Psoriasis is a disease which leads to thick red scaly patches on the body, especially on scalp, lower back, bony prominences (elbows and knees), palms / soles. They are moderately itchy but but unsightly. The scale falling from the spots give the patient an awkward feeling. Nails can be sometimes damaged. Some patients develop joint involvement, called as psoriatic arthropathy.
Psoriasis develops due to excess growth of skin cells which flake out. It is due to immunological disturbance. It can have a hereditary trait in some patients. Friction or any kind of skin damage due to any reason (abrasion, burns) can predispose the site for development of new patches. This is the reason why friction-prone areas like elbows and knees are involved. Some drugs can aggravate psoriasis.
Psoriasis can be controlled with treatment. Various treatments are available. But unfortunately (similar to high blood pressure and diabetes) it cannot be cured in most cases. So we need continuous or at least repetitive treatment for psoriasis to keep it under control.
Topical steroid creams along with additives like salicylic acid, tar, anthralin and calcipotriol (Vitamin D analogue) are the mainstay of external applications. Moisturisers are added to reduce scaling.
here are many oral / injectable drugs in psoriasis. Methotrexate, Cyclosporine, Acitretin, Apremilast and Biologicals are some of these drugs which can control the disease effectively. They can be used in cyclic manner, i.e. drug is changed every 3-4 months to control the side effects. Oral steroids, which are useful in many other skin diseases, are unsuitable for psoriasis treatment (except in pregnancy when many other drugs are unsuitable.)All the special drugs mentioned below are routinely used in Alok Clinic for patients of psoriasis.
Methotrexate is effective and cheap. But it is unsuitable for people with liver problems and alcoholics. Monitoring of blood and liver parameters before and during the treatment is required. It is unsuitable in pregnancy and married females who have yet to complete the family.
Acitretin is an alternative in males. It is expensive and more useful for psoriasis of palms and soles. Once suited in an individual, it requires less monitoring as compared to other oral drugs. As the drug is not suitable in pregnancy and to be stopped 3 years before pregnancy, we in Alok clinic generally give this drug to ladies only after completion of family and after family planning surgery.
Cyclosporine is fast to act but expensive. It requires more careful monitoring of blood pressure and some blood parameters and kidney function. This is a suitable drug for children and in females during pregnancy.
Apremilast is a relatively new drug. If the patient does not develop nausea, vomiting, headache which is seen in around 7% patients, then there are no serious side effects.
Biologicals like secukinumab, adalimumab are very effective but expensive. Secukinumab is safe.
Ultraviolet light is very useful in the treatment of psoriasis. UV-A, which requires pretreatment with psoralen tablets was popular in the past. But now it is virtually replaced by UV-B, which does not require any pretreatment. In Alok Clinic, there are 3 different types of UVB treatments available.
Chamber UVB : This is available in Alok Clinic Panvel. It is useful when whole body is to be exposed and when patient needs to derobe and needs privacy.
308 Excimer Lamp : This is also available in Alok Clinic Panvel. It is a laser like monochromatic light which can be used to give exposure to individual spots in a targeted manner.
Hand and Foot UVB : This equipment is available in alok Clinic, New Panvel and is very useful to give exposure to hands and feet. We have found it extremely useful and a value for money. It can also be used to expose the one side of whole body.
Is psoriasis infectious ?
No. Psoriasis is not caused by infectious agent, so cannot get transmitted to other person.
Is psoriasis curable ?
Psoriasis cannot be cured completely but can be controlled with appropriate drugs. This is similar to high blood pressure or diabetes
Is psoriasis hereditary ?
Psoriasis is a multifactorial disease like diabetes and high blood pressure. There are many factors known and unknown to mankind. Heredity is just one factor. So it has some but limited role.
But I watched a TV Program showing that psoriasis is a very dreaded disease !!
It has been found out that many non-allopathic practitioners conduct TV programs about psoriasis to boost that they have a remedy for it. While conducting these programs, they show pictures of very severe psoriasis, to create the scare. But very few patients develop such a severe picture. Most people have a manageable moderate picture, which can be controlled. So, in nutshell, psoriasis cannot be considered as a dreaded disease.
I was taking prednisolone tablets for psoriasis.
Oral steroids (including prednisolone) are useful in other skin diseases but generally not preferred in psoriasis. So please do not take them.
Can psoriasis affect the groins and buttock fold?
Yes, that is called as flexural psoriasis. It requires different set of drugs.
Is psoriasis related to weather change?
Psoriasis generally increases in winter.
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