Psoriasis

medical dermatology
A treatable skin condition

Psoriasis is a skin condition which causes thick, scaly rashes on the skin. A dysregulated, overactive immune system causes the normal skin replacement process to speed up, resulting in thickened inflamed skin. There are 5 types of psoriasis, classified based on their distinctive appearance. The most common form is plaque psoriasis, where the rash appears as pink, raised patches with some silvery scales. Some types of psoriasis, for example pustular psoriasis and erythrodermic psoriasis are rarer but can be life threatening. Guttate and inverse psoriasis are the other forms of psoriasis. For some patients, the inflammatory process underlying psoriasis can also affect the joints. This condition is called psoriatic arthritis and presents as painful, stiff joints.

Some patients with psoriasis will have a family member who is also affected with psoriasis. A flare-up of psoriasis can be triggered by stress, injury to the skin, infections and certain medications. Psoriasis has also been found to be associated with heart disease and diabetes mellitus.

For more information, please refer to www.psoriasis.org.sg, of the Psoriasis Association of Singapore.

Psoriasis can be mild, moderate or severe. Those patients with rashes covering less than 3% of their body is considered having mild disease, those with 3-10% covered is considered moderate. These categories are useful for deciding which treatments may be most appropriate for the patient. However, other deciding factors in selecting treatments such as the impact of psoriasis on the quality of life need to be taken into consideration too.

Psoriasis Can Be Kept Under Control If Properly Managed.

Specialist Skin Clinic Provides Customized & Targeted Treatment Plans – Call 6734 1411 To Enquire Today.

Mild cases of psoriasis are usually treated with topical creams such as calcipotriol and calcipotriol/betamethasone dipropionate. Phototherapy using narrow-band ultraviolet B (UVB) is a good adjunctive treatment. For more severe cases of psoriasis, systemic or oral medications may be necessary. These include methotrexate, cyclosporine and acitretin. Like many other drugs, the effectiveness of these medications must be balanced with the side effects that they may cause.

Biologic treatments or “biologics” are a new class of medication that have revolutionized psoriasis treatment. They are protein-based drugs derived from living cells in the laboratory and they have been in use to treat psoriasis in the last decade. This class of medication offers hope to psoriasis patients who have failed other treatments or have experienced side effects from their previous treatments. These medications are given as injections via the subcutaneous or intravenous route and help to reduce the inflammatory process that is driving the replication of skin cells and destruction of the joints.

In psoriasis, a protein in the immune system called tumour necrosis factor is known to be present at increased levels and this leads to inflammation. Tumour necrosis factor - alpha (TNF-α) inhibitors are a big group of biologics that binds to the excess TNF-α to decrease the inflammation process. Examples are Eternacept, Adalimumab and Infliximab. Another class of biologics works against interleukin 12/23 which are associated with psoriatic inflammation. Example of this class of biologics is Ustekinumab which specifically targets and blocks the action of IL-12 and IL-23.

The latest biologics that is available in Singapore are Secukinumab (Cosentyx®), Guselkumab (Tremfya®) and Ixekizumab (Taltz®). Cosentyx is a human monoclonal antibody that selectively binds to interleukin-17A (IL-17A). IL-17A is involved in the development of psoriasis. Tremfya is a human monoclonal antibody that binds to IL-23 with high specificity and affinity. Taltz is a humanized monoclonal antibody against IL-17A. All these biologics interrupt the inflammatory cycle of psoriasis leading to improvement of the condition.

These injections are all available in the clinic. Patients are assessed for their suitability for biologics based on their clinical history, concurrent medical issues and lifestyle needs.

Our Dermatologists
Our team of dermatologists with a combined experience of more than 60 years provides a complete range of professional dermatological services to manage all varieties of skin problems affecting the skin, hair and nails and also sexually transmitted infections. They are equally adept at performing skin surgery and laser procedures.
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