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Laser Therapy for Psoriasis

Source: www.cigna.com
Topic: Psoriasis
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Sort Desciption: Inverse psoriasis is characterized by smooth, red lesions ... Pustular psoriasis involves the appearance of pus-like blisters and is either ... Psoriasis is ...

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Psoriasis is a chronic skin disease that affects 1â 3% of the U.S. population. There are several types of psoriasis, each of which has distinctive characteristics. Plaque psoriasis, also called psoriasis vulgaris, is the most common type and is characterized by raised, thickened patches of inflamed skin, called plaques, which are covered with silvery-white scales. The hallmark of guttate psoriasis, which usually affects children and young adults, is the appearance of small, drop-like lesions that may be accompanied by an upper respiratory infection and sore throat. Inverse psoriasis is characterized by smooth, red lesions appearing in the folds of the skin in the armpit, under the breast, and around the groin and buttocks. Pustular psoriasis involves the appearance of pus-like blisters and is either localized (i.e., limited to the palms or soles of the feet) or generalized (i.e., during which symptoms can be systemic). Erythrodermic psoriasis is characterized by intense inflammation and swelling of extensive areas of skin. Psoriasis is usually diagnosed by clinical examination and visual inspection, with skin biopsy performed when the diagnosis is uncertain. Between 10% and 30% of psoriasis patients develop psoriatic arthritis, which can affect multiple joints in the body (Pardasani, et al., 2000; Geilen and Orfanos, 2002; American Academy of Dermatology AAD , 2003; National Institute of Arthritis and Musculoskeletal and Skin Diseases NIAMS , 2003).

In research settings, there are various scales utilized to determine the severity of psoriasis. Typically, severity scales are based on the body surface area affected, the intensity of signs and symptoms, previous treatments, duration of disease, and the impact on the patient's quality of life. Despite some reported variability among authors, the Psoriasis Area and Severity Index (PASI) is reported as the most frequently used measurement tool for psoriasis and combines the extent of psoriasis lesions and the area affected into a single score of severity which ranges from 0 to 72. The PASI tool is used primarily in research settings to assess effectiveness of treatment, and not in clinical practice (Langley, Ellis, 2004). In clinical practice, the severity of psoriasis is usually graded as mild, moderate or severe. While there is no consensus regarding what represents mild, moderate or severe cases, the National Psoriasis Foundation (2007) reports mild psoriasis affects less than 3% of the body, moderate affects 3â 10% of the body, and psoriasis affecting more than 10% of the body is severe. Moreover, the severity of psoriasis is also measured by how psoriasis affects a person's quality of life.

The major goals of psoriasis treatment are to reduce inflammation and to control the excessive proliferation and shedding of the skin cells. Treatment is individualized, depending on the type and severity of disease and the patient's health, lifestyle and age. Localized disease can often be treated with topical therapies, whereas generalized or refractory psoriasis may require oral medications, phototherapy or photochemotherapy. Topical therapies include the use of creams and lotions to loosen the scales and alleviate itching, as well as emollients to control skin dryness. First-line medical therapy is usually a topical corticosteroid, combined with a coal tar product or calcipotriene, a vitamin D derivative. If adequate control is not achieved with these measures, anthralin or tazarotene may be added to the treatment regimen.

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