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Psoriasis

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of psoriasis.


Treatment

Many creams, ointments, lotions, and pills are available for the treatment of psoriasis. Many patients require only over-the-counter treatment, or even none at all during relapses. About a third of patients with psoriasis, however, do not respond to over-the-counter remedies and lifestyle changes, and require aggressive treatments. In some cases, such treatments need to be lifelong.

Treatment Options

In general, the following three treatment options are used for psoriasis, from least to greatest strength:

Determining the most effective treatments requires controlled comparison studies. In any case, individual requirements vary widely, and treatment selection must be carefully discussed with the doctor.

Treatment Sequences

Giving treatment in a particular order is a strategy for providing both quick relief of symptoms and long-term maintenance. It involves three main steps:

Choices for transitional or maintenance treatments depend on the severity of the condition. Some examples are described in the following sections.

Rotational Therapy

In severe chronic cases, a doctor may recommend rotational therapy. This approach alternates treatments. The goal is to prevent severe side effects or build-up of resistance from long-term use of a single medicine. An example of a rotational schedule may be the following:

Oral and Injected Therapy

Some doctors use the Koo-Menter Psoriasis Instrument (KMPI) to decide which patients should receive a pill (oral) or an injection. The KMPI’s questions include

If the answer to these questions is "yes," three additional questions are considered:

If the answer to these questions is “yes,” a doctor may decide to prescribe a pill or injected drugs.

Combination Therapies

Doctors increasingly use combinations of pills, creams, ointments, and phototherapy instead of single medications. Combinations of oral treatments are particularly useful, since the doses of each drug can be reduced. This lowers the risk of severe side effects. Thousands of combinations are possible, and the patient and doctor should discuss the best treatment for individual needs.


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