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Psoriasis



Psoriasis on the knuckles
Psoriasis on the knuckles


Psoriasis

Alternative Names:

Plaque psoriasis
Treatment:

Treatment is focused on control of the symptoms and prevention of secondary infections. It varies with the extent and severity of the disorder. Severe or resistant cases may require intensive treatment.



Psoriasis lesions that cover all or most of the body are an emergency symptom that require hospitalization. The disorder may be acutely painful. The body loses vast quantities of fluid and is susceptible to severe secondary infections that can become systemic, involve internal organs and even progress to septic shock and death. Treatment includes analgesics, sedation, intravenous fluids, and antibiotics.

Mild cases are usually treated at home. Topical medications include:

  • Prescription or nonprescription dandruff shampoos
  • Shampoos or lotions that contain coal tar
  • Cortisone or other corticosteroids
  • Lubricants
  • Antifungal medications
  • Antibiotics
  • Phenol
  • Sodium chloride
  • Other ingredients

Oral or injected immunosuppressive medications (such as corticosteroids or methotrexate) may be prescribed, but only in very severe cases. Other medications may include retinoids or cyclosporine.

Other treatments may include moderate exposure to sunlight or phototherapy. The skin is sensitized by the application of coal tar ointment or by taking oral psoralens (a medication that causes the skin to become sensitive to light). The person is then exposed to ultraviolet light. Avoid sunburn, which can worsen the condition.

For patients with severe disease, a newer option is treatment with medicines such as etanercept (Enbrel) that target the cause of psoriasis on a cellular level. These medications are very expensive, however, and like all medications they may have side effects. Etanercept is approved by the FDA for the treatment of psoriatic arthritis as well as psoriasis.

Psoriatic arthritis, which occurs in a very small percentage of patients with psoriasis, may be treated with non-steroidal analgesics in much the same way as normal arthritis.

Maintain good general health to reduce the risk of flare-ups. Obtain adequate rest and exercise, eat a well-balanced diet and avoid stress (see stress management). Treat respiratory and other infections promptly.

Maintain good skin hygiene to prevent secondary infections. Daily baths or showers are recommended. Avoid harsh scrubbing, which can irritate the skin and cause new outbreaks.

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