The Difference Between Topical And Systemic Psoriasis Treatments

Psoriasis is a chronic inflammatory skin disease that affects an estimated 2 to 3 percent of the population. Psoriasis causes the skin to become scaly, red, and itchy. There are five main types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic. The psoriasis treatment is based on the type of psoriasis so let’s know about psoriasis in brief.

What is psoriasis?

It is a chronic autoimmune disease in which the patient’s immune system attacks its own body. In typical cases, skin cells mature and replace old cells about once every 28 days. However, people with psoriasis have a rapid turnover of skin cells. It was replacing them every 3 to 4 days instead of the usual 28-day cycle. These fast-growth cycles cause scaly patches (plaques) to appear on the surface of the skin.

What are the symptoms of psoriasis?

The most common symptom of psoriasis is a scaly, red patch of skin that may be itchy and painful. These patches, known as plaques, tend to appear on the elbows, knees, other parts of the legs, scalp, lower back, face, neck, chest, stomach, genitals, genital folds, and groin. If you have psoriasis in one location for several months or years without treatment, it can turn into thicker areas called plaques. Plaques are often described as being “islands” of scaling surrounded by normal-appearing skin. Psoriasis patches can vary from small and localized to complete body coverage.

What are the types of psoriasis?

The five main types are plaque, guttate, inverse, pustular, and erythrodermic. Of these categories, plaque psoriasis is the most common. The other types are much less common.

Plaque Psoriasis: The most common type of psoriasis, plaque psoriasis causes raised and often red patches of skin that may be covered with silvery-white scales. A person may have just a few plaques or several dozen. The size, location, and several plaques can vary from person to person.

Guttate Psoriasis: This type of psoriasis appears as small (pimple-like), water-based (clear) bumps on the skin, which tends to affect children and teens more than adults. It is triggered by a bacterial infection such as strep throat or scarlet fever. As many as one in five people with psoriasis will develop guttate psoriasis during their lifetime.

Inverse Psoriasis: This type of psoriasis causes the skin to appear smooth and often lighter than the normal skin tone. The affected areas of skin are often between folds of skin. Such places on the body include armpits, groin, under breasts, etc.).

Pustular Psoriasis: Pustular psoriasis appears as raised bumps filled with noninfectious pus (pustules). It usually starts with a red patch that evolves into raised bumps over hours or days. Pustular psoriasis can be localized or cover large parts of the body. Erythrodermic Psoriasis: This form of psoriasis is extremely rare. It is also called exfoliative psoriasis because it causes severe peeling of the skin over large body areas. People with this type of psoriasis may have a fever, chills, and other flu-like symptoms for several days before the onset of skin changes. The reasons that trigger erythrodermic psoriasis are unknown.

How is psoriasis diagnosed?

1. Your doctor will ask you about your medical history and examine your skin for signs of psoriasis.
2. Your doctor may take a small piece of skin (biopsy) from an affected area to check for psoriatic changes in the skin cells that haven’t yet appeared on the surface. The biopsy can be done using a local anesthetic, and the sample removed using a tiny blade or needle puncture followed by scraping with a metal spatula. The raw surfaces are examined under a microscope to look for changes characteristic of psoriasis, such as rapid turnover of skin cells, inflammation, etc.
3. Sometimes, blood tests, including erythrocyte sedimentation rate ESR, C-reactive protein CRP, and complete blood count CBC may be required depending on the severity of your condition.

What are the types of psoriasis treatments?

Psoriasis is treated by topical and systemic treatment.

1) Topical treatments:

1. a) Corticosteroids: The most common medication for psoriasis is a topical corticosteroid. These steroid creams, ointments, and gels help reduce inflammation that triggers psoriasis symptoms, including redness, itching, swelling, scaling, and pain. Itching may occur with this treatment but should go away as your skin starts to improve.

Creams are suitable for surface lesions (red patches), while ointments are better for thicker plaques (lumps). Gels can be used on all types of psoriasis. Some dermatologists prescribe more vigorous preparations that require prescriptions; others sell over-the-counter strength topical corticosteroids that you can buy without a prescription.

1. b) Coal tar: It is another standard treatment for psoriasis. Tar derivatives help reduce the scaling and thickening of the skin, which results from chronic plaque psoriasis. Look out for products that list coal tar as an ingredient – but also check the other ingredients as some over-the-counter preparations include medicines other than coal tar, such as salicylic acid, sulfur, or resorcinol.
2. c) Vitamin D analogs: The most commonly prescribed vitamin D medicine for psoriasis is calcipotriene (Dovonex). Psoriatic plaques may absorb more topical steroids through expansion due to inflammation; therefore, this medication works best on those plaques where you need an anti-inflammatory effect. However, calcipotriene is not effective on the scalp and face.
3. d) Other topical treatments: Other topical psoriasis medications include anthralin (Drithocreme, Micanol), tazarotene (Tazorac cream or gel), salicylic acid (Neutrogena, Fostex), dithranol (Liqosone ointment).

2) Systemic treatments:

1. a) Oral retinoids: These are vitamin A derivatives that work by slowing down epidermal cell turnover. Skin cells in people with psoriasis reproduce too quickly; therefore, these medications help slow down cell production and promote normal differentiation of skin cells. The most common oral retinoid is acitretin (Soriatane).
2. b) Systemic corticosteroids: These medications suppress the immune system, which is overactive in psoriasis. They may be needed when other treatments fail to control your symptoms, but they also have many side effects such as weight gain, acne, and diabetes mellitus, so they are not used long term.
3. c) Immunomodulators: These drugs alter the immune functions in psoriasis, which slows down cell turnover rate. The most common ones are methotrexate (Rheumatrex Dose Pack), alefacept (Amevive), efalizumab (Raptiva).
4. d) Biologics: This type of treatment targets specific biochemical pathways required to develop psoriatic plaques. The most common drug in this category is adalimumab (Humira).
5. e) Other systemic treatments: These medications are used to treat psoriatic arthritis, including medicines such as sulfasalazine (Azulfidine), leflunomide (Arava), and hydroxychloroquine sulfate.
6. f) Biologic response modifiers: This class of drugs uses human proteins that have been engineered into a specific shape that mimics the standard immune system signal for cells to stop growing. Etanercept (Enbrel) and infliximab (Remicade) are examples of these types of drugs; they target tumor necrosis factor-alpha TNF-.

