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Patients afflicted with psoriasis often give up treatment because they loose faith in medicine efficiency and consider treatment more burdensome than the disease itself.
In most cases psoriasis is conditioned by hereditary predisposition (in 30-40% of cases the whole families are afflicted with psoriasis) and declares itself under the influence of various adverse environmental factors. Stress plays the dominant role in the development of illness for 30-40% of patients.
Psoriasis can proceed in various clinical forms. Most often erythematosquamous skin lesion occurs. These are red spots covered with white scales situated symmetrically near elbows, knees and in the sacrum area. The number of such spots can vary greatly in different periods of patient’s life and is different for various patients. Lesion of nails and scalp is also possible.
Psychological factor of the progress of disease shouldn’t be forgotten during treatment. That is why it is important for the doctor to establish trust relationship with the patient.
Drug treatment of psoriasis can be both local and general. Ointments for external application contain corticosteroids, derivatives of vitamin D, retinoids, and tar. If lesion is extensive, phototherapy is recommended: various types of UV rays, PUVA therapy (UVA + psoralen), balneo-PUVA therapy, complex treatment by retinoids + UV rays or derivatives of vitamin D + UV rays.
Retinoids are prescribed for internal use; in this case control of liver function is required.
If the course of disease is severe and recurrent or in case of psoriatic arthritis immunosuppressants like methotrexate are prescribed.
Balneotherapy courses can be prescribed to psoriatic patients; they are not contraindicated even with severe type of psoriasis.
Currently new methods of psoriasis treatment are studied, particularly with preparations that regulate T-lymphocytes activity.
It is very important for psoriatic patients to fight depressive and anxious state and avoid stress situation when possible. |
