L. Guenther, MD, FRCPC
Psoriasis vulgaris is the most common form of psoriasis, and has a hereditary component. A third of those with psoriasis have a relative with psoriasis, and 85% have a link with the HLA-Cw6 gene. It is a disease that affects the immune system, which trigger faster skin generation, causing the skin to thicken and scale. Psoriasis can have a devastating emotional and social impact as well, causing depression in some. To learn more about psoriasis, visit www.psoriasisguide.ca.
Presence of scaly skin, which are often itchy. They are often found on the scalp, lower back, the elbow, and the knees.
The nail can detach from the skin or thicken.
Approximately a third of people will develop psoriatic arthritis. Visit www.psoriaticarthritisguide.ca for details.
The condition is chronic, but may recede for periods.
Treating Psoriasis Vulgaris:
These are commonly used treatments for psoriasis:
Vitamin A Derivates: Topical Tazarotene is a topical medication, found in gel and cream form.
Vitamin D Derivates: Topical calcopotriol is applied to the trunk and limbs and is used for treating psoriasis. Some contain topical corticosteroids, which have greater overall efficacy.
Topical Calcineurin Inhibitors: Topical pimecrolimus and tacrolimus can be applied to facial psoriasis.
Intralesional Corticosteroids: Plaques are injected with triamcinolone, diluted with water or saline.
Topical Corticosteroids: Available in various potencies, these topical medications are available in various forms. The lowest potency that has an effect should be used to minimize resistance and side-effects.
Treating Severe Psoriasis:
Psoriasis is said to be severe when it affects more than 10% of one’s body area, if the plaques become very scaly, or itchy, when it becomes resistant to medication, or when it otherwise has a very negative effect on one’s quality of life. For more discussion on psoriasis and quality of life, visit http://www.psoriasisguide.ca/medical_treatment/quality_of_life.html.
For severe cases, the following treatments are usually done in conjunction with topical treatments:
Phototherapy with UVB
Systemic drugs such as Methotrexate, Cyclosporine, Acitretin
Biologics such as Alefacept, Etanercept, or Efalizumab