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Psoriasis Treatment

The main problem with psoriasis however, is that this treatment does not prevent the appearance of new lesions and thus the same treatment has to be repeated, wherever and whenever new lesions appear. With regular application of these medicines, it should be possible to keep the skin almost.completely normal except when the disease takes a serious turn.

A psoriasis patient does not need any precautions and there are no prohibitions. He/she should thoroughly clean his /her skin and hair regularly with a normal soap and shampoo, eat food of choice (no dietary restrictions), and not be afraid of any damage to the internal organs. Thus, except for a small amount of effort in applying the ointment on the skin lesions, twice or more number of times as and when required, a psoriasis patient can lead a perfectly normal life. We often compare the precautions/prohibitions/ risks in a diabetic state with psoriasis and make the psoriasis patient realise that he is much better off (and luckier) than a patient having diabetes because

(1) a diabetic patient can neither overeat nor avoid eating as per his fancies / fads, whereas a psoriasis patient need not observe any dietary precautions;

(2) a diabetic patient never undergoes a spontaneous remission, whereas several psoriasis patients become completely alright during summer and may even have a remission for several years;

(3) a diabetic patient lives under the threat of damage to almost all the important organs of the body and can develop a heart attack, hypertension, paralysis (brain damage), gangrene, kidney damage, etc., while psoriasis does not involve any of these organs and therefore, the patient can lead a fearless life.

Both the diseases though, are incurable and require continuous surveillance and treatment.

During the phases when psoriasis is severe, the patient requires intensive treatment which should be under the supervision of a dermatologist. The various modalities of treatment include:

(1) use of Psoralen orally followed by exposure to ultraviolet light from the special apparatus (PUVA) or from sunlight (PUVASOL);

(2) oral or intramuscular injections of Methotrexate or other immuno-suppressive drugs, including Cyclosporin; or

(3) oral retinoid drugs. Each of these drug regimens are highly effective in controlling the severe forms of psoriasis; but they have to be administered only under proper medical supervision.

The treatment must be continued till the severity of the disease has been controlled completely. Appropriate laboratory tests are mandatory during this period to prevent side effects of these drugs, but once the severity of the disease has been controlled, the intensive phase of treatment can be withdrawn and the patient reverted back to routine management of psoriasis.

We once again often compare psoriasis with cockroaches in the house, because whatever you do for eliminating them, they keep on appearing somewhere or the other. A proper surveillance on a regular basis is therefore, very essential. Killing a few cockroaches does not prevent the re-appearance of the next batch of cockroaches which have to be treated in the same manner. Taking the similarity still further, whenever there are too many cockroaches one generally
needs the help of pest control people for a quick and appropriate control. Similarly, a psoriasis patient also has to learn to manage the psoriasis lesions on a regular basis, but, whenever the disease becomes severe, the management has to be handed over to experts.

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