Psoriasis is usually a lifelong, relapsing disease in which the main treatment goal is resolution of lesions. The treatment approaches are not curative but can be very effective in controlling the disease. The basic approaches to therapy involve a reduction in the rate of epidermal proliferation in addition to a decreased dernal inflammatory and immune response.
An appropriate selection of therapy combined with compliance will usually result in a satisfactory outcome in a few days to a few weeks. The risk-benefit issues are very important when determining a treatment approach as is the recognition of the pathogenic factors involved. The main goal of treatment is to allow the patient to be functional in all aspects of their life and to maintain good physical and emotional health. Patients with limited disease can usually be managed with topical therapy.
Topical therapy can include sunlight, moisturizers, baths, salicylic acid, retinoids, dithranol, coal tar preparations, calcipotriene, tacrolimus and corticosteroids. Sunlight in short, regular daily doses that do not produce a sun burn will clear up psoriasis in some cases. Moisturisers that are thick and greasy, or emollients, aid in hydrating the skin and reducing scaling and itching. They are generally used regularly and over a long time period.
Baths consisting of an oil (generally dispersed with the aid of a surfactant) added to the bath water can be soothing. Generally, the body is soaked for about 15 minutes in water containing a tar preparation, oilated oatmeal or Epsom salts.
Salicylic acid, a keratolytic, aids in removing the scales. It is considered most effective when used in association with topical steroids, coal tar or dithranol.
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