European Antipsoriasis 2006 Guide (Extract)
Psoriasis is a chronic skin disease, non -content, which can occur at any age, affects about 3 % of the population, and the incidence is constantly increasing. The exact cause of the disease is not known. As a result, at present there is no healing by causal drug treatment, but only temporary improvements.
Psoriasis usually occurs on a genetic predisposed land, over which triggering and aggravating factors overlap. The most important trigger and aggravating factor is acute or chronic stress.
The diagnosis of psoriasis is clinical, the laboratory examinations being rarely useful.
Therapeutic objectives:
-Maximum objective: Full remission of skin lesions over a longer period of time
-Minimal objective: remission with at least 50 % of skin lesions
Treatment principles:
-when establishing the treatment plan, the risk ratio is always considered: benefit (ie the severity of side effects is related to skin improvement);
-Attention will be paid to psycho-behavioral and social disorders (depression, tendency to suicide), which prints high diseases, along with the extension of skin lesions.
Limitations and adverse effects of drug treatments
(With extracts from the European Antipsoriazis 2006 guide):
- Local Treatment:
-dermatocorticoids can give exacerbations to reuse, produce skin atrophy, aggravate viral, fungal, bacterial infections, develop tachyphylaxia (disappear the therapeutic effect after long use = the skin gets used to the product), the application in children is risky and are inefficient in psoriasis;
-Topic vitamin D derivatives can cause important irritation in the face and folds, hypercalcemia may occur in uncontrolled use, with all its negative effects;
-Topical retinoids have irritating effect, with pruritus and skin peeling, not used during the day (photosensitivity)
-The reducing preparations give severe irritation, unpleasant odor, dirty linen
-The use of high concentrations of salicylic acid in children can be followed by its absorption and the appearance of general toxic effects (SD Reye: fatal hepatic and central nervous system)
Conclusion: Any substance placed on the skin, in 24 hours circulating through blood throughout the body. The adverse reactions of local treatment have a variable severity, going from irritation and itching of the skin, to very serious reactions (hypercalcemia or Cushing’s syndrome).
- PUVA TERAPY (PSORENEAN + ULTRUVIOLETE A):
-it is associated with the risk of developing various forms of cancer, especially in case of simultaneous use of immunosuppressive treatments (described below);
-is associated with a high risk of developing skin cancer in skin and II phototypes, including risk of melanoma a few years after PUVA interruption
- Immunosuppressive therapy- is forbidden in pregnancy, presents a risk of developing some types of cancer, requires periodic, monthly control of biological samples:
- methotrexate: diffuse pulmonary fibrosis, renal and liver damage, myelosuppression, spermatogenesis impairment, forbidden in active infections and gastric ulcer;
- etanercept: forbidden in case of infections, heart failure, pregnant women, laurels;
- Cyclosporine: renal impairment, hypertension.
- Biological therapy: Infliximab, Efalizumab: forbidden in pregnant women, risk of malignant tumors, require rigorous monitoring, cost prices are very high.
Deniplant® achieves the maximum objective of the European Antipsoriazis 2006 guide: “The almost complete remission of all psoriasis lesions for a long time”.