After Fits and Starts, New Hope for Psoriasis Patients

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After Fits and Starts, New Hope for Psoriasis Patients

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MONDAY, Aug. 25 (HealthDay News) - Psoriasis can be a maddening disease.

Patches of thick, inflamed skin covered with silvery scales form here and

there on the patient's body, often on the elbows, knees, other parts of the

legs, scalp, lower back, face, palms, and soles of the feet. They usually

itch or feel sore, and the more of the patches there are, generally, the

worse the person suffers.

And because psoriasis is a genetic condition that causes inflammation by

striking at the immune system, it can have other health effects. An

estimated 10 percent to 30 percent of people with psoriasis also develop

psoriatic arthritis, which causes pain, stiffness and swelling in and around

the joints, according to the National Psoriasis Foundation.

Psoriasis sufferers also have higher rates of cardiovascular disease and

other systemic health problems, said Dr. Cather, a Dallas

dermatologist and a member of the Baylor University Medical Center's

Division of Dermatology.

" Often patients think psoriasis is just a rash, [but] it is a systemic

inflammatory disease with far-reaching affects, " Cather said. " Patients

should be aware of that and understand that controlling that systemic

inflammation can help with other diseases. "

That's a message doctors are looking to share during August, Psoriasis

Awareness Month.

Until recently, there was little that could be done about the systemic

damage done by psoriasis. Sufferers used topical creams to ease their itches

or aches, or underwent expensive ultraviolet light treatments that disrupted

the surface spread of psoriasis but did not address the underlying problems

within the immune system.

But the past few years have seen the development of a new wave of drug

treatments known as biologics. These medications do what previous treatments

could not - go after the root of the problem by influencing the immune

system.

" It's really changed the way we can treat psoriasis, " said Dr. Lawrence

Green, assistant professor of dermatology at Washington University

School of Medicine in Washington, D.C. " It really has made life much more

tolerable for patients. "

Psoriasis occurs when the body's immune system is somehow mistakenly

triggered, which speeds up the growth cycle of skin cells, according to the

National Psoriasis Foundation. Normal skin cells mature and fall off the

body in 28 to 30 days. A psoriatic skin cell takes just three to four days

to mature and move to the surface, and, instead of falling off, the cells

pile up and form lesions.

According to the National Institutes of Health, as many as 7.5 million

Americans have psoriasis.

Biologics are made from human or animal proteins, and they treat psoriasis

by going after the overactive immune cells causing the disease.

" They are based on natural processes, " Green said. " They're similar to

chemicals or compounds we already have in our system. They help lessen

immune responses. They help soak up or diminish the extra inflammatory

compounds. "

Currently, five biologics are approved by the U.S. Food and Drug

Administration for treatment of psoriasis, and three of those five are

approved for psoriatic arthritis. Biologics are effective, and they also are

more affordable than ultraviolet therapy, the other leading treatment for

dealing with medium-to-severe cases of psoriasis, according to

dermatologists.

Ultraviolet light kills the immune cells in the skin that are causing the

problem, Cather said. The problem is, a person must come in three to five

times a week for treatment, racking up hundreds of dollars in co-payments.

Biologics, by comparison, are self-administered through injection. The

patient usually must inject the medication somewhere between twice-weekly to

once every other week, Cather said.

Patients undergoing biologic therapy need to have periodic re-evaluations by

their dermatologist to check for the development of new symptoms, including

infections and potential cancers, according to guidelines issued earlier

this year by the American Academy of Dermatology.

SOURCES: Cather, M.D., Dallas dermatologist, member, Baylor

University Medical Center's Division of Dermatology; Lawrence Green, M.D.,

assistant professor, dermatology, Washington University School of

Medicine, Washington, D.C.; National Psoriasis Foundation; U.S. National

Institutes of Health