Vitamins For Psoriasis - Oral Retinoids

Vitamins For Psoriasis

Retinoids are synthetic drugs derived from vitamin A. There are two types of retinoids used in dermatology: isotretinoin (Accutane) and acitretin (Soriatane). Isotretinoin contains an ingredient related to vitamin A and is used mainly to treat acne. Acitretin is also related to vitamin A, but is prescribed by dermatologists to treat psoriasis. Another type of retinoid that is still in clinical research trials is oral tazarotene, which is the systemic form of topical tazarotene used occasionally for treating localized psoriasis.

Acitretin (Soriatane)

Before you take acitretin tell your doctor if you are: 

• pregnant or planning a pregnancy
• taking vitamins or other supplements containing vitamin A
• sensitive to retinoids
• allergic to any food or drugs
• taking any other drugs
• taking an antibiotic (particularly tetracycline [Sumycin])

Psoriasis Cyclosporine Side Effects

Psoriasis Cyclosporine Side Effects

Before beginning treatment with cyclosporine, your doctor will ask you several questions, examine you, and then discuss the possible treatments and their side effects. If you and your doctor decide cyclosporine is a good choice for you, some tests will be performed, including a careful skin and physical examination, a test of your kidney function, and a complete blood cell count. In addition, your blood pressure will be measured prior to starting the medication and regularly thereafter.

Who Should Not Take Cyclosporine?


Cyclosporine might not be a good choice for you if you have kidneys that are not functioning normally, if you have uncontrolled high blood pressure, or if you have an allergy to the drug.

Cyclosporine For Psoriasis

Cyclosporine For Psoriasis

Cyclosporine is a pill given to patients with moderate to severe psoriasis. Initially discovered in 1976, and used as an immune-suppressing drug for organ transplant patients, cyclosporine was observed to also have a beneficial effect on a series of patients who had psoriasis but who were taking the drug for an unrelated disease.
 
How Does Cyclosporine Work?


Cyclosporine is prescribed for the treatment of severe, resistant, plaque-type psoriasis. Many patients will use cyclosporine after they have failed topical therapies (creams and ointments), ultraviolet therapy (phototherapy), or other oral medications (methotrexate, retinoids). Cyclosporine works by inhibiting the activation of the T-lymphocyte, which is one of the key immune cells responsible for the development of psoriasis. It is highly effective in treating psoriasis, and works rapidly.

Methotrexate And Psoriasis - How Do You Take Methotrexate

Methotrexate And Psoriasis

Methotrexate is available in tablets (2.5 milligrams) or as a liquid that is injected into the muscle. Your doctor will ask you to take methotrexate only once a week.
 
Taking Medication

• Many medications are taken daily, but it is important that you take methotrexate only once a week (not daily) as prescribed by your doctor.
• Always take only the dosage your doctor prescribed.
• If you miss a dose, take it as soon as possible.
• Because your doctor might change your dose, check the label every time you fill your prescription.
• If you develop severe difficulty breathing or shortness of breath, stop this medication and contact your doctor.
• Notify your doctor immediately if you have taken more medication than prescribed.
• Methotrexate should be kept and stored away from children.

Shot For Psoriasis - Systemic Therapies

Shot For Psoriasis

Systemic drugs are medications that are given either orally (pills) or as injections just below the skin (subcutaneous) or into the muscle (intramuscular), Since these medications enter the body's circulatory system directly, they are called systemic agents, and are usually reserved for patients with moderate to severe psoriasis, or for those with psoriatic arthritis. In addition, these medications are also used in combination with other therapies, including topicals and phototherapies, especially when a patient does not respond to a single type of treatment.
 
Currently, the most commonly used systemic agents for the treatment of psoriasis are methotrexate (Rheumatrex), cyclosporine (Sandimmune), and retinoids. These medications can provide significant benefit in clearing psoriasis, but they can have side effects. These side effects might occur either at the outset or shortly after starting the medication (acute side effects) or after prolonged use (long-term, chronic side effects). While on these medications, it is important to be closely monitored by your doctor. When taking any systemic agent, it is vital that the drug is taken as directed by your doctor.

