According to Beverly Hills dermatologist Monika Kiripolsky, MD, FAAD, psoriasis increases risk for psoriatic arthritis, cardiovascular disease, diabetes, depression and some types of cancer including prostate cancer, lymphoma and skin cancer. "The common denominator is likely inflammation, which is a hallmark of psoriasis and thought to play a role in many other diseases," she says.
This understanding has led to dramatic changes in how psoriasis is treated, explains Marnie Nussbaum, MD, FAAD, a dermatologist in New York City and Clinical Instructor of dermatology at Weill Cornell Medical Center. In the past, psoriasis was treated with topical corticosteroids, antikeratolytic agents, light therapy, tar therapy, retinoids, vitamin D analogs and antimetabolites like methotrexate, to name a few.
Not anymore. "The most significant change in psoriasis therapy has been the addition of biologic agents which are essentially proteins that have pharmacologic activity which manipulate the immune system," she explains. These drugs basically cool inflammation at various points during the inflammatory cascade. Approved biologics for psoriasis include Enbrel (etanercept), Humira (adalimumab), Remicade (infliximab), Simponi (golimumab) and Stelara (ustekinumab).
These drugs do have their share of risks. "They blunt the immune system in such a way that leaves the patient at higher risk for infections and therefore, any minor infection must be taken seriously," she says. "Biologics also may increase the risk of certain types of cancers. "For these reasons, they are not prescribed lightly. A series of blood tests is needed before initiation to check for any underlying conditions and risk factors.
"Depending on the type and severity of the psoriasis, an individualized treatment regimen can be made by both physician and patient together in order to accommodate lifestyle factors in addition to severity of disease," she says.
5 Step Psoriasis Action Plan
1. Manage risks for other diseases. This includes maintaining a normal weight, eating a healthy diet, getting regular exercise and not smoking. These healthy changes all help lower risk for heart disease, diabetes and some cancers. "It is extremely important for patients with psoriasis to maintain a healthy lifestyle and be diligent with routine physician examinations," says Nussbaum.
2. See a dermatologist. "It is absolutely essential for a psoriasis patient to be seen by a dermatologist for an individualized assessment and treatment plan," she says. Ask your doctor about newer medications, such as the biologics to see if you are a candidate. Visit aad.org for more information.
3. Bathe daily. "I recommend bathing daily to cleanse skin with lukewarm water and a wash which is soap-free pH balanced, as regular soap can strip the skin of moisture and essential oils," she says.
4. Choose a gentle all-over wash. "Use a product like Sebamed Liquid Face & Body Wash," she says.
5. Moisturize. "To keep skin soft and treat areas of the skin affected by psoriasis, apply a prescribed ointment or a hydrating lotion like Sebamed Moisturizing Body Lotion before bed," Nussbaum says.
-Additional reporting by Denise Mann
Wendy Lewis is President of Wendy Lewis & Co Ltd, Global Aesthetics Consultancy, author of 11 books and Founder/Editor in Chief of http://www.beautyinthebag.com
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