Psoriasis is a chronic skin condition which results in flaky red areas of the skin which can become itchy and painful. At this time there is no definitive cause for psoriasis although, researchers believe that there is a combination of genetics and environmental factors which are the cause. Because there is no cause identified there is also no way to prevent the illness or condition from happening.
However, researchers and doctors do have a number of treatment protocols which can help individuals to control the skin condition that so often causes pain, disfigurements and discomfort. Through research, treatment has changed from the traditional charcoal treatments to using ultra violet light, topical corticosteroids and biologics.
Research into the treatment of psoriasis has opened up a new line of biologic agents being studied. These are called anti-TNF agents and T cell agents. Some of the anti-TNF agents include Etanercept. Sixty percent of patients have reported improvement using it although at a slower rate than using other medications. At this time no side effects have been reported from the medication and weekly doses need to be taken for one year.
Adalimumab is a recombinant antibody and binds with TNF. The FDA has approved this drug to be used with psoriatic arthritis and requires weekly dosages. Patients have found excellent results within a year of starting the medication. Infliximab is given intravenously and is a monoclonal antibody. There is a three dose schedule for six weeks and initial results show that 85 percent of people with psoriasis report improvement after three administrations. Within a period of one year 60 percent of the patients have reported clearing of their psoriasis.
Some of the T cell biologic agents include Alefacept which is an immunosuppressant fusion protein that inhibits the T cells. This is given as an intramuscular injection once every 12 weeks. The results of this are not as good as TNF since about only 10 percent of the psoriasis patients reported a total cure. However, when combined with methotrexate is also effective for psoriatic joint disease.
Efalizumab is known to give response within 24 weeks of initial dosage. About 66 percent of the patients have shown improvement within the first two to four weeks of administration. It is considered a very safe drug with very rare cases of thrombocytopenia or aggravation of their psoriasis.
In research published in the Journal of Investigative Dermatology, researchers from the University of Manchester in Britain provided some evidence that there are alterations in a gene involving the development of the vascular system that can contribute to this susceptibility of individuals to psoriasis. The National Psoriasis Foundation believes that this research can eventually lead to additional therapies for treatment for this and now incurable immune mediated disease that affects 5 million Americans. (1)
It was previously observed that different aspects of the vascular system were altered in individuals who suffer from psoriasis. Researchers found that an essential regulator of vascular development produced by skin cells was found in high levels in psoriatic skin lesions. In this particular study researchers found that the gene which controls these regulators occurred in greater frequency in a subset of people with psoriasis.
This research points others to the development of drugs that can block the activity of these regulators and can one day be used to treat psoriasis much the same way as current therapies are being tested in clinical trials as cancer treatments.
The National Psoriasis Foundation supports ongoing research and one-year pilot study grants in support of both basic and clinical research into the cause and cure of psoriasis and psoriatic arthritis. Their purpose is to provide support for innovative early-stage ideas in the grants are designed to be used by investigators to determine whether their idea is worth pursuing to secure a longer-term funding.
In another study researchers at the Dead Sea in Israel set out to determine the effect of natural sunlight combined with the salt water bathing in the Dead Sea on the inflammatory response of individuals who have psoriasis. Ten patients were treated in the Dead Sea for four weeks and skin biopsies were obtained afterwards which, when compared to normal subjects, showed there was a positive effect of the UVA and UVB sunlight but no conclusive therapeutic impact from bathing in the Dead Sea water\’s. (2)
Research into the treatment protocols for psoriasis is ongoing and continues to make great strides in the ability to decrease the number of flareups which individuals suffer. Although, unless an extreme cases, Psoriasis is not life-threatening there are significant changes which impacts the productivity of an individual and negatively impact the community.
(1) Journal of Investigative Dermatology: Genetic Alterations in Psoriasis
http://www.nature.com/jid/journal/v128/n7/full/jid2008160a.html
(2) Internet Health Library: Sun or Salt Water for Psoriasis
http://www.internethealthlibrary.com/Health-problems/Psoriasis-dead-sea-000210.htm
RESOURCES
Society of Investigative Dermatology: Molecular Dissection of Psoriasis
http://www.sph.umich.edu/csg/abecasis/publications/pdf/J.Invest.Dermatol.vol.130-pp.1213.pdf
PubMed Health: Psoriasis
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001470/
National Institute of Arthritis and Musculoskeletal and Skin Diseases: Fast Facts Psoriasis
http://www.niams.nih.gov/health_info/Psoriasis/psoriasis_ff.asp