Psoriasis FAQs

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Psoriasis FAQs

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Psoriasis FAQs

  1. 1. Psoriasis FAQs 1) What is psoriasis? What causes psoriasis? Is it hereditary or an outcome of environment? Psoriasis is a chronic, disfiguring, inflammatory and proliferative condition of the skin in which both genetic and environmental influences are present and is characterized by red, scaly, sharply demarcated, indurated plaques, present particularly over the back of the elbows and front of the knees and scalp. Type 1 psoriasis appears to have a strong hereditary element given its association with early onset and positive family history (41% if both parents are affected, 14% if one parent is affected, 6% if one sibling is affected and 2% if no sibling or parent is affected). However environmental factors such as sunlight, trauma, drug intake, infections, emotional stress, alcohol and smoking do act as aggravating factors. 2) How can one prevent psoriasis? Psoriasis is an autoimmune disease caused by multiple factors. There are no specific vaccines to prevent this disease and it is also difficult to predict who can develop psoriasis. However at the earliest development of symptoms of the disease, timely intervention could prevent progression and development of other medical conditions. 3) What can a psoriatic patient do to prevent the condition from flaring up? Psoriasis is a chronic condition with remissions and exacerbations. However, prolonged remission can be obtained by:  Good diet  Healthy lifestyle  Taking adequate steps to avoid physical, chemical, electrical, surgical trauma, streptococcal infections (for guttate psoriasis), Metabolichypocalcemia (calcium deficiency), sunlight, drugs (antihypertensives like beta blockers, anti-malarials like chloroquine, pain killers, antipsychotics), alcohol, smoking, emotional stress, obesity  Regular use of moisturisers  Regular follow-ups
  2. 2. Psoriasis FAQs 4) Can psoriasis spread through touch? Is it lifelong? Psoriasis does not spread through touch or sharing of clothes, food and bed. It is a life-long condition. Guttate psoriasis (a type of psoriasis), however, has good prognosis and often runs a self-limited course. Other types of psoriasis like erythrodermic and pustular psoriasis typically have a bad prognosis. Early onset and a family history of psoriasis are also considered bad prognostic indicators. 5) What are the available treatment options for psoriasis? A. Depending on the severity of the condition: B. Topical – Coaltar, Keratolytics (salicylic acid), Corticosteroids, Vitamin D Analogues, Tacrolimus C. Systemic –Methotrexate, Retinoids, Mycophenolic Acid D. Phototherapy – Narrow band 311 nm, 308 nm excimer laser E. Biologicals – The use of biologicals like Etanercept, Infliximab, Adalimumab is finding greater acceptance over other systemics as it ensures better efficacy and longer remission without significant systemic side effects. If you qualify for this treatment, a doctor would do the necessary investigations to put you on this therapy. Biologics find its use among chronic patients with psoriasis affecting their bones and nails. However, at present these drugs are expensive. More recently an Indian company has launched a new biologic, Itolizumab, which is a ‘first-inclass’ novel antibody therapy and claims to have an excellent safety and efficacy profile with much longer remission periods. This could be a promising therapy for patients suffering from Chronic Plaque Psoriasis. 6) Allopathy, Homeopathy, Ayurveda, Biologics – which among these offer the best treatment for psoriasis? Biologics are specifically tailored to inhibit only a targeted portion of the immune system and are believed to result in a more favorable side-effects profile, thus providing an effective and safe alternative choice for treatment. However the disadvantage is the cost involved. Any system of medicine – Homeopathy, Ayurveda, Unani – could work for psoriasis, provided a patient
  3. 3. Psoriasis FAQs responds to that particular treatment and the treatment is genuine, authenticated and properly administered. Caution should be exercised as these medicines could be fortified with corticosteroids which are known to flare up and worsen psoriasis. The responses are from Dr. B.S. Chandrashekhar, Chief Dermatologist, Cutis Clinic, Bangalore. Address: 5/1, Behind Godrej Interior, Near Veeresh Theatre, 4th Main, MRCR Layout, Magadi Road, Vijayanagar, Bangalore -560040 T: (080) 41159049, 41159051, 23401200, 23401300

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