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| |  Advances In Psoriasis Treatment Offer Hope To Millions NEW YORK, NY -- October 30, 1997 -- An estimated six million Americans suffer from psoriasis. The disease occurs in a variety of forms that differ in severity, duration, location and the shape and pattern of scales. Some cases are so mild people don't know they have it. At the opposite extreme, severe psoriasis can interfere with everyday life and is very debilitating. The most severe cases of psoriasis destroys the skin's protective functions, allowing the skin to lose fluids and nutrients: losing control of body temperature; making patients susceptible to infection; and possibly causing death. Currently there is no cure, only suppressive therapy. However, Mark Lebwohl, MD, professor and chairman of the department of dermatology at Mount Sinai School of Medicine, said there is cause for hope in the near future. He spoke of the advances in psoriasis research at the American Academy of Dermatology’s Derm Update ’97. "There has been an explosion of research in the treatment of psoriasis," he said. "Some are brand new, and others are improvements of old standard therapy" Although it can run in families, psoriasis is not contagious. The exact cause is unknown and there is no cure. It results from the body's inability to control the production of skin. Subsequently, there is an overproduction of skin cells that can lead to thickening of the skin and scaling. There are approximately 150,000 new cases of psoriasis occurring each year and the disease can begin at any age. The major goal of treatment is to decrease the severity and the extent of the outbreak so that it no longer interferes with the patient's work, personal or social life, or general well-being. The initial treatment for mild psoriasis may be as simple as moisturizing creams and lotions. A doctor may also prescribe topical medications to apply to the skin containing cortisone-like compounds, synthetic vitamin D, tar or anthralin. These may be used in combination with natural sunlight or ultraviolet light. The most severe forms of the disease may require oral medications with or without light treatment. Dr. Lebwohl said new treatments are very promising. Calcipotriene (Dovonex) was introduced three years ago, as the first non-corticosteroid vitamin D derivative. In ointment form, it was a successful treatment with no cortizone side effects( stretch marks, thinning of skin or dilated bloodvessels); however it was greasy. "New formulations offer the medication in both cream and solution form. The cream is absorbed into the skin, and the solution evaporates and is perfect for scalp treatments," Dr. Lebwohl said. Mometasone/salicylic acid (Combisor), is a combination of steroids and salicylic acid. This topical treatment is an effective mainstay of psoriasis medications, he said. Tazarotene (Tazorac gel) is considered a major breakthrough in the use of topical retinoids. "Tazarotene is the first topical retinoid developed specifically for psoriasis,” he said. “Once-daily therapy can be effective as early as one week into treatment. This treatment holds real promise for prolonged remission." Of importance to women of child-bearing age, Acitretin (Soriatain) is a new treatment that is quickly eliminated from the body. Many psoriasis treatments can be dangerous for women of child-bearing potential because of the prolonged possibility of birth defects. While an improvement over Etretinate, a currently available medication which is not to be administered to women planning future pregnancies, the FDA still recommends that women stop taking Acitretin, then wait three years before conceiving. Perhaps the most exciting of the new drugs to combat psoriasis are the fusion proteins, usually a combination of unique molecules with antibody fragments, he said. "These are proteins that block the activation of T-cells that lead to the development of psoriasis. Although not yet approved by the FDA, they have performed well in clinical trials. Just a few injections can result in dramatic improvement and may be the long-term answer to controlling the disease," Dr. Lebwohl said.
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