Brief Answer: Psoriasis treatment Detailed Answer: Hello and welcome to healthcaremagic. I am Dr. Kakkar. I have gone through your concern and I have understood it. Psoriasis is an inflammatory skin disease characterised by well defined erythematous scaly plaques with silvery white or candle wax type of scaling. Chronic plaque psoriasis is the most common type. It can affect sites like scalp, arms, and legs, (specifically elbows and knees), palms and soles etc Other types of psoriasis are: Erythrodermic psoriasis, Pustular psoriasis (generalised and localised), Nail psoriasis and Scalp psoriasis. There are various precipitating factors for psoriasis: Infections(sore throat, dental infections etc), drugs (b-blockers used for hypertension), pregnancy, winters (psoriasis becomes worse in winters), stress, alcohol intake and cigarette smoking, topical irritants like coal tar, salicylic acid and withdrawal of oral/ topical steroids etc. The disease has a chronic course and there topical creams/ointments/gels/lotions etc as well as oral and injectable medicines which can treat psoriasis but there is no permanent cure for psoriasis. Topical treatment: Moisturizers specially those which contain hygroscopic (attract water from the atmosphere and lock it into the skin) and keratoloytic agents like Ammonium lactate(Amylac cream), Urea, Lactic acid etc are especially useful in dry scaly conditions like psoriasis. For the patches you could use a steroid+salicylic acid ointment, twice daily (clobetasol+3% OR 6% salicylic acid in an ointment base e.g propysalic) over and above the moisturizer for 4 weeks. Other treatment modalities which can be used for localized plaque psoriasis are: Vit D analogues like calcipotriol, calcipotriene alone or in combination with steroid. Oral treatment: -Once weekly oral methotrexate is another option in case of plaque psoriasis but it should always be taken under the supervision of a dermatologist since it can rarely cause serious side effects like bone marrow suppression. -Oral cyclosporine is given for extensive psoriasis involving more than 20% of the body surface area. It is rapidly effective but it requires monitoring of kