Suggest treatment for psoriasis vulgaris
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Hello and welcome to healthcaremagic
I am Dr. Kakkar. I have gone through your query and I have understood it.
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-Have you tried any medications?
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Hi. Thanks for the picture.
This is classical Psoriasis Vulgaris.
I can understand your concern and frustration regarding recurrences, as psoriasis often recurs after topical treatment. I will try to guide you to the best of my knowledge.
Psoriasis is characterized by the presence of well defined, thick scaly plaques mainly involving the scalp, and extensor surfaces like elbow, knee, lower back 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 you seem to have localized disease, limited to the hand/arm 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 weeks. Steroid sparing agents can also be used, twice daily e.g Calpsor ointment ( contains calcipotriol, which is a vitamin D derivative)
However, you must remember that psoriasis is characterized by recurrences.
Hope this helps
This was quite informative. I was looking for a probable remedy from a long time. I thank you for your efforts and time.
Summarizing your suggestion:
1. Amylac Cream twice daily
2. Dipsalic-f twice daily for two weeks
3. Calpsor Ointment twice daily
Please suggest me if I have summarized correctly.
Last Question: Does it go same with my toe or other parts of the body if ever occur?, because I do sometimes!!
Yes, you have rightly understood:
1. Amylac Cream twice daily. It is a moisturizer for dry scaly conditions like psoriasis.
2. Dipsalic-f twice daily for 2-4 weeks and then to be discontinued
3. Thereafter you may begin with Calpsor Ointment twice daily instead of Dipsalic-f ointment
4. An oral antihistamine e.g cetrizine tablet once daily would provide symptomatic relief from itching
The treatment remains the same for patches elsewhere.
These are all prescription medications. Therefore I would suggest that you seek an appointment with a dermatologist in your vicinity, before trying these medication
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