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Suggest Treatment For Psoriasis Patches On Knee And Foot
Question: My dwaughter her age is 5 year had psoriasis since last two year . She had patches her knee and on foot bit down from knee and also upfro knee . Some patch are very worst condation .
Brief Answer:
Psoriasis vulgaris treatment
Detailed Answer:
Hello and welcome to healthcaremagic
I am Dr. Kakkar. I have gone through your query and I have understood it.
I have looked at the pictures.
Psoriasis is characterized by the presence of well defined, thick scaly plaques mainly involving the scalp, and extensor surfaces like elbow, knee, lower back, palms and soles etc. The disease has a chronic course and the course is fluctuated by remissions and relapses, however there is no permanent cure for psoriasis.
Specific topical treatment options for psoriatic plaques consists of ointments containing potent steroid (clobetasol OR Halobetasol) with or without salicylic acid. These are available in ointment form for plaques involving the body and as lotions/gels/foam form for scalp psoriasis. Topical Vitamin D analogues like calcipotriol, calcipotriene etc are also effective for localized plaque psoriasis.
Besides specific remedies for psoriasis, moisturizers form an important part in the management of psoriasis because of the thick scaly nature of the plaques. Moisturizers enhance the penetration of topical active ingredients as well as prevents or delays side effects like skin atrophy etc.
Unlike extensive psoriatic disease for which both oral and topical treatment is required, for limited disease topical treatment alone is effective.
Systemic treatment for widespread disease is with Immunosuppressives like Methotrexate, Cyclosporin and Phototherapy (NB-UVB OR PUVA)
Oral retinoids e.g Acitretin can also be used for widespread psoriasis either alone or combined with phototherapy
Since she seem to have localized disease, limited to the feet/legs therefore I would suggest you to apply an 12% ammonium lactate based moisturizer e.g Amylac Cream twice daily. This should be followed by application of a topical potent Steroid+salicylic acid combination ointment e.g Dipsalic-f Ointment, twice daily for 2-4 weeks. Subsequently, steroid sparing agents may be started, twice daily e.g Calpsor ointment (contains calcipotriol, which is a vitamin D derivative).
I would also suggest for her a course of an oral antibiotics since some of the plaques show crusting/dried secretions, which might be due to infection from scratching. My choice would have been Cefadroxil 250 mg (tab droxyl 250 mg) twice daily for a week.
An OTC antihistamine e.g Syp Alerid 5mg /5 ml (cetrizine ) once daily in the evening, would provide her symptomatic relief from itching
However, you must remember that psoriasis is characterized by recurrences.
Hope this helps
Regards
Psoriasis vulgaris treatment
Detailed Answer:
Hello and welcome to healthcaremagic
I am Dr. Kakkar. I have gone through your query and I have understood it.
I have looked at the pictures.
Psoriasis is characterized by the presence of well defined, thick scaly plaques mainly involving the scalp, and extensor surfaces like elbow, knee, lower back, palms and soles etc. The disease has a chronic course and the course is fluctuated by remissions and relapses, however there is no permanent cure for psoriasis.
Specific topical treatment options for psoriatic plaques consists of ointments containing potent steroid (clobetasol OR Halobetasol) with or without salicylic acid. These are available in ointment form for plaques involving the body and as lotions/gels/foam form for scalp psoriasis. Topical Vitamin D analogues like calcipotriol, calcipotriene etc are also effective for localized plaque psoriasis.
Besides specific remedies for psoriasis, moisturizers form an important part in the management of psoriasis because of the thick scaly nature of the plaques. Moisturizers enhance the penetration of topical active ingredients as well as prevents or delays side effects like skin atrophy etc.
Unlike extensive psoriatic disease for which both oral and topical treatment is required, for limited disease topical treatment alone is effective.
Systemic treatment for widespread disease is with Immunosuppressives like Methotrexate, Cyclosporin and Phototherapy (NB-UVB OR PUVA)
Oral retinoids e.g Acitretin can also be used for widespread psoriasis either alone or combined with phototherapy
Since she seem to have localized disease, limited to the feet/legs therefore I would suggest you to apply an 12% ammonium lactate based moisturizer e.g Amylac Cream twice daily. This should be followed by application of a topical potent Steroid+salicylic acid combination ointment e.g Dipsalic-f Ointment, twice daily for 2-4 weeks. Subsequently, steroid sparing agents may be started, twice daily e.g Calpsor ointment (contains calcipotriol, which is a vitamin D derivative).
