Psoriasis treatments may be used topically or systemically. We are going to consider the various topical and systemic therapies, their utilization strategies and the problems raised by the particular cases encountered most often.
Psoriasis treatment breaks down into two phases: the clearing phase and the maintenance phase. The aim of the clearing phase is to get rid of the lesions; the aim of the maintenance phase is to avoid relapses. In the clearing phase, effectiveness is the chief consideration; in the maintenance phase, tolerability and the convenience of the drugs become the main concern, since the skin lesions will have disappeared.
It is considered necessary to pursue maintenance therapy for about a year in order to hope for a lasting remission. This important point has never been validated by a clinical study. Such consideration lies on a number of factors: that relapse is usually observed swiftly if treatment is stopped at the end of the clearing phase; that the microcirculatory anomalies will persist for months after the clinical disappearance of the lesions; and that relapse usually begins on the spot of the old plaques as if the skin retained its memory of the inflammation for a long time, perhaps through the persistence of receptors enabling the inflammatory cells to adhere to the endothelial cells.
However, around 30% of patients benefit from prolonged remission, being able to pass the one-year mark after a properly conducted clearing phase, as it has been demonstrated with PUVA therapy and cyclosporine. This prolonged remission seems to be more frequent when the clearing phase is halted progressively rather than suddenly.
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Recent publications on Psoriasis and Atopic Dermatitis
on Psoriasis
Antipsoriatic effect of fatty acid enriched fraction of Vernonia anthelmintica Willd. fruits.
J Ethnopharmacol.
2018 Oct 05, 224:85-90.
Vernonia anthelmintica has been utilized conventionally as an ingredient in Ayurveda and traditional Uighur medicine for management of various skin ailments, and scientific data's have substantiated its use in treating vitiligo, dermatosis and leucoderma. The present investigation was focused to evaluate the antipsoriatic activity of V. anthelmintica fruit extracts and fractions.
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Properties and in vitro drug release of pH- and temperature-sensitive double cross-linked interpenetrating polymer network hydrogels based on hyaluronic acid/poly (N-isopropylacrylamide) for transdermal delivery of luteolin.
Int. J. Biol. Macromol..
2018 Oct 15, 118, (Pt A):731-740.
In this study, we prepared double cross-linked interpenetrating polymer network (IPN) hydrogels composed of temperature sensitive poly (N-isopropylacrylamide) (PNIPAM) and pH sensitive hyaluronic acid (HA) by radical polymerization and Michael addition. Their physicochemical properties for transdermal delivery of luteolin inhibiting the hyperproliferation of keratinocytes in psoriasis were investigated and drug release studies were performed. Double networks of HA/PNIPAM IPN hydrogel were (...)
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Proanthocyanidins: novel treatment for psoriasis that reduces oxidative stress and modulates Th17 and Treg cells.
Redox Rep..
2018 Dec , 23, (1):130-135.
Psoriasis is a common, chronic, inflammatory skin disease that affects 2%-4% of the global population. Recent studies have shown that increased oxidative stress (OS) and T-cell abnormalities are central to the pathogenesis of this disease. The resulting reactive oxygen species (ROS) induces proliferation and differentiation of Th17/Th1/Th22 cells and inhibits the anti-inflammatory activities of regulatory T lymphocytes (Treg). Subsequent secretions of inflammatory cytokines, such as (...)
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on Atopic Dermatitis
Lactobacillus plantarum-derived Extracellular Vesicles Protect Atopic Dermatitis Induced by Staphylococcus aureus-derived Extracellular Vesicles.
Allergy Asthma Immunol Res.
2018 Sep , 10, (5):516-532.
The microbial environment is an important factor that contributes to the pathogenesis of atopic dermatitis (AD). Recently, it was revealed that not only bacteria itself but also extracellular vesicles (EVs) secreted from bacteria affect the allergic inflammation process. However, almost all research carried out so far was related to local microorganisms, not the systemic microbial distribution. We aimed to compare the bacterial EV composition between AD patients and healthy subjects and to (...)
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Hyaluronic acid decorated tacrolimus-loaded nanoparticles: Efficient approach to maximize dermal targeting and anti-dermatitis efficacy.
Carbohydr Polym.
2018 Oct 01, 197:478-489.
Nano-delivery systems have gained remarkable recognition for targeted delivery of therapeutic payload, reduced off-target effects, and improved biopharmaceutical profiles of drugs. Therefore, we aimed to fabricate polymeric nanoparticles (NPs) to deliver tacrolimus (TCS) to deeper layers of the skin in order to alleviate its systemic toxicity and improved therapeutic efficacy against atopic dermatitis (AD). To further optimize the targeting efficiency, TCS-loaded NPs were coated with (...)
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Environmental factors associated with allergic rhinitis symptoms in Japanese university students: A cross-sectional study.
Auris Nasus Larynx.
2018 Oct , 45, (5):1006-1013.
Numerous studies have reported that various environmental factors during early life are key determinants for developing allergic disease. Herein, we aimed to investigate the impact of environmental factors on allergic rhinitis.
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