Suggest treatment for psoriasis
Hello and welcome to healthcaremagic
I am Dr. Kakkar. I have gone through your query.
I would request you kindly upload a few clear digital photographs of the patches, so that I may be able to guide you better.
Psoriasis is an inflammatory skin disease characterised by well defined erythematous scaly plaques with silvery white or candle wax type of scaling. Chronic plaque psoriasis is the most common type. It can affect sites like scalp, arms, and legs, (specifically elbows and knees), palms and soles etc
The disease has a chronic course and there are topical creams/ointments/gels/lotions/foams etc as well as oral and injectable medicines which can treat psoriasis but there is no permanent cure for psoriasis.
-Moisturizers specially those which contain hygroscopic (attract water from the atmosphere and lock it into the skin) and keratoloytic agents like Ammonium lactate(Amylac cream), Urea, Lactic acid etc are especially useful in dry scaly conditions like psoriasis.
-For the patches you could use a steroid+salicylic acid ointment on skin and lotion on scalp, twice daily (clobetasol+3% OR 6% salicylic acid ointment/lotion e.g propysalic NF Ointment and lotion) for a few weeks.
Other treatment modalities which can be used for localized plaque psoriasis are:
-Vit D analogues like calcipotriol, calcipotriene alone or in combination with steroid.
-Once weekly oral methotrexate is another option in case of plaque psoriasis but it should always be taken under the supervision of a dermatologist since it can rarely cause serious side effects like bone marrow suppression.
-Oral cyclosporine is given for extensive psoriasis involving more than 20% of the body surface area. It is rapidly effective but it requires monitoring of kidney functions and BP.
Other commonly used oral treatment modalities are:
-Oral Psoralens e.g 8-methoxypsoralen and UV A phototherapy (PUVA)
-Biologics response modifiers
Topical treatment is an essential part of therapy along with oral treatment.
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