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Psoriasis Archives - JDDonline - Journal of Drugs in Dermatology

Watch On Demand: Proper Hydration and Exfoliation Support Treatments for Patients with Inflammatory Skin Conditions

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This exclusive #SkinChat webinar originally aired on December 16th, 2020. Dr. Leon H. Kircik and Professor Petra Staubach-Renz  discussed the importance of adjunctive skincare solutions for your patients with Keratosis Pilaris and Psoriasis.

Proper hydration and exfoliation support treatments for patients with inflammatory skin conditions

By Heather Onorati

People with conditions characterized by an impaired skin barrier and hyperkeratosis can benefit from incorporating a uniquely formulated skincare regimen with other recommended treatments, according to two experts who shared insights into how a variety of ingredients work to complement therapeutic selections and improve outcomes for these patients. 

In a recent webinar, Professor Petra Staubach-Renz, department of dermatology, University Medical Center, Mainz, Germany, and Leon H. Kircik, M.D., Icahn School of Medicine at Mount Sinai, New York, delivered very relevant presentations on adjunctive skincare solutions for hyperkeratolytic conditions.

Dry, rough, uneven skin is a common symptom for many of these hyperkeratolytic conditions, according to Prof. Staubach-Renz. This is characterized by a build-up of cells on the skin’s surface that create an irregular, thick texture. Hyperkeratosis commonly presents in patients with conditions like keratosis pilaris, ichythyosis, psoriasis, and atopic dermatitis.  

More than 40% of people around the world suffer from keratosis pilaris, also called follicular keratosis, Prof. Staubach-Renz noted. In addition, there are more than 125 million people globally who suffer from psoriasis, 60% of which report that the disease significantly affects their lives, Dr. Kircik added. The biggest problems that those affected report are the appearance of the skin and the scaling, which result from transepidermal water loss and a dysfunctional epidermal barrier, he explained. 

Dry, rough, uneven skin is a common symptom for many of these hyperkeratolytic conditions, according to Prof. Staubach-Renz. This is characterized by a build-up of cells on the skin’s surface that create an irregular, thick texture. Hyperkeratois commonly presents in patients with conditions like keratosis pilaris, ichythyosis, psoriasis, and atopic dermatitis.  

According to Prof. Staubach-Renz, this is important to understand in order to treat the skin with the proper basic therapy. There are several critical components, and those include mild exfoliation with keratolytics and an occlusive moisturizer. 

Keratolytics break down the outer layers of the skin, which ultimately allow for other topical therapeutics like corticosteroids to penetrate, Dr. Kircik explained. Often, people who are prescribed topical corticosteroid treatments will complain they are unsatisfied and that the treatment is not working. 

“This is where the keratolytics come into the picture, Dr. Kircik said. Compounds like urea and salicylic acid break down that thick skin and allow the topical medication to penetrate. 

Pairing this activity with humectants and an occlusive will support repair of the epidermal barrier by allowing the skin to attract and then retain moisture.  

One over-the-counter skincare system that utilizes this combination of ingredients in a unique timed-release delivery system demonstrated both efficacy and tolerability in two studies cited by Prof. Staubach-Renz, which examined their use in the treatment of keratosis pilaris. 

Researchers found in one study that patients experienced a decrease in transepidermal water loss 1 hour following use of both a cleanser and cream, cell turnover time accelerated at 3-5 days, and 9 of 10 patients subjectively agreed that the skin felt softer, smoother and more comfortable after week 4. In a second study, the severity of dryness, texture and erythema began to improve at two weeks on dermatologic exam. At 8 weeks, skin dryness was reduced by 76%, and there was a visual improvement in roughness and erythema.

 

 

 

 

Heather Onorati is an experienced medical writer and editor with more than 20 years covering the dermatology industry.

 

 

 

 

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Adjunctive Skincare Solutions for Hyperkeratotic Skin Conditions, Including Keratosis Pilaris and Psoriasis

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JDD Webinars

This #SkinChat orignally aired on December 16th, 2020. Tune in as Dr. Leon H. Kircik and Professor Petra Staubach-Renz discuss the importance of adjunctive skincare solutions for your patients with Keratosis Pilaris and Psoriasis.

Supported By

CeraVe #SkinChat

 

Adjunctive Skincare Solutions for Hyperkeratotic Skin Conditions, Including Keratosis Pilaris and Psoriasis

Featuring Leon Kircik, MD & Prof. Petra Staubach-Renz

Watch On Demand

Join the JDD & CeraVe for this exclusive, on-demand #SkinChat webcast, where Dr. Leon H. Kircik and Professor Petra Staubach-Renz discuss the importance of adjunctive skincare solutions for your patients with Keratosis Pilaris and Psoriasis.

