Hello everyone! I would like to go more into the different therapies of Psoriasis because we discussed as a group that there could be a lot of options.
UVB for psoriasis
UV therapy is one of the first line therapies available for chronic plaque psoriasis, if available. The type of light that is used to treat psoriasis is UVB phototherapy. There are different types of UVB therapy, narrow-band, broad-band, and laser UVB. Narrow-band phototherapy is the most common light therapy and limits wavelengths used. Broad-band UVB therapy is the oldest form of light therapy and has a wider wavelength. Excimer Laser UVB lastly is for targeting smaller areas. Healthcare professionals use this type of therapy when the psoriasis is affecting less than 5 percent of the body. Some benefits to narrow-band UVB is that the light release a smaller range, making it able to clear psoriasis faster and give longer remissions. This treatment might also be quicker than the other types of UVB treatments. It is estimated that about 75% of people using UVB therapy will develop clear skin.
https://www.psoriasis.org/about-psoriasis/treatments/phototherapy#uvb
https://www.medicalnewstoday.com/articles/323593#types-of-light-therapy
soriasis
Psoriasis is a chronic inflammatory skin disorder more common in adults. psoriasis is an autoimmune disorder, where the T-cells become uncontrolled. they increase inflammation by increasing the release of tumor necrosis factor, interleukin-2, and interferon-gamma. The most common type of psoriasis is chronic plaque psoriasis. This is characterized by well-defined, coarse, red plaques. Plaques are areas of thick scales. It can be found on the scalp. knees, gluteal cleft, palms, soles, and ears. Guttate psoriasis is the onset of multiple, small, and inflamed plaques. They are sized about 1 cm in diameter and can be an acute onset in children. Other types of psoriasis include pustular psoriasis and erythrodermic psoriasis. Pustular psoriasis is the most severe form. There is a characterization of erythema, scaling, and superficial pustules across the body. Generally, psoriasis is defined by scaling, hardening, and redness of the skin. Patients with psoriasis usually have cycles, with flares occurring, and then diminishing. Risk factors include genetics, smoking, obesity, and alcohol use. It can be triggered by stress, skin injuries, and medicines, such as lithium, prednisone, and hydroxychloroquine. Psoriasis is also associated with different comorbidities. All patients with psoriasis should be screened for psoriatic arthritis. Common symptoms of this include joint pain, stiffness, and back pain. Other comorbidities include obesity, hypertension, metabolic syndromes, and atherosclerotic diseases. Psoriasis can also increase the risk of eye improvements disorders such as conjunctivitis, xerosis, and corneal lesions. Symptoms of this include swollen, crusty, and red eyes.
Although psoriasis is not life-threatening, the physical and social impacts may negatively impact people's lives. The treatment regimen depends on the severity, comorbidities, and patient preference and response. For limited psoriasis, topical corticosteroids and emollients are commonly used. Corticosteroids are used due to their antiproliferative and anti-inflammatory actions. It is recommended to only use corticosteroids in the presence of active psoriasis, then wean off it. Abruptly discontinuing corticosteroids can cause a rebound flare-up of psoriasis. Calcipotriene is a vitamin D analog that can be used for short-term treatment. For sensitive areas, such as the face and armpits, topical tacrolimus or pimecrolimus can be used. Severe psoriasis systemic therapies such as retinoids, methotrexate, cyclosporine, or biologic immune modifying agents. Examples of biologics used TNF agents (adalimumab, infliximab), IL-12/IL-23 antibodies (ustekinumab) and anti-IL-23/IL-39 antibodies (guselkumab, tildrakizumab, and risankizumab). the biologics target t-cells, inhibiting their action, and in return, inhibiting the actions and release of tumor necrosis factor-alpha, interleukin 17-A, or interleukins 12 and 23. It may take a few weeks to see improvements in severe psoriasis. For scalp psoriasis, it is more common to use topical corticosteroids in the form of shampoos, lotions, and gels.
Boehncke WH, Schön MP. Psoriasis. Lancet. 2015 Sep 5;386(9997):983-94. doi: 10.1016/S0140-6736(14)61909-7. Epub 2015 May 27. PMID: 26025581.
Tam A, Geier KA. Psoriatic arthritis. Orthop Nurs. 2004 Sep-Oct;23(5):311-4. doi: 10.1097/00006416-200409000-00006. PMID: 15554467.