question-icon

Suggest treatment for psoriasis vulgaris

default
Posted on Thu, 31 Jul 2014
Question: Getting itching on the right hand, white-colored rashes formed, its been more than a year. I have used
doctor
Answered by Dr. Kakkar S. (5 minutes later)
Brief Answer:
Upload a picture

Detailed Answer:
Hello and welcome to healthcaremagic

I am Dr. Kakkar. I have gone through your query and I have understood it.

Kindly upload a clear/focused digital photograph of the lesions.

-Have you tried any medications?

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Kakkar S. (11 minutes later)
I have used betahistamine ointment which have worked when used,but, after the course, it came again. I have attached a pic of how it looks in the reports section. The area of itching is slowly growing. The rashes come and go, but the itching remains. A similar pattern of itching and rashes is on my toe. Can you please suggest a solution for it.

I am extremely sorry I have raised it as another question rather than replying to it. Please ignore that.
doctor
Answered by Dr. Kakkar S. (1 minute later)
Brief Answer:
Try again and upload a picture

Detailed Answer:
Hi.

I have not received the photograph. Kindly try and upload it again.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Kakkar S. (5 minutes later)
Hi

I have attached the pic to this query. Please check and let me know.

Regards
XXXX
doctor
Answered by Dr. Kakkar S. (2 hours later)
Brief Answer:
Psoriasis vulgaris

Detailed Answer:
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
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Kakkar S. (2 hours later)
Hi Kakkar

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:

Apply
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!!

Regards
XXXX

doctor
Answered by Dr. Kakkar S. (5 minutes later)
Brief Answer:
Psoriasis Vulgaris

Detailed Answer:
Hi.

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

Regards
stay healthy!!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 9483 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for psoriasis vulgaris

Brief Answer: Upload a picture Detailed Answer: Hello and welcome to healthcaremagic I am Dr. Kakkar. I have gone through your query and I have understood it. Kindly upload a clear/focused digital photograph of the lesions. -Have you tried any medications? Regards