Dr. Robert Salmon
25 Osborne Street
WOLLONGONG NSW 2500
Ph 02 4226 3088
Fax 02 4227 1606
mail@idlc.com.au
Psoriasis
Psoriasis is one of the most common skin conditions, affecting between 1.5 & 2% of all populations, regardless of race. Recent research points towards an abnormality in the body’s immune system as the primary cause of the problem.
Small areas of involvement are usually not a major issue and can usually be treated with creams. Tar based creams have been in use for many years, and steroid creams also have a limited role to play in mild cases. Retinoid creams, derivatives of vitamin A, and calcipotriol, a vitamin D derivative can also be helpful.
Extensive psoriasis can be much more of a problem, affecting the patient’s psychological health and their ability to work. Narrow band UVB therapy, also known as phototherapy, can be of great benefit in this situation. ID+LC has had this therapy available for the last 18 years, and has been able to help many patients over that time. It works by causing localised immune suppression in the top layers of the skin without affecting the rest of the body’s immune system. Its major potential side effects are an increase in skin cancer risk after many treatments, and possible sunburn if any individual dose is larger than the patient’s skin can cope with. We use our extensive experience to monitor dosage to minimise those risks. Another derivative of vitamin A, acitretin, taken by mouth can also be of help, and is often used in conjunction with phototherapy. Like all drugs it has potential side-effects which need to be monitored.
Working further up the treatment scale, methotrexate, a chemotherapy drug used in smaller doses in severe psoriasis, can be of great help. Most patients tolerate it well, but some can develop liver or blood count abnormalities. Monthly blood tests are required. Cyclosporin A, a drug used in organ transplant patients is also used in severe cases.
If none of the above treatments are successful, and their failure has been strictly documented by your dermatologist, then Medicare allows access to the very new and very expensive biological therapies. Fortunately these are subsidised by the PBS once your dermatologist has provided the supporting documentation. They are not successful in all cases, but have been the biggest breakthrough in psoriasis treatment in recent years.
SIDE-EFFECTS: ALL THE TREATMENTS LISTED ABOVE HAVE POTENTIAL SIDE-EFFECTS, AND SHOULD BE DISCUSSED WITH YOUR TREATING DOCTOR, BEFORE YOU START THERAPY.