Negative Results in Psoriasis Treatments, Essay Example

Psoriasis is a chronic skin disease known to affect 2-3% of the world’s population today[1]. There are many forms of treatment used in the management of psoriasis. These methods have different outcomes with each having different levels of efficacy. The different methods of treatment also have their unique advantages and disadvantages in relation to the management of the condition.  The method used by a doctor to treat psoriasis in a patient depends on the type of psoriasis, the area that has been affected and also the size of the affected area with consideration on earlier methods that have been used to treat psoriasis in the patient and how the patient reacted to the treatment.

Because of the diverse methods used in the treatment of psoriasis with different outcomes, there have been studies and researches conducted to ascertain the effectiveness of the different known methods used in the management of the condition in different patients. It is important to note that this paper only focuses on the treatment methods of psoriasis that have been found to be ineffective or have led to negative results. So, providing information for effective ways for the management of psoriasis in patients is beyond the scope of this paper.

One of the most known ways that have been used in the treatment of psoriasis is by use of Cyclosporine. This treatment method has been in use for the last two decades. Although this treatment method has been in use for a long time, Koo, Kadonaga, Wintroub and Lozada-Nur [2]study suggests that the use of this method alone in the management of the condition cannot be successful. Their study suggests that the use of Cyclosporine in treating patients with psoriasis often leads to lymphoma.

The use Corticosteroids in the treatment of the psoriasis results to some complications such as the occurrence of tachyphylaxis especially with repeated use. The study of du Vivier and Stoughton[3]suggest that the use of Corticosteroids alone in the management of the psoriasis cannot be effective.  They provide that clinical trials have shown that the use of single therapy such as steroids in the treatment of the condition often lead to relapse of psoriasis often leading to more acute cases. The use of corticosteroids in the management of the condition has also been associated with very high chances of tolerance which affects use of the same treatment in management of similar conditions in the patient.

Alefacept has also been approved for treating psoriasis. Its use has been associated with increased rate of maliganacny. Krell, Bagel, and Coynik[4] study on use of Alefacept in treating patients found that cases of malignancy often occurred in patients with psoriasis.

Light therapy has also been successfully used in the treatment of psoriasis. Although newer methods may be very successful, early clinical trials for the use of this method were not very successful. Early trials for use of light therapy in treatment of psoriasis have been investigated by Stern, Leibman, and Vakeva.[5] They followed up studies which utilized the use of UVB therapy with the use of UVA light. Research indicated that the use of the PUVA therapy in the management of the condition often increased the chances of the patients developing other forms of skin cancers which are not related to melanoma skin cancer and Squamous cell carcinoma. Squamous cell carcinoma increased cases of mortality in the patients. The use of this treatment also according to the study increased with the disease spreading to the other unaffected areas of the skin. According to the study, patients that have been in the therapy for more than 15 years often developed malignant melanoma.

References

National Institute for Health and Clinical Excellence,.2009

J.Y. Koo, J.N. Kadonaga, B.V. Wintroub and F.I. Lozada-Nur.1992

du Vivier & Stoughton, 1975

J. Krell, J. Bagel and D. Coynik. 2007

R.S. Stern, E.J. Leibman and L. Vakeva. 1998

National Institute for Health and Clinical Excellence, Etanercept and efalizumab for the treatment of adults with psoriasis. Technology Appraisal Guidance T103. July 2006.

J.Y. Koo, J.N. Kadonaga, B.V. Wintroub and F.I. Lozada-Nur, The development of B-cell lymphoma in a patient with psoriasis treated with cyclosporine, J Am Acad Dermatol 26 (1992), pp. 836–840.

du Vivier and R.B. Stoughton .1975, Tachyphylaxis to the action of topically applied corticosteroids. Arch Dermatol 111 (1975), pp. 581–583.

Krell, J. Bagel and D. Coynik, Assessment and tracking of long-term alefacept safety (ATLAS): analysis of data from approximately 1,200 patients [abstract], J Am Acad Dermatol 56 (2 Suppl. 2) (2007), p. AB191

R.S. Stern, E.J. Leibman and L. Vakeva, Oral psoralen and ultraviolet-A light (PUVA) treatment of psoriasis and persistent risk of nonmelanoma skin cancer,J Natl Cancer Inst 90 (1998), pp. 1278–1284.

[1] National Institute for Health and Clinical Excellence,.2009

[2] J.Y. Koo, J.N. Kadonaga, B.V. Wintroub and F.I. Lozada-Nur.1992

[3] du Vivier & Stoughton, 1975

[4] J. Krell, J. Bagel and D. Coynik. 2007

[5] R.S. Stern, E.J. Leibman and L. Vakeva. 1998