatments has been available for patients with psoriasis. Topical therapies such as corticosteroids, vitamin D analogues, and retinoids are used for localised disease. Phototherapy including broadband ultraviolet B (UVB), narrowband UVB, PUVA, and climatotherapy are effective for more extensive disease.
-Sun exposure (but use proper SPF) called Climatotherapy -Ultraviolet Light therapy (Phototherapy). safest treatment in pregnancy. + Phototherapy (3) Topical Agents + Systemic Therapy Use moisturizers with ALL choices. -Used for severe cases in combo with phototherapy -ADR– hepatotoxicity, dry lips (cheilitis), dry mouth, dry nose DO NOT donate blood within 3 years of d/c med and women of child bearing age–use 2 forms of BC. Over time, psoriasis can become resistant to a specific therapy. Psoriasis which is resistant to topical treatment and phototherapy is treated by medications that are taken internally by pill or injection. Patients undergoing systemic treatment are required to have regular blood and liver function tests because of the toxicity of the medication. Climatotherapy involves the notion that some diseases can be successfully treated by living in particular climate. We are now entering a therapeutic era of psoriasis treatment with very specific mechanisms of action which target the inflammatory pathway of cutaneous immunology. Before the development of systemic retinoids and cyclosporine, there were few tenable choices for systemic agents, except for methotrexate (MTX). This is the basis for climatotherapy at the Dead Sea and the use of natural sunlight to benefit psoriasis, especially for people who live in the northern latitudes. In fact, it is rare for phototherapy to be used alone without the combination of a topical agent.
If topical psoriasis treatment fails to achieve the desired goal then the next step would be to expose the skin to ultraviolet (UV) radiation. This type of psoriasis treatment is called phototherapy. The third step involves the use of medications which are ingested orally or by injection. This approach is called systemic psoriasis treatment. Over time, psoriasis can become resistant to a specific therapy. Dithranol is a topical therapy that has been used to treat psoriasis for over a century. Psoriasis treatment natural vitamins, herbs, supplements, alternative therapy, role of food and diet, research studies by Ray Sahelian, M. Treatments range from topical applications, systemic therapies, and phototherapy; while some are effective, many are associated with significant adverse effects. Phototherapy including broadband ultraviolet B (UVB), narrowband UVB, PUVA, and climatotherapy are effective for more extensive disease. Topical therapy provides symptomatic relief, minimizes required doses of systemic medications, and may even be psychologically cathartic for some patients. Limited plaque psoriasis can be treated topical corticosteroids and emollients. (climatotherapy) has also been used as a therapy for psoriasis, as has the use of salt water baths with artificial UV exposure (balneophototherapy). Unfortunately, none of the available treatments for psoriasis is a cure. This approach to treating psoriasis is called climatotherapy.