Missy Gough (847) 240-1734 [email protected]
Karen Klickmann (847) 240-1735 [email protected]
EMBARGOED UNTIL JULY 29, 1999
NEW TREATMENTS OFFER RELIEF TO MILLIONS OF AMERICANS WITH PSORIASIS
NEW YORK (July 29, 1999) - More than 2 percent of Americans have psoriasis, a chronic and often painful skin disease that can be difficult to heal. While there is no cure, many new treatments are now available to help patients with psoriasis.
Speaking today at Academy '99, the American Academy of Dermatology's summer scientific meeting, dermatologist Mark Lebwohl, MD, Professor and Chairman, Department of Dermatology, Mount Sinai School of Medicine, New York, discussed new developments in topical psoriasis therapy.
Psoriasis is a non-contagious disease in which skin cells reproduce much faster than normal, resulting most often in round, reddish skin patches with silvery scales. When severe, most of the person's body may be affected, and painful cracks sometimes develop among the patches.
"The goal of psoriasis treatment is to reduce inflammation and to slow down rapid skin cell division," stated Dr. Lebwohl. "In addition to standard topical treatments such as steroids, synthetic vitamin D, and anthralin, many new therapies are available to treat psoriasis."
A betamethasone valerate mousse was recently approved for the treatment of scalp psoriasis. Since this foam quickly liquefies at body surface temperature, it can be quickly and neatly distributed in the scalp. "In clinical trials, the betamethasone valerate mousse was found to be significantly more effective than betamethasone valerate lotion in clearing scalp psoriasis and patients preferred it to the lotion," reported Dr. Lebwohl. While warm temperatures can cause the foam to liquefy, refrigerating the can, even briefly, restores the foam's consistency which is easier to apply to the scalp.
Anthralin is a medication that has worked well on tough-to-treat thick patches of psoriasis, but its use has declined since past preparations stained fabrics and furniture. A new temperature-sensitive formulation of anthralin has recently been introduced which alleviates some of its past side effects. Since this medication is delivered to the skin only at body surface temperature, it does not stain household items. "Because warm water will release its active ingredient, patients should be careful to wash it out with cold water," recommended Dr. Lebwohl.
Calcipotriene, also known as calcipotriol, is a topical vitamin D synthetic. It is useful for individuals with small areas of psoriasis and can be used with other treatments. In clinical trials, the combination therapy of calcipotriene ointment with halobetasol ointment has proven to be more effective than either of these ointments used alone. Yet, combinations of calcipotriene with other medications should be done cautiously since many other medications, such as salicylic acid, ammonium lactate lotion, and hydrocortisone valerate ointment, have adverse effects on it.
The main side effect of topical calcipotriene is the development of a rash at the application site. Up to 20 percent of patients will experience irritation if calcipotriene is applied to the face or genital areas. Nevertheless, it has been shown that when calcipotriene is applied to those areas, many patients will respond more quickly. Regimens in which calcipotriene is used with a topical steroid, or diluted with petrolatum, may minimize irritation. "With long-term treatment, calcipotriene appears to be well tolerated and continues to be clinically effective without significant adverse effects," stated Dr. Lebwohl.
Studies have shown a beneficial effect of the use of calcipotriene in combination with PUVA, a phototherapy treatment in which patients are given a drug called psoralen and exposed to a carefully measured amount of a special form of ultraviolet A (UVA) light. Because UVA inactivates calcipotriene, it is important that the topical medication is applied after UVA exposure rather than before.
The combination of calcipotriene with ultraviolet B (UVB) light has been shown to produce more improvement in psoriasis patients than UVB in combination with any other treatment. Unlike UVA, UVB does not inactivate calcipotriene.
Calcipotriene cream has recently been introduced. While it is almost as effective as the ointment, the cream is more cosmetically acceptable for daytime use. In addition, calcipotriene solution has been developed for scalp psoriasis. Although it has been shown to be less effective than betamethasone valerate solution, it is not a steroid.
Topical retinoids, prescription vitamin A-related drugs, may be prescribed alone or in combination with ultraviolet light for severe cases of psoriasis. Tazarotene gel is a topical retinoid that has recently been approved for the treatment of psoriasis. When used alone, tazarotene may cause severe local irritation, but when used in combination with a mid- to high-potency steroid cream, patients have experienced significant improvement and less irritation.
Tazarotene also results in greater improvement when it is used in combination with UVB phototherapy. While neither UVA nor UVB inactivate tazarotene, tazarotene does increase the patient's sun sensitivity. Therefore, when tazarotene is added to the phototherapy regimen, ultraviolet doses should be reduced by one-third.
The American Academy of Dermatology, founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership over 12,000 dermatologists worldwide, the Academy is committed to: advancing the science and art of medicine and surgery related to the skin; advocating high standards in clinical practice, education, and research in dermatology; supporting and enhancing patient care; and promoting a lifetime of healthier skin, hair, and nails. For more information, contact the AAD at 1-888-462-DERM or www.aad.org.
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