PUVA Therapy Negative Sides

PUVA Therapy Negative Sides

Reasons a Psoriasis Patient Should Not Receive PUVA Therapy

• history of skin cancer, particularly malignant melanoma
• systemic lupus erythematosus
• history of reaction to psoralen
• pregnant or nursing
• prior treatment with X-rays
• use of medication that makes the patient more sensitive to ultraviolet light (check with your doctor)

PUVA Therapy Negative Sides

UVB Light Psoriasis - Home Ultraviolet-B Therapy

UVB Light Psoriasis

Ultraviolet therapy can be done at home using equipment that can be purchased through several distributors in the United States. If you are thinking about starting a program of ultraviolet-B therapy at home, first meet with your dermatologist to see if this is an appropriate option for you. If you are a suitable candidate for this therapy, your dermatologist will provide you with a prescription for the light panels.

Home therapy must be carefully monitored so that excessive exposure to ultraviolet light (which can increase your risk of skin cancer) is avoided, and to ensure the proper dosage is chosen and used to avoid burning.

UVB Light Psoriasis

UVB Psoriasis Treatment - Ultraviolet-B Light Therapy

UVB Psoriasis Treatment

Ultraviolet-B rays are highly effective in treating psoriasis. Phototherapy with ultraviolet-B alone or in combination with other agents, such as coal tar or anthralin (Psoriatec), can improve psoriasis. Ultraviolet-B can be given as:

• Ultraviolet-B (290-320 nanometers) - known as broadband UVB 
• Narrow-band UVB (311 nanometers)
• Goeckerman regimen (UVB plus coal tar)
• Ingram regimen (UVB plus anthralin)
• UVB plus systemic agent
• UVB plus another topical agent (calcipotriol [Dovonex, Daivonex], tazarotene [Tazorex], topical steroid)

The starting dose for each patient depends on his or her skin type, and typically ultraviolet-B treatments start with only a few seconds of exposure to light. Over time the exposure time is gradually increased until the skin is clear. You could require treatment anywhere from three to five times a week, and as your skin begins to clear, your doctor might stop light treatments or start you on a regular schedule to maintain your improvement. This can include coming in once every week, two weeks, or monthly. During your active treatment period, you will be examined on a regular basis by the treatment staff at the phototherapy unit. If you burn during treatment, immediately notify your dermatologist or the treatment staff.

Psoriasis Light Therapy - Light Therapy

Psoriasis Light Therapy

Natural sunlight is known to have a beneficial effect on patients with psoriasis. In rare instances, psoriasis patients might find that sunlight actually worsens their condition. Natural sunlight is composed of three types of radiation: ultraviolet (UV) radiation, the visible light spectrum, and infrared radiation. Visible light waves are the only light waves we can see, and we see them as colors of the rainbow. Infrared light cannot be seen. Longer infrared light waves can be felt as heat similar to that of the sun, fire, or a radiator. Short or near infrared light waves cannot be felt. Near infrared, for example, is used by a TV's remote control.
 
Each category in the light spectrum comprises different components that have their own unique wavelength. The shorter the wavelength, the less energy the light source carries. Just as we measure distance with meters, we measure light waves using a wavelength measurement called nanometers. A wavelength is a measure of 1 nanometer. You would need 1 million nanometers just to make 1 millimeter.

Psoriasis Coal Tar - Coal Tar

Psoriasis Coal Tar

Different types of coal tar are used to treat psoriasis-affected skin (shale, wood, coal, and distilled coal tar). Crude coal tar is one of the oldest psoriasis treatment options available. Many patients dislike using tar because it may be messy, smelly, and irritating. However, coal tar can provide significant benefit for patients.
 
Topical coal tar is available as a gel, cream, ointment, liquid bath solution, or shampoo. Coal tar can stain white hair, clothing, towels, and bedding; therefore, if you apply it before going to bed, use old pajamas and bedding. Coal tar can make the skin more sensitive to sunlight (photosensitizer), so be careful when exposing your skin to sunlight the day of coal tar application and carefully follow your doctor's instructions.

Skin Psoriasis Treatment - Topical Steroids

Skin Psoriasis Treatment

Topical steroids are anti-inflammatory medications that reduce skin inflammation in psoriasis. Topical steroid creams can help control the itch of psoriasis and decrease the thickness of the outer layer of the skin. Corticosteroids are the most commonly prescribed topical therapy for the management of psoriasis and are available in several forms, including ointments, creams, lotions, aerosols, or tapes (in the United States). An advantage of topical steroids is that they work relatively quickly and the cost is quite reasonable.
 
Steroid Potencies
 
Topical steroids range from low to high or ultra-high potency. Ointments are usually more potent than creams that contain the same concentration and type of steroid.

Psoriasis Topical Treatment - Topical Therapies

Psoriasis Topical Treatment

Topical treatments (applied directly to the skin) are the first medications most often prescribed by doctors for patients with psoriasis. These treatments are used alone for mild disease, or in combination with phototherapy or systemic therapy for moderate to severe disease. Topical medications are typically used when psoriasis involves only a few areas or is not creating discomfort for the patient. 

In patients with mild disease, such therapies can be quite effective in controlling the signs and symptoms of psoriasis. These therapies are generally not effective when used alone in patients with more severe disease; for these patients, topicals can be used in addition to phototherapy or systemic therapy. Also, topicals can be used after psoriasis clears or nearly clears to maintain the improvement of the disease while off phototherapy or systemic therapy.

Psoriasis Topical Treatment

New Treatments For Psoriasis - Introduction to Treatment Approaches

New Treatments For Psoriasis

There are four main types of treatments for psoriasis, each of which will be explained and discussed in the following posts:

• topical treatment
• phototherapy
• systemic therapy
• biologics

Some patients might use only one type of therapy, while others could use a combination.
 
The type(s) of therapy used depends on many factors; the treatments prescribed for each patient can be highly individualized - what works for some will not necessarily work for all. Sometimes finding the right treatment is a process of trial and error. Given the increasing options for psoriasis therapy, psoriasis experts wanted to establish a way for doctors to diagnose, categorize, and prescribe a treatment for psoriasis based on its type and severity. 

Psoriasis Disability Index

Psoriasis Disability Index

The Psoriasis Disability Index is intended for patients 16 years and older, and consists of fifteen simple, disease-specific questions. Each question is graded from 0 to 4, resulting in a maximum score of 45. The overall score suggests the impact that psoriasis has had on the patient during the last four weeks.
 
This score is used to show changes in disability following treatment. The scoring of each question is based on a four-point scale:

Not at all = 0
A little = 1
A lot = 2 
Very much = 3

When totaled, the score from each of the questions results in a maximum of 45 and a minimum of 0.

Coping With Psoriasis - What You Can Do

Coping With Psoriasis

Psoriasis is a chronic skin disease that disrupts daily life based on the necessity of ongoing medical treatment, the physical discomfort, and the pain that accompanies the condition. Even more important, at least for most of us, is the effect the disease has on our appearance and in how we present ourselves to the outside world.

It is important to remember that others' perception of our physical appearance may not be the same as the appearance that we think we project. Although it is silly to think that others do not notice our condition or that their judgment of us is never influenced by outward appearance, we can easily slip into patterns of hypersensitivity, where we overestimate how negatively others view us. if we present ourselves to others in ways that betray insecurity or unnecessary fear about prejudicial treatment, we risk damaging our social relationships much more than would be the case based only on our physical appearance.

Coping With Psoriasis

Forms Of Psoriasis - A More Professional Look

Forms Of Psoriasis

My interest in psoriasis shifted several years ago from the purely personal to the professional. I work as a university based researcher and clinical psychologist, so the idea of how other people experienced their psoriasis intrigued me. I collaborated with Dr. Sandy Murray, Ms. Janet Lowe (both dermatology associates in Halifax), Dr. Cynthia Mathieson (Mount Saint Vincent University), and Dr. Karen Ruggiero (formerly of Harvard University) to answer this question with the help of about 100 people receiving light treatments for their psoriasis. As two of the resulting published studies are some of the most recent in the scientific literature, I thought that sharing some of the results here might be useful.
 
What Is Physical and What Is Psychological?
 
Our findings showed that people think in more than one way about the negative effects of psoriasis. Most people make a clear distinction between what bothers them psychologically (what we call psychosocial impact) and what bothers them physically (how much people can do on a daily basis).
 
Although this may seem obvious, it seems important to note that two very different thought processes come into play when considering this disease. On the physical side, people reported different degrees of distress about how much pain, stinging, and itching they experienced. Psychosocial distress involved other people noticing their psoriasis, disruptions to social life, and disruptions to daily routines. It was interesting that the amount of scaling on the skin was associated with psychological distress and not physical impact.