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
Immunological and clinical effects of low-dose interleukin-2 across 11 autoimmune diseases in a single, open clinical trial.
Ann. Rheum. Dis..
2019 Feb , 78, (2):209-217.
Regulatory T cells (Tregs) prevent autoimmunity and control inflammation. Consequently, any autoimmune or inflammatory disease reveals a Treg insufficiency. As low-dose interleukin-2 (ld-IL2) expands and activates Tregs, it has a broad therapeutic potential.
see on pubmed
A Chinese cross-sectional study on depression and anxiety symptoms in patients with psoriasis vulgaris.
Psychol Health Med.
2019 Mar , 24, (3):269-280.
Previous studies have reported a higher incidence of depression and anxiety in psoriasis patients compared to the general population, which has important implications for assessment and treatment. In this study, we determined the frequency of depression and anxiety in Chinese patients with psoriasis and its relationship with disease severity and other demographic variables. The study included 208 Chinese patients with psoriasis vulgaris. The Patient Health Questionnaire (PHQ-9) and (...)
see on pubmed
Downregulated miR-187 contributes to the keratinocytes hyperproliferation in psoriasis.
Tang L et al.
Downregulated miR-187 contributes to the keratinocytes hyperproliferation in psoriasis.
J. Cell. Physiol..
2019 Apr , 234, (4):3661-3674.
Psoriasis is a common chronic skin disease characterized by epidermal hyperplasia and inflammation. However, the pathogenesis of psoriasis is multifactorial and is not fully understood. MicroRNAs (miRNAs) represent a promising class of small, noncoding RNA molecules that have a large impact on cellular functions by regulating gene expression. Here we reported that microRNA-187 (miR-187), which is one of the most dynamic microRNAs identified in the deep screening miRNAs profile, is (...)
see on pubmed
on Atopic Dermatitis
Interleukin-4/interleukin-13 versus interleukin-5: a comparison of molecular targets in biologic therapy for the treatment of severe asthma.
Curr Opin Allergy Clin Immunol.
2019 Feb , 19, (1):30-37.
Asthma is a chronic, inflammatory disorder of the airways caused by a complex interplay of various biologic mechanisms. Several monoclonal antibody therapies targeting interleukin (IL)-4/IL-13 and IL-5 cytokine pathways have been developed for the treatment of severe eosinophilic asthma. As individuals can display biomarkers and clinical features characteristic of several asthma phenotypes, selection of anoptimal biologic can be (...)
see on pubmed
A tale of 2 poles.
Bach RO et al.
A tale of 2 poles.
Contact Derm..
2019 Feb , 80, (2):131-132.
Neopterin Levels and Indoleamine 2,3-Dioxygenase Activity as Biomarkers of Immune System Activation and Childhood Allergic Diseases.
Ann Lab Med.
2019 May , 39, (3):284-290.
Although Th2 immune activation is predominant in allergic diseases, neopterinlevels and indoleamine 2,3-dioxygenase (IDO)-1 activity (kynurenine:tryptophan ratio), which reflect Th1 immune activity, increase with interferon-gamma (IFN-γ) stimulation. We investigated neopterin, tryptophan, and kynurenine levels as biomarkersof the Th1 immune system activation and changes in IDO-1 activityin children with asthma, allergic rhinitis, and atopic dermatitis, as well as the relationship between (...)
see on pubmed