What is the fundamental difference between the topical and systemic treatment of psoriasis?

1. a) Topical treatments are applied directly to skin lesions, while systemic treatments are given through the bloodstream.
2. b) Topical treatments include creams, ointments, and gels, while systemic treatments include vitamin D analogs.
3. c) The main difference between topical and systemic treatment for psoriasis is that topical preparations only treat the affected area. In contrast, systemic medications affect other organs in your body as well.
4. d) Systemic treatments require a prescription, but topical ones do not.
5. e) Stronger topical corticosteroids can be used, whereas more potent systemic corticosteroids need a prescription.
6. f) The main difference between topical and systemic treatment for psoriasis is that topical preparations target immune cells in the skin. In contrast, systemic medications affect other organs in your body as well.
7. g) Both topical and systemic treatments are equally effective in treating psoriasis.
8. h) Topical treatments include anthralin, salicylic acid, and dithranol, while systemic treatments include methotrexate and adalimumab (Humira).
9. i) Systemic treatments need to be taken orally, whereas topical ones can be applied topically.
10. j) The main difference between topical and systemic treatment for psoriasis is that one targets immune cells within the skin while the other does not.

What other procedures can help in management?

1. a) Phototherapy is the application of ultraviolet light to the skin. A class of drugs called psoralens is used along with this type of treatment. These drugs help regular exposure to ultraviolet light, which helps reduce inflammation in psoriasis plaques.
2. b) Acupuncture may be helpful for some people with psoriasis by reducing stress and relieving pain, though more studies are needed to confirm these effects.
3. c) Mesotherapy is a non-invasive procedure that uses injections of pharmaceutical or homeopathic medication into subcutaneous fat tissue or muscle under local anesthesia. . It has not been shown to have many benefits over placebo treatment.
4. d) Regular physical exercise can improve symptoms of psoriasis, especially if you stay at a healthy weight.
5. e) Beware of sun exposure as it can worsen symptoms. Wear sunscreen and protective clothing to avoid burning the skin during sunlight hours.
6. f) If you have moderate to severe symptoms, your doctor may recommend light therapy, which uses ultraviolet light to reduce inflammation in plaques.
7. g) Most people with psoriasis should take fish oil capsules that contain omega-3 fatty acids or other supplements that contain vitamins A, C, E, or B12 for additional relief from symptoms.
8. h) Patients are encouraged to avoid triggers such as stress which can make symptoms worse.
9. i) Your doctor may recommend other medical procedures such as light therapy (phototherapy) or acupuncture to help improve your psoriasis symptoms.
10. j) Patients are encouraged to avoid triggers such as stress which can make symptoms worse.
11. k) Seek out support groups and ask for help if you need it because psoriasis can be difficult emotionally.
12. l) Light therapies, like phototherapy, can provide relief from some of the physical discomforts of this condition.
13. j) Homeopathic treatment for psoriasis is one of the best treatments for psoriasis. Homeopathic treatment for psoriasis treats the root cause of psoriasis and hence is effective.

Homeopathy and psoriasis:

Homeopathy treats the root cause of psoriasis and hence is effective in treating psoriasis. Homeopathy does not have any side effects when compared to conventional medicine. Homeopathic remedies have been used to treat psoriasis for more than a century.

Homeopathy is based on the principle that “like cures like,” where a substance that causes symptoms in a healthy person can cure similar symptoms in a sick person. Homeopathy uses highly diluted substances of plant, mineral, or animal origin to stimulate a healing response.

Homeopathic remedies for psoriasis are made from plants or minerals. These medicines work by correcting the natural imbalance in your body to help restore health and well-being.

What are the benefits of using the homeopathic treatment for vitiligo?

A homeopathic remedy for psoriasis contains diluted natural substances that help in stimulating the body’s healing response.

• Homeopathy works with your immune system rather than against it and hence is effective.
• Homeopathy has no side effects when compared to conventional medicine used for psoriasis treatment.
• The positive effect of homeopathy is noticed over some time, and hence the treatment is safe.
• Homeopathy treats psoriasis from its root cause and hence is effective in treating psoriasis.
• Homeopathy has no side effects when compared to conventional medicine.
• Homeopathic remedies have been used to treat psoriasis for more than a century.
• Homeopathy is based on the principle that “like cures like,” where a substance that causes symptoms in a healthy person can cure similar symptoms in a sick person.
• Homeopathy uses highly diluted substances of plant, mineral, or animal origin to stimulate a healing response.

When to consider homeopathic treatment for psoriasis?

Homeopathy is helpful for vitiligo treatment in the following cases:

• Psoriasis occurs on its own without any external factors.
• Recurrent or frequent outbreaks of psoriasis.
• A skin condition associated with digestive system disorders and fever.
• Patches of hair loss, mainly if located on top of the head of the eyebrows.
• Skin condition is not improving even after taking treatment.
• History of psoriasis in your family member.

People with psoriasis, who have tried all the other conventional treatments available to no avail, can opt for homeopathic treatment. Homeopathy is effective in treating psoriasis and does not have any side effects when compared to traditional medicine. It is always better that you choose a registered homeopathy doctor for treatment. You can book an appointment through OHO Homeopathy for more information.