I would also suggest for her a course of an oral antibiotics since some of the plaques show crusting/dried secretions, which might be due to infection from scratching. My choice would have been Cefadroxil 250 mg (tab droxyl 250 mg) twice daily for a week.
An OTC antihistamine e.g Syp Alerid 5mg /5 ml (cetrizine ) once daily in the evening, would provide her symptomatic relief from itching
However, you must remember that psoriasis is characterized by recurrences.
Hope this helps
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I start use today daivobet cream also use wellkid syrp for vitamin d , supplement also for vitamin d .is it okey for her are some medicene you suggest from your self ?
Brief Answer:
Psoriasis vulagris
Detailed Answer:
Hi.
Daivobet is combination of a Vit D analogue (calcipotriol) along with a topical steroid (betamethasone) and is ideal for plaque psoriasis. You may use it twice daily.
I would like to add an oral antibiotic as there seems to be some oozing and crusting from one of the plaques probably secondary to scratching from itching. My choice would have been Cefadroxil 250 mg (tab droxyl 250 mg) twice daily for a week.
An OTC antihistamine e.g Syp Alerid 5mg /5 ml (cetrizine ) once daily in the evening, would provide her symptomatic relief from itching
Regards
Psoriasis vulagris
Detailed Answer:
Hi.
Daivobet is combination of a Vit D analogue (calcipotriol) along with a topical steroid (betamethasone) and is ideal for plaque psoriasis. You may use it twice daily.
I would like to add an oral antibiotic as there seems to be some oozing and crusting from one of the plaques probably secondary to scratching from itching. My choice would have been Cefadroxil 250 mg (tab droxyl 250 mg) twice daily for a week.
An OTC antihistamine e.g Syp Alerid 5mg /5 ml (cetrizine ) once daily in the evening, would provide her symptomatic relief from itching
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I just wana ask you dont have syrup place of cefadroxil ? I am using zyrtec syurp for itching . Is it okey or i use what you sugest here ? And cream is okeywhati start using today ? Also suggest me how long i give her ? What next if doesnt work in time perioud .
Brief Answer:
Psoriasis vulgaris treatment
Detailed Answer:
Hi.
Cefadroxil is also available as a syrup (250 mg/5ml). You can give her 1 tsf, twice daily for a week.
Daivobet is absolutely fine. Apply it twice daily for 2-4 weeks, the patches should improve in 2-4 weeks. Thereafter you may switch to daivonex ointment(it contains calcipotriol and is devoid of betamethasone) twice daily, till the patches resolve.
Zyrtec and Alerid are one and the same, both contain cetrizine. Therefore you may continue with Zyrtec.
Regards
Psoriasis vulgaris treatment
Detailed Answer:
Hi.
Cefadroxil is also available as a syrup (250 mg/5ml). You can give her 1 tsf, twice daily for a week.
Daivobet is absolutely fine. Apply it twice daily for 2-4 weeks, the patches should improve in 2-4 weeks. Thereafter you may switch to daivonex ointment(it contains calcipotriol and is devoid of betamethasone) twice daily, till the patches resolve.
Zyrtec and Alerid are one and the same, both contain cetrizine. Therefore you may continue with Zyrtec.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Please I wana suggest me about her diet ? She eat every thing or some thing else ? Also sugest former soap and shampoo , I mean to ask describe each and every thing for her mean caution and what she can eat and can do ? She can go out side from room in summer ?
Brief Answer:
Psoriasis treatment
Detailed Answer:
Hi.
No specific diet or dietary restrictions.
For scalp involvement, she can use a coal tar based shampoo (e.g protar shampoo) every alternate days.
No specific precautions except that she needs to apply the medications as advised.
She can move out of the room. In fact sunlight is considered to be good for psoriasis.
Regards
Psoriasis treatment
Detailed Answer:
Hi.
No specific diet or dietary restrictions.
For scalp involvement, she can use a coal tar based shampoo (e.g protar shampoo) every alternate days.
No specific precautions except that she needs to apply the medications as advised.
She can move out of the room. In fact sunlight is considered to be good for psoriasis.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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