More than 6.7 million American adults are living with the discomfort of
red, scaly plaques on their skin. These rough, raised spots are the hallmark
symptom of psoriasis, a chronic inflammatory skin condition that can appear
anywhere on the body, but most often occurs on the elbows, knees and scalp.
For some people, the discomfort is cosmetic, but for many others the rash
is painful, itchy, and prone to cracking and bleeding.
For early disease, over-the-counter medicine is usually the first resort,
but the itching, burning and stinging that can accompany psoriatic disease
won’t necessarily be relieved by a drug store ointment. That’s
because the inflammation in psoriasis comes from within, not from outside
like when coming into contact with poison ivy.
“Your body is constantly growing new skin cells deep within that
take about a month to rise to the surface, where they form a new protective
layer against injuries and infections from the outside world,” explains
Hong Nguyen, MD, a board-certified dermatologist at
Mission Heritage Medical Group. “In people with psoriasis, the T cells in their immune system are
overreacting to potential threats, setting off immune responses that cause
new skin cells to surge to the surface. Because they aren’t waiting
long enough to come up, they don’t fit into their proper place when
they get there. The patches of thick, red skin build up as the result
of this overly fast turnover of cells.”
Topical moisturizers and prescription anti-inflammatory creams have long
been the first treatment strategy—and often the only treatment needed--in
cases of mild psoriasis. For patients with more severe symptoms, newly
developed "biologic" drugs administered by injection or IV can
be used to clear the skin.
Biologics are drugs derived from natural sources or from cells cultured
in a laboratory. Conventional drugs, in contrast, are synthesized from
chemicals. Biologic products isolated from humans, animals, or microorganisms
have been used for years in vaccines, blood, and allergenics. With ongoing
advances in biotechnology, new biologics have been developed that address
the underlying causes of psoriasis, rather than just treating the symptoms.
The National Psoriasis Foundation Medical Board has called the introduction
of biologic products “the most significant advancement in care for
the psoriasis and psoriatic arthritis community in recent decades.”
Dr. Nguyen says that biologics represent a breakthrough in psoriasis treatment
because “they give dermatologists a powerful tool to consider in
combination with other approaches, such as ultraviolet light therapy,
and prescription medications given topically or orally.” In some
cases, she says, they have been the first effective therapy that a patient
has ever had.
What makes biologic drugs so effective, says Dr. Nguyen, is that they hone
in on problematic cells and proteins. “Traditional psoriasis drugs
affect the entire immune system. They’re known as systemic drugs,
and they’re developed from different kinds of chemicals or plants.
Biologics, on the other hand, are protein-based, and they work by blocking
only certain proteins or certain types of T cells. The targeted approach
can be very effective in inhibiting the development of psoriasis.”
Biologics may not be the right answer in every case. Your doctor will probably
recommend other therapies first, but, says Dr. Nguyen, “if psoriasis
is covering 3 percent or more of your body, or if it is having a serious
impact on your quality of life regardless of the size of the affected
area, biologics can form a potent part of the treatment strategy.”
The most common side effects are mild and, since biologics lower the body’s
immune defenses, may include respiratory infections and flu-like symptoms.
In rare instances, serious disorders of the nervous system or blood can occur.
Dr. Nguyen emphasizes, “The most important part of planning a course
of treatment for psoriasis is a trusted relationship between patient and
doctor. Every patient interested in biologics should consult a dermatologist
who clearly explains the benefits and risks and who thoroughly understands
the patient’s condition, health history and lifestyle. This will
allow the patient and doctor to make the best decision on treatment.”
How did you and your doctor find a psoriasis treatment that cleared your
skin? Share a comment below.
Learn more about
Dr. Nguyen. Learn more about
Mission Heritage Medical Group.
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