in fact, There are many therapeutic appliances, designed to accelerate the disappearance of the slick psoriatic arthritis; these medications are very effective for some patients, less for others; then there are cases where the psoriasis heals spontaneously without pharmacological intervention.
In principle, however, it is necessary to adapt the treatment to different extent and location of disease, age, sex, seriousnessà of the form and so on. the The choice of treatment must always be carried out by a doctor, as some drugs may present specific contraindications or determine the side effects were severe.
In mild-to-moderate you prefer topical medications (local treatment), in the forms of considerable extent and seriousnessà, it has recourse to systemic therapies, often rather challenging.
Both treatments are local and systemic should be made in cycles and not continuously, in order to reduce the risk of toxicity isà and the side-effects of a long-term treatment; the suspension, especially in the case of systemic therapy, should be implemented in a gradual manner.
Definitely recommended the use of moisturizers, which help to maintain the elasticityà of the skin and help to eliminate or minimize the micro-cracks. Among the topical treatments are to be mentioned the products of messina to the base of acetylsalicylic acid, with concentrations ranging from 3% to 20%, or tar, which facilitate the removal of the scales and make the skin more elastic.
also used cortisone, in the form of lotions, creams, ointments, in addition to acting on the inflammatory component, reduces the proliferation of keratinocytes (cytostatic action); their action is usually rapid, but prolonged use can; cause thinning of the skin up to the atrophy; other drugs are represented by ointments of calcipotriol and tacalcitol (like vitamin D), that stimulate the proper maturation of keratinocytes, without the risk of the appearance of significant side-effects, and the tazarotene, a retinoid, derivative of vitamin A) used in gel 0.1%, is particularly effective in mild forms and light, which acts both as an anti-inflammatory that normalizes the differentiation of the skin cells.
systemic therapy must be made with the two major classes of drugs, retinoids and immunosuppressants. The only retinoid available by the oral via is the acitretin, effective, but toxic and reserved to the forms più severe.
The immunosuppressants of choice are represented by a methotrexate and ciclosporin, (the latter reserved for patients not responding to or with contraindications to the use of other therapies). Are effective drugs but they have side effects, sometimes very serious.
Often, in the case of local therapy that is systemic, is associated with the phototherapy, based on the application of ultraviolet radiation of type A and B (in particular, narrow-band UVB) lamps with fluorescent lamps or halogen-metal, to run always under a doctor’s supervision.
Cinzia Confalone – Ministerosalute.it
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Page updated on 26/7/2006