Psoriasis - Treatment

(Page 2)

Choices for transitional or maintenance treatments depend on the severity of the condition. Some examples are described in the following sections.

Rotational Therapy

In severe chronic cases, a doctor may recommend rotational therapy. This approach alternates treatments. The goal is to prevent severe side effects or build-up of resistance from long-term use of a single medicine. An example of a rotational schedule may be the following:

• The patient gets phototherapy for about 2 years.
• The patient then takes one or two powerful body-wide drugs for 1 - 2 years and stops.
• Phototherapy starts again, and the cycle repeats.

---

---

Oral and Injected Therapy

Some doctors use the Koo-Menter Psoriasis Instrument (KMPI) to decide which patients should receive a pill (oral) or an injection. The KMPI’s questions include

• Does psoriasis cover at least 5% of the patient’s body?
• Is the patient disabled by psoriasis?
• Does psoriasis affect the patient’s quality of life?

If the answer to these questions is "yes," three additional questions are considered:

• Is light therapy inappropriate for the patient?
• Is the patient’s psoriasis resistant to light therapy?
• Does the patient have psoriatic arthritis?

If the answer to these questions is “yes,” a doctor may decide to prescribe a pill or injected drugs.

Combination Therapies

Doctors increasingly use combinations of pills, creams, ointments, and phototherapy instead of single medications. Combinations of oral treatments are particularly useful, since the doses of each drug can be reduced. This lowers the risk of severe side effects. Thousands of combinations are possible, and the patient and doctor should discuss the best treatment for individual needs.

Review Date: 10/30/2006
Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).