Can Psoriasis be cured?

Psoriasis is a chronic autoimmune condition characterized by the rapid overproduction of skin cells, leading to the formation of thick, red, scaly patches on the skin. While it is a non-contagious condition, it can have a significant impact on one’s physical and emotional well-being.

What causes psoriasis?

Although the exact cause of psoriasis is not fully understood, there is a strong genetic component to the condition. Many individuals with psoriasis have a family history of the disease, suggesting that certain genetic factors play a role in its development. Environmental factors and triggers can also exacerbate psoriasis symptoms or trigger flare-ups. Common triggers include stress, infections, certain medications such as lithium, beta-blockers, and antimalarial drugs, injury to the skin and more.

Types of psoriasis

• Plaque psoriasis: The most common form, characterized by raised, red patches covered with silvery-white scales.
• Guttate psoriasis: Often triggered by bacterial or viral infections, characterized by small, drop-shaped lesions on the skin.
• Inverse psoriasis: Affects skin folds such as the armpits, groin, and under the breasts, causing smooth, red patches of irritated skin.
• Psoriatic arthritis: A type of inflammatory arthritis that affecs some individuals with psoriasis, causing joint pain, stiffness, and swelling.
• Other less common types include pustular psoriasis and erythrodermic psoriasis.

Treatments for psoriasis

While there is no cure for psoriasis, several treatment options are available to help manage symptoms and improve quality of life.

These include biologic therapies, topical treatments such as corticosteroids, vitamin D analogs, and retinoids, pulsed-dye laser, narrow band UBV Phototherapy, oral medications such as methotrexate, cyclosporine, and apremilast.

Pulsed-dye Laser

Pulsed-Dye Laser treatment works by delivering precisely controlled pulses of potent laser energy to targeted areas, effectively halting the excessive growth of skin cells. The treatment works by delivering controlled pulses of intense laser energy to targeted treatment areas to slow down and stop excessive skin cell growth. The laser treatment works via 3 main mechanisms:

• Partial suppression of overactive immune system by reducing the activity of key proteins involved in inflammatory reactions like E-selectin and IL-23.
• Directly collapsing tiny blood vessels supplying the psoriasis tissues, interrupting their blood supply.
• Decreasing the expression of key proteins involved in the formation of new vascular tissue (blood vessels) like VEGFR2 and VEGFR3.

Phototherapy

Narrowband UVB (NB-UVB) phototherapy is a common and effective treatment option for psoriasis. NB-UVB involves exposing the skin to ultraviolet B (UVB) light within a specific narrow range of wavelengths, typically around 311 to 313 nanometers. This suppresses the immune system and reduce inflammation in the skin, which is a key factor in the development of psoriasis lesions. NB-UVB therapy induces apoptosis, also knowned as programmed cell death, in the abnormal skin cells characteristic of psoriasis. This helps to normalize the growth cycle of skin cells and reduce the thickness of psoriatic plaques.

The Clifford Clinic also carries the only FDA approved oral medication to treat plaque psoriasis and psoriatic arthritis.

How does Apremilast treat psoriasis?

Apremilast is taken orally in the form of tablets. The medication works by inhibiting an enzyme called phosphodiesterase 4 (PDE4). By inhibiting PDE4, Apremilast reduces the production of certain pro-inflammatory mediators within cells, thereby helping to decrease inflammation associated with conditions like psoriasis and psoriatic arthritis.

Side effects of Apremilast

Apremilast is generally well-tolerated, but like all medications, it can cause side effects. Common side effects may include diarrhea, nausea, headache, and upper respiratory tract infections. In some cases, Apremilast may also increase the risk of depression or suicidal thoughts, so it’s important for patients to be monitored closely, especially if they have a history of depression or mental health issues.

Apremilast is contraindicated in patients with known hypersensitivity to the drug or its components. It should not be prescribed if you have severe renal impairment (creatinine clearance less than 30 mL/min) or severe hepatic impairment. Apremilast is not recommended during pregnancy or breastfeeding due to potential risks to the fetus or infant.

Psoriasis treatment at The Clifford Clinic

Apremilast offers an oral treatment option for individuals with psoriasis and psoriatic arthritis, providing an alternative to traditional systemic medications or biologic therapies. At The Clifford Clinic, we tailor treatment plans to suit the individual’s specific symptoms, disease severity, and medical history.