This presentation  also includes relevant clinical data supporting the need for ceramides and skin barrier restoration regarding these Keratolytic skin conditions.

Faculty

Leon Kircik, MD
Clinical Professor of Dermatology
Icahn School of Medicine at Mount Sinai, New York, NY
Indiana University Medical Center, Indianapolis, IN
Medical Director
Physicians Skin Care, PLLC, Louisville, KY
DermResearch, PLLC, Louisville, KY
Skin Sciences, PLLC, Louisville, KY

Prof. Petra Staubach-Renz
Senior Physician Dermatology and Allergy
Managing Director, Clinical Research Centre,
Department of Dermatology, University Medical Center
Mainz, Germany
Watch on Vimeo

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Topical Cannabinoids for the Management of Psoriasis Vulgaris: Report of a Case and Review of the Literature

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Featured Article

Featured Article

The interest in use of medical cannabis for chronic dermatologic conditions such as psoriasis, eczema, and acne has been growing mostly owing to rapidly emerging decriminalization across the country and impressive commercially driven popularization of a variety of cannabinoid preparations including topical forms such as creams, salves, lotions, lubricants, and many others.

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This report details a case of a young man with psoriasis managed with topical cannabinoids.

Adam J. Friedman MD, Kimia Momeni BS, Mikhail Kogan MD

 

The interest in use of medical cannabis for chronic dermatologic conditions such as psoriasis, eczema, and acne has been growing mostly owing to rapidly emerging decriminalization across the country and impressive commercially driven popularization of a variety of cannabinoid preparations including topical forms such as creams, salves, lotions, lubricants, and many others.

However, while the market is exponentially growing, the rate at which mechanistic and clinical evidence supporting the use of cannabinoids in a litany of diseases is significantly slower. In fact, Robinson et al highlighted significant gaps in dermatologists understanding of the biology of cannabinoids and comfort with this space, further highlighting the great need to disseminate information throughout the medical community.

Along this vein, we present a case of a young man with psoriasis managed with topical cannabinoids.

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Increased Trend of Cosmetic Procedures in Patients With Psoriasis Who Attain 75% or Greater Improvement

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Featured Article

Featured Article

A survey was conducted at a single dermatology center to determine if there was an increased trend in cosmetic procedures in patients with moderate to severe psoriasis who attained 75% or greater reduction of the body surface area (BSA) with biologic agents and oral systemic therapies, and if this was related to an improvement in quality of life following psoriasis clearance.

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A survey was conducted at a single dermatology center to determine if there was an increased trend in cosmetic procedures in patients with moderate to severe psoriasis who attained 75% or greater reduction of the body surface area (BSA) with biologic agents and oral systemic therapies, and if this was related to an improvement in quality of life following psoriasis clearance.

Michelle E. Walters MD, Delphine J. Lee MD PhD, Paul S. Yamauchi MD PhD

Psoriasis is a chronic skin condition with a negative impact on patient quality of life. The National Psoriasis Foundation states that an acceptable response to psoriasis treatment is at least a 75% reduction in body surface area (BSA) at 3 months after initiation of treatment.

This reduction in BSA has been associated with improvement in quality of life, with clearance rates of clear to almost clear leading to an even greater improvement in quality of life.2,3 To date, there have been no studies examining the relationship between improvement in quality of life following a reduction in BSA, and the increased utilization of cosmetic procedures. Here, we examine the relationship between quality of life and the use of various cosmetic procedures in patients treated for psoriasis with systemic and biologic therapies who achieved at least 75% reduction in BSA.

This was a retrospective study assessing quality of life and the use of cosmetic procedures in psoriasis patients after attaining a75% or greater reduction of the body surface area with biologic agents only, systemic agents only, or a combination of both. This study was conducted according to the ethical guidelines of the 1975 Declaration of Helsinki. All patients provided informed consent.

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Phototherapy for Psoriasis: A Safe and Effective Treatment Modality

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Dermatology News

Featured Article

“Fewer people are doing mainstay full-body phototherapy as in the past, as biologics and other systemic therapies have proven to be safe and much more effective,” Dr. Nestor said in a recent interview with Dermatology Times.

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Phototherapy for Psoriasis: A Safe and Effective Treatment Modality

A study recently published in the JDD reveals phototherapy remains a safe and effective treatment modality for mild to moderate psoriasis vulgaris

Phototherapy remains a safe and effective treatment modality for mild to moderate psoriasis, according to Mark S. Nestor, M.D., Ph.D., in a study recently published in the Journal of Drugs in Dermatology.
Current options for treating psoriasis include systemic and topical agents: systemic treatment options may involve immune inhibitors, and/or immune modulators. For moderate to severe cases, biologic agents may be used.
Topical agents may be comprised of ointments, medicated baths, and phototherapy.

