Psoriasis is an inflammatory, incurable skin disease caused by the proliferation (excessive division) of epidermal cells and an increase in the further number of keratinizing cells, the body of which contains pathological keratin. The characteristic signs of psoriasis are rounded psoriatic plaques of red or bright pink color, with a surface covered with gray-silvery scales. The sites of localization of lesions are located, most often on the joints of the lower and upper extremities, on the hands, feet, on the neck or head, less often on the human torso.
Treatment of this disease should be carried out in a comprehensive manner, using keratolytic agents that help dissolve pathological keratin in dead skin cells and drugs that reduce hyperproliferation (excessive growth) of keratocytes. Medicines for the treatment of psoriasis are used in both local and systemic therapy.
Local therapy
At the initial stage of the development of the disease, the use of special emollient creams shows quite good results, and for more severe cases, patients are prescribed to take analogs of vitamin D, dithranol and other drugs, such as pyrithione zinc, sulfur, Naftalan oil. Good results are shown by the use of topical medicinal ointments, which include salicylic or boric acid, birch tar.
Hormonal agents for the treatment of psoriasis , glucocorticosteroids, which include, for example, triamcinolone, betamethasone and fluocinolone, help to reduce inflammatory processes in the lesions, reduce the rate of division of epidermal cells, and activate the body’s immune responses. Thanks to this, the external symptoms of the disease become less pronounced, peeling, burning and itching of the skin decreases.
However, hormonal drugs can cause addiction and further skin atrophy, so the use of any creams and ointments with glucocorticosteroids should be limited.
Calcipotriol (vitamin D) helps to reduce the formation of keratinocytes. Most effective in combination with hormonal agents. It is not recommended to combine the use of calcipotriol with salicylic acid preparations, which neutralizes its effectiveness. In turn, salicylic acid, as well as ointments, creams and gels with coal or wood tar relieve inflammation at the sites of skin lesions, promote the early healing of erosions, reduce itching, flaking, and redness.
Systemic therapy
Systemic therapy involves the use of medications that also suppress the immune system and help reduce the proliferation of epidermal cells. All systemic treatments for severe psoriasis should be taken orally or by intramuscular injection. Given the fact that many of these drugs have a number of side effects and have a negative effect on internal organs, they should be taken only as directed by a qualified specialist and only under the strict supervision of the attending physician.
Systemic therapy for psoriasis includes drugs such as:
- Sandimmun-Neoral (cyclosporin A), which helps to reduce inflammation in the affected areas by suppressing the production of anti-inflammatory cytokines in T-lymphocytes;
- Methotrexate, due to which DNA synthesis in skin cells decreases, that is, there is a cytostatic effect on the heat of cell division;
- Acitretin (retinoic acid preparation), which helps soften the skin and inhibits the processes of rapid keratinization of skin cells.
Of course, this is not a complete list of drugs used by official medicine to treat psoriasis. To combat this chronic disease, various innovative techniques are used, drugs of targeted and general action, additional therapies (PUVA, BUF, phototherapy, etc.), as well as traditional medicine, which, with proper management of the disease, show extremely positive results.