Psoriasis is a chronic, non-contagious autoimmune disease that affects the skin and joints. It usually causes redness, scaly patches that appear on the skin. These scaly spots, which caused by psoriasis, called plaque psoriasis (inflamed areas by excessive skin production). Skin rapidly accumulates at these points and and create a silvery-white appearance. Plaques frequently occur on the skin of the elbows and knees, but can affect any area, including the scalp, palms of hands, and soles of feet, and genitals. In contrast to eczema, psoriasis is more likely to be found on the inner side of the joint.

The disorder is a chronic recurring condition which may vary in severity from minor localized patches to complete body coverage. Fingernails and toenails are frequently affected (psoriatic nail dystrophy) and can be seen as an isolated sign. Psoriasis can also cause inflammation of the joints, known as psoriatic arthritis. 10% - 15% of people with psoriasis has psoriatic arthritis.

The causes of psoriasis are not fully understood, but it's believed that they have a genetic component. Stress, withdrawal of systemic corticosteroids, excessive alcohol consumption and smoking have each been suggested as a trigger for psoriasis. There are several treatments available, but because of the chronic nature of the disease, the treatment is a challenge.

Treatment for Psoriasis

Treatments of psoriasis are divided into:

  • Topical treatments for psoriasis
  • Systemic treatments for psoriasis
  • Combinations of these

Topical treatments for Psoriasis

They are first-line therapies and used before the systemic in mild and moderate types of psoriasis.

  • Topical corticosteroids: Topical corticosteroids are ointments or creams that are applied topically to the affected area, thereby reduce the growth of skin cells and limit the inflammation and itching.
  • Analogue of vitamin D3: The latest available topical treatment for psoriasis is the combination of analogue of vitamin D3 (calcitriol or calcipotriol) with a corticosteroid (betamethasone).
  • Tar: Older type of treatment for psoriasis but still effective for mild types of the scalp psoriasis, in shampoo form (in the form of herbal tar).
  • Salicylic acid: Is keratolytic agent that combined with the above topical products in order to strengthen their action. There is a time and quantitative restriction on application.
  • Tazarotene: Is local retinoid, derivative of vitamin A that used for the treatment of moderate plaque psoriasis.
  • Calcineurin inhibitors (for intertriginous psoriasis).
  • Urea.
  • Emollient creams and other moisturizing factors.

Systemic treatments for Psoriasis

  • Phototherapy: Is form of therapy with UV radiation (usually nb-UVB) which improves psoriasis. The body exposure to ultraviolet radiation from artificial sources helps to reduce the inflammation and limit of psoriasis.
    • UVB therapy
    • PUVA therapy (photochemotherapy)
    • Narrow band UVB therapy
  • Treatment of psoriasis with excimer laser: This treatment of psoriasis uses localized laser light beams (UVB radiation with specific wavelength) controlling thereby, moderate types of psoriasis without affecting the surrounding healthy area.
  • Biological factors: Biological factors are proteins produced by living cells and act in the immune system. The biological treatments of psoriasis are administered by subcutaneous or intravenous infusion for the treatment of moderate or severe plaque psoriasis, when other therapies have failed or are not tolerated.
    • Efalizumab (has been withdrawn)
    • Etanercept
    • Infliximab
    • Adalimumab
    • Ustekinumab
    • Alefacept (Not available in Greece)
  • Cyclosporine: This is an immunosuppressive therapy. It is drug non-cytotoxic and non-myelotoxic, used for many years in the treatment of moderate and severe psoriasis as monotherapy with fast and good results.
  • Methotrexate: The action focuses on reducing the inflammation by reducing the rate of metabolism of cells of the skin and the immune system.
  • Retinoids: Acitretin, an analogue of retinoic acid, is an established therapy for Palmoplantar pustulosis (palms and feet).

Does eventually psoriasis be treated?

The ideal therapy for psoriasis that will cause permanent treatment has not yet been found, and the lesions usually recur. The currently available drugs intended to decrease the disease, a fact which helps to improve the quality of life of people with psoriasis.