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Suggest treatment for persistent psoriasis

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Posted on Mon, 15 Feb 2016
Question: Thank you I am a massage Therapist of 22 years and I have a client that is in her late 60's. and she has some very big patches of psoriosis, on her legs and it is very warm to touch and the skin is very shining and now she is getting patches on her face chest arms buttocks is there anything you might suggest that will give this client a break from all of this ?
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Answered by Dr. Ilyas Patel (2 hours later)
Brief Answer:
Psoriasis vulgaris

Detailed Answer:
Hi,

Welcome to HCM..

You said that your client is having psoriasis on the legs and now spreading to other parts of the body. I hope you are sure about the diagnosis.

Psoriasis is a chronic autoimmune skin disease with genetic tendency. It is a relapsing disease. There may be triggering factors like stress,dry weather,tension, trauma,drugs like chloroquine. It is a controllable disease.

Blood tests may be done to rule out other diseases like HIV,DM,blood diseases,liver and kidney diseases.

I would recommend as below..

- methotrexate in low dose..15 mg per week.. Consecutive 3 doses of 5 mg at 12 hour interval in a week, continue till the control.

- acitretin 10 to 25 mg daily may be considered

- antihistaminics to relieve itch

- application of steroid with salicylic acid ointment or calcipotriol ointment

- avoidance of soap bath

- tar shampoo for scalp lesions

- avoidance of triggers

- regular eye check up

- regular blood tests Hb,blood cell count, liver and renal function tests

- psychotherapy

I hope this would help your client. But, you consult the dermatologist and have regular treatment under his observation.

Thanks..

Dr. Ilyas Patel MD
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Ilyas Patel

Dermatologist

Practicing since :1982

Answered : 4518 Questions

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Suggest treatment for persistent psoriasis

Brief Answer: Psoriasis vulgaris Detailed Answer: Hi, Welcome to HCM.. You said that your client is having psoriasis on the legs and now spreading to other parts of the body. I hope you are sure about the diagnosis. Psoriasis is a chronic autoimmune skin disease with genetic tendency. It is a relapsing disease. There may be triggering factors like stress,dry weather,tension, trauma,drugs like chloroquine. It is a controllable disease. Blood tests may be done to rule out other diseases like HIV,DM,blood diseases,liver and kidney diseases. I would recommend as below.. - methotrexate in low dose..15 mg per week.. Consecutive 3 doses of 5 mg at 12 hour interval in a week, continue till the control. - acitretin 10 to 25 mg daily may be considered - antihistaminics to relieve itch - application of steroid with salicylic acid ointment or calcipotriol ointment - avoidance of soap bath - tar shampoo for scalp lesions - avoidance of triggers - regular eye check up - regular blood tests Hb,blood cell count, liver and renal function tests - psychotherapy I hope this would help your client. But, you consult the dermatologist and have regular treatment under his observation. Thanks.. Dr. Ilyas Patel MD