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.

Psoriasis symptoms:

• 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

Related:

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