Antipsoriatic

Antipsoriatic

An antipsoriatic is a type of medication or treatment specifically used to manage and alleviate the symptoms of psoriasis, a chronic autoimmune condition characterized by the rapid growth of skin cells leading to scaling and inflammation. Psoriasis can manifest in various forms, including plaque psoriasis, guttate psoriasis, inverse psoriasis, pustular psoriasis, and erythrodermic psoriasis.

Mechanism of Action

Antipsoriatic treatments work through various mechanisms to reduce the symptoms of psoriasis:

• Anti-inflammatory action: Many antipsoriatics reduce inflammation by inhibiting the production of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-17 (IL-17), and interleukin-23 (IL-23).
• Immunomodulation: Some treatments modulate the immune system to decrease the overactive immune response that characterizes psoriasis.
• Keratolytic effects: Certain topical treatments help to remove scales and smooth the skin by breaking down keratin, a protein that forms part of the skin structure.
• Inhibition of cell proliferation: By slowing down the rapid growth of skin cells, these treatments help to reduce the formation of psoriatic plaques.

Types of Antipsoriatic Treatments

Antipsoriatic treatments can be classified into several categories:

Topical Treatments

• Corticosteroids: These are anti-inflammatory agents that reduce redness and swelling. They are often used as first-line treatments for mild to moderate psoriasis.
• Vitamin D analogs: Such as calcipotriene, these help to slow down skin cell growth and remove scales.
• Coal tar: A traditional treatment that helps to reduce scaling, itching, and inflammation.
• Salicylic acid: A keratolytic agent that helps to remove scales and smooth the skin.

Phototherapy

• UVB phototherapy: Involves exposing the skin to ultraviolet B light, which can slow down the growth of affected skin cells.
• PUVA therapy: Combines psoralen (a light-sensitizing medication) with UVA light exposure to treat severe psoriasis.

Systemic Treatments

• Methotrexate: An immunosuppressant that reduces the rapid turnover of skin cells.
• Cyclosporine: Another immunosuppressant that helps to control severe psoriasis by suppressing the immune system.
• Acitretin: An oral retinoid that helps to normalize skin cell growth.

Biologic Agents

• TNF inhibitors: Such as etanercept, infliximab, and adalimumab, these target and neutralize TNF-α, a key cytokine in the inflammatory process of psoriasis.
• IL-17 inhibitors: Such as secukinumab and ixekizumab, these block the action of interleukin-17, a cytokine involved in the inflammatory response.
• IL-23 inhibitors: Such as ustekinumab and guselkumab, these target interleukin-23, another cytokine involved in psoriasis pathogenesis.

Side Effects and Considerations

The choice of antipsoriatic treatment depends on the severity of the disease, the patient's overall health, and the presence of any comorbid conditions. Each treatment comes with potential side effects:

• Topical treatments: May cause skin irritation or thinning with prolonged use.
• Phototherapy: Can increase the risk of skin aging and skin cancer with long-term use.
• Systemic treatments: May cause liver damage, kidney problems, or increased risk of infections.
• Biologics: Can increase the risk of infections and may have other systemic effects.

Also see

• Psoriasis
• Autoimmune disease
• Dermatology
• Biologic therapy

Dermatology and Rheumatologic diseases A - Z

A | B | C | E | F | G | H | I | J | K | L | M | O | P | R | S | T | V

Glossary of dermatology