“Fewer people are doing mainstay full-body phototherapy as in the past, as biologics and other systemic therapies have proven to be safe and much more effective,” Dr. Nestor said in a recent interview with Dermatology Times.

“Additionally,” he added, “laser has largely taken over for individual and spot treatment of specific areas because you don’t have the same issue of systemic problems with burning.”

In the study, “Randomized, Investigator-Blinded Study to Compare the Efficacy and Tolerance of a 650-microsecond, 1064-nm YAG Laser to a 308-nm Excimer Laser for the Treatment of Mild to Moderate Psoriasis Vulgaris,” co-authored by Dr. Nestor, Daniel Fischer DO MS,a and David Arnold DOa eligible subjects enrolled in a randomized, investigator-blinded study.

Psoriatic plaques on one side of the body were treated with the 650-microsecond laser and plaques on the other side were treated with the 308-nm excimer laser. Study subjects received up to 15 treatments, twice weekly, or fewer if full clearance was achieved. Efficacy and tolerance were evaluated by the mPASI scores and local skin reactions, respectively.

Both devices showed efficacy in treating psoriatic plaques. Differences between the two devices were not significant for redness, thickness, scaliness, mPASI scores for arms and legs, and overall mPASI scores for the treated psoriatic plaques on each side of the body. The investigator-assessed scores for erosion/ulceration, vesicles, erythema, scaling, edema, and atrophy were low and identical for both sides of the body.

“There is potential for utilizing this therapy much more in the future, especially in areas such as the palms and soles, where excimer appears to be less effective,” Dr. Nestor said.

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Treatment of Plaque Psoriasis With an Excimer Laser Utilizing an Optimal Therapeutic UVB Dose Protocol

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Treatment of Plaque Psoriasis With an Excimer Laser Utilizing an Optimal Therapeutic UVB Dose Protocol

Psoriasis is a chronic, immune-mediated disease that mainly affects the skin and joints.

Treatment for psoriasis depends on the severity, along with many other factors, and limited psoriasis can often be treated with topical agents, while patients with moderate to severe disease may also need phototherapy by ultraviolet irradiation or systemic therapy.

During phototherapy treatments, therapeutic doses of ultraviolet light may be administered by broadband ultraviolet B (UVB) radiation (290-320 nm), narrowband UVB (311-313 nm), and PUVA – photochemotherapy with psoralen followed by ultraviolet A radiation (320-400 nm).6,7
A recent study published in the Journal of Drugs in Dermatology investigates the efficiency and efficacy of the Multi-Micro Dose® diagnostic tip accessory for STRATA’s proprietary XTRAC® 308nm excimer laser in treatment of plaque psoriasis:
[…] treatment with the excimer laser was well tolerated. Similar to previous reports,11,14-16 erythema was the most common adverse event. No erosions or hyperpigmentation were reported. Two patients experienced blistering after initiation of the actual treatment. Blistering is an expected side effect in phototherapy with the excimer laser, and is usually well tolerated by patients.14,17,18 Blistering might be related to the user’s techniques (overlapping of laser treatment fields), or it may occur if the plaque’s thickness varies.

The OTDTM protocol with the MMD tip allows adjusting the treatment dose with the excimer laser to specific plaques, resulting in more effective dosing levels and a lower frequency of treatment sessions.

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What Women Don’t Want … Psoriasis

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"What Women Don't Want ... Psoriasis"

In this edition of the JDD Podcast, Dr. Adam Friedman is joined by Dr. Deirdre Hooper, Associate Clinical Professor in the Department of Dermatology at both Louisiana State University and Tulane University, to discuss her article “Impact of Psoriasis on Women” in the September 2019 issue of the JDD on the unique considerations for the adult female psoriasis patient.

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Topcials in Psoriasis Treatments

By JDD in the Media No Comments

Psoriasis is a chronic disease that can affect many areas of the body. The use of topical corticosteroids (TCS) is a common treatment, although long-term safety of TCS remains a concern.

A recent article in Dermatology Times cites a Journal of Drugs in Dermatology study which examines how Topical Halobetsol Propionate 0.01% lotion appears to “safely and quickly improve lower-extremity psoriatic lesions,” over typical TCS treatments.
“A post hoc analysis of data from phase 3 studies investigating the efficacy of halobetasol propionate 0.01% lotion for treating moderate-to-severe plaque psoriasis showed that the topical corticosteroid was associated with rapid improvement, and  findings should help dermatologists with treatment decisions for patients with disease involving leg lesions, said Neal Bhatia, M.D., director of clinical dermatology at Therapeutics Clinical Research, San Diego, and the lead author of the paper.”

At the conclusion of the eight-week treatment, the rate of success was significantly higher for patients randomized  to once-daily treatment with halobetasol 0.01% lotion compared with vehicle-treated controls (P<.001 for both comparisons).

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