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.
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| New Treatments For Psoriasis |
To expedite such a system, a group of psoriasis and psoriatic arthritis experts from the United States and Canada organized a psoriasis education therapy conference under the support of the American Academy of Dermatology and the National Psoriasis Foundation in November 2002 in Louisville, Kentucky. There, a consensus statement and guidelines of care for the management of psoriasis were developed.
Here is a list of factors that doctors and patients can take into account before starting a specific treatment. Disease-related factors that could influence the effectiveness of a particular therapy include:
- type of psoriasis (e.g., chronic plaque-type versus pustular psoriasis)
- extent of disease (e.g., localized versus widespread)
- area affected (e.g., hands or feet can be disabled and require more aggressive therapy)
- location (e.g., more sensitive areas - groin or armpits - may require different treatments)
- lifestyle
- occupation
- geographic location (if at a distance from treatment centers, it could be difficult for the patient to receive certain therapies, such as phototherapy)
- other health problems that require medication (certain psoriasis medications might interact with other medications)
- If less than 10 percent of the body surface area was involved, the patient was classified as having mild to moderate disease.
- If more than 10 percent of the body surface area was involved, the patient was classified as having moderate to severe disease.
- If more than 30 percent of body surface area was affected, a patient was deemed to have severe psoriasis.
Basing the severity of disease on the extent of involvement alone fails to recognize other important factors that can impact the severity of disease. For example, factors such as the location of lesions (face, hands, or feet), resistance to prior therapies, and the impact on social and emotional well-being of affected people are very important, as is the impact on their quality of life. Some of the key aspects that determine quality of life include:
- physical factors, such as the severity of itching, irritation, pain, insomnia, or inability to use the hands or feet
- psychological factors, such as the degree of a patient's self-consciousness, embarrassment, frustration, anger, helplessness, depression, stigmatization, and anticipation of rejection
- social impact, such as the fear of going to social functions, shaking hands, and wearing certain types of clothing to hide lesions
- sexual impact, including feelings of physical unattractiveness leading to less sexual activity
- occupational impact, such as being eliminated from certain jobs, lost days of work due to psoriasis, and loss of productivity due to time-consuming treatment schedules
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| New Treatments For Psoriasis |
Goals of Therapy
Define the goal of therapy with your doctor so that together you can determine if it is realistic and matches the type of therapy you are currently receiving. Although complete clearing of psoriasis is achievable with some new therapies, it should be understood that in many cases complete clearance might not be possible. What is possible is significant improvement by clearing a large portion of the disease. However, it is important to remember that because psoriasis is not currently curable, the disease usually does come back after clearance or near clearance is obtained.
The time it takes for psoriasis to clear depends on a number of factors, which range from the type(s) of therapy being used to the type and degree of psoriasis that presents, In addition, maintenance therapy (the therapy that continues after initial improvement) might be required. Depending on the patient and the doctor, the therapy used can range from topicals to phototherapy to systemics to biologics. To find out more, you can check out New Treatments For Psoriasis.