Tulsa Dermatology Clinic

Psoriasis is a complex and chronic condition requiring a multifaceted treatment approach tailored to individual patient needs. While topical treatments are effective for mild cases, systemic treatments and biologics are often necessary for more severe forms. With current therapeutic advances, our goal is to get our psoriasis patients completely clear! Phototherapy provides another viable option, particularly for widespread psoriasis. Complementary therapies can offer additional relief and improve overall well-being. A personalized treatment plan, developed in consultation with our physicians, is essential for effective psoriasis management and improved quality of life.

Psoriasis is a chronic autoimmune disease that affects millions worldwide, causing discomfort, pain, and emotional distress. While there is no cure, we currently have extremely effective treatments that can significantly improve patients' quality of life. We provide comprehensive care tailored to individual needs. We are addressing the challenges posed by prioritizing patient education, empowering individuals to better understand their condition and actively participate in self-management strategies.

Effective management of psoriasis requires ongoing monitoring and follow-up care. Psoriasis Treatment Centers prioritize continuity of care, ensuring that patients receive regular check-ups and timely interventions as needed. Through routine assessments, our physicians can track treatment responses, identify potential complications, and adjust therapy plans accordingly. This proactive approach minimizes disease flare-ups and optimizes long-term outcomes.

One of the primary advantages of our Psoriasis Treatment Centers is access to specialized expertise. Unlike conventional dermatology clinics, our center is staffed by healthcare professionals with extensive experience in managing psoriasis. This expertise enables our physicians to accurately diagnose and monitor psoriasis, ensuring timely adjustments to treatment regimens.

What Is Psoriasis? (credit NPF)
Psoriasis is an immune-mediated disease (a disease with an unclear cause that is characterized by inflammation caused by dysfunction of the immune system) that causes inflammation in the body. There may be visible signs of inflammation such as raised plaques (plaques may look different for different skin types) and scales on the skin.

This occurs because the overactive immune system speeds up skin cell growth. Normal skin cells completely grow and shed (fall off) in a month. With psoriasis, skin cells do this in only three or four days. Instead of shedding, the skin cells pile up on the surface of the skin. Some people report that psoriasis plaques itch, burn, and sting. Plaques and scales may appear on any part of the body, although they are commonly found on the elbows, knees, and scalp.

Inflammation caused by psoriasis can impact other organs and tissues in the body. People with psoriasis may also experience other health conditions. One in three people with psoriasis may also develop psoriatic arthritis. Signs of PsA include swelling, stiffness, and pain in the joints and areas surrounding the joints. PsA often goes undiagnosed, particularly in its milder forms. However, it's important to treat PsA early on to help avoid permanent joint damage. Symptoms often start between ages 15 and 25 but can start at any age. Men, women, and children of all skin colors can get psoriasis.

Treatment options

Treatments for Psoriasis: An Overview

Psoriasis is a chronic autoimmune condition characterized by the rapid buildup of skin cells, leading to scaling, inflammation, and thick, red patches on the skin. While there is no cure for psoriasis, a range of treatments is available to manage symptoms, reduce flare-ups, and improve patients' quality of life. This paper provides a comprehensive overview of the various treatment options for psoriasis, spanning topical therapies, systemic treatments, biologics, phototherapy, and complementary approaches.

1. Topical Treatments

Topical treatments are often the first line of defense for managing mild to moderate psoriasis. These medications are applied directly to the skin and include:

• Corticosteroids: These anti-inflammatory drugs reduce redness and swelling. They are available in various strengths, from mild to very potent, and are typically used short-term to prevent side effects like skin thinning.
• Vitamin D Analogues: These compounds, such as calcipotriol and calcitriol, slow down the growth of skin cells. They are often used in combination with corticosteroids.
• Coal Tar: An older treatment, coal tar can reduce scaling, itching, and inflammation. It is available in shampoos, creams, and ointments.
• Anthralin: This medication helps to normalize DNA activity in skin cells and reduce scaling.
• Topical Retinoids: Derived from vitamin A, these treatments can decrease inflammation and normalize skin cell production. Tazarotene is a commonly used topical retinoid.
• VTAMA cream: This is a non steroid cream that can decrease inflammation, normalize skin barrier proteins, and boosts antioxidants.
• ZORYVE cream is a once-daily, steroid-free cream that can reduce inflammation.

2. Systemic Treatments

For moderate to severe psoriasis, systemic treatments that affect the entire body are often necessary. These include:

• Methotrexate: This immunosuppressive drug can reduce the turnover of skin cells and control inflammation. It requires careful monitoring due to potential side effects like liver damage.
• Cyclosporine: Another immunosuppressant, cyclosporine is effective but can cause high blood pressure and kidney problems with long-term use.
• Acitretin: A retinoid taken orally, acitretin is used for severe cases. It can cause significant side effects, including birth defects, so it is not recommended for women who are pregnant or planning to become pregnant.
• Apremilast: Used for all severities of psoriasis and psoriatic arthritis
• Sotyktu: Used to treat moderate to severe psoriasis

3. Biologic Treatments

Biologics are a newer class of drugs that target specific parts of the immune system. They are typically prescribed for moderate to severe psoriasis when other treatments have failed. Biologics include:

• Tumor Necrosis Factor-alpha (TNF-a) Inhibitors: Drugs like etanercept, infliximab, certolizumab, and adalimumab reduce inflammation by blocking TNF-a, a substance in the immune system that contributes to inflammation.
• Interleukin Inhibitors: These drugs target specific interleukins (IL), such as IL-12, IL-23, IL-17, and IL-36, which are involved in the inflammatory process of psoriasis. Examples include ustekinumab (IL-12/23 inhibitor), secukinumab, ixekizumab, brodalumab, binekizumab (IL-17 inhibitor), and risankizumab, guselkumab, tildrakizumab (IL-23 inhibitors), Spevigo(I L-36).

4. Phototherapy

Phototherapy, or light therapy, involves exposing the skin to ultraviolet (UV) light under medical supervision. Types of phototherapy include:

• UVB Phototherapy: Narrowband UVB is the most common type, helping to slow the growth of affected skin cells. It is effective for widespread psoriasis.
• PUVA Therapy: This involves taking a photosensitizing medication (psoralen) before UVA exposure. PUVA is generally used for more severe cases.
• Excimer Laser: This targets specific areas of the skin with high-intensity UVB light, beneficial for localized psoriasis.

5. Complementary and Alternative Treatments

Some patients find relief through complementary and alternative treatments, though these should complement, not replace, conventional treatments:

• Moisturizers and Emollients: Keeping the skin hydrated can reduce dryness and scaling.
• Dietary Supplements: Omega-3 fatty acids, vitamin D, and other supplements may have anti-inflammatory effects, though evidence is mixed.
• Stress Management: Techniques such as yoga, meditation, and mindfulness can help manage the stress that can trigger or exacerbate psoriasis flare-ups.