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Psoriasis Treatment:
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Plaque Psoriasis: (Psoriasis Vulgaris)
Available treatment choices:
Topical
- Mild corticosteroid
- Potent corticosteroid
- Tars
- Anthralin
- Calcipotriol/calcipotriene
- Tazarotene
- Calcipotriol + corticosteroid (i.e., Dovobet®)
Systemic
- Acitretin
- Methotrexate
- Cyclosporine
Light
- UVB
- Narrow-band UVB (311nm)
- PUVA
For Mild - Localized Psoriasis Treatment
Try topical therapy first with a single agent or best combination from a different class of drug.
- Mild steroid alone
- Mild steroid + one of the following: calcipotriol (i.e., Dovobet®), tazarotene, tar, anthralin
- Potent steroid in pulses, for example, on weekends only
- Potent steroid + one of the following: calcipotriol, tazarotene, tar, anthralin
Dovobet® can be used as an initial or flare-up treatment. Since Dovobet® contains betamethasone dipropionate, a strong corticosteroid, the guidance of a physician should be sought if daily application does not resolve the plaque after 4 weeks. Dovonex® can also be used for long-term treatment.
When your psoriasis is extensive or symptomatic
- Topical therapy is always the first option to discuss.
- Ultraviolet light is most useful when large surface areas need to be treated.
- UVB has been used for many years, narrow-band UVB is gaining popularity, although it takes more time, but the side-effects are likely to be less.
- PUVA is effective and gives a longer period of remission, but there is an increased risk of skin cancer - it is used when UVB has not worked.
- Acitretin can be added to both UVB and PUVA.
- Methotrexate and cyclosporine are very effective and can be rotated to minimize accumulative side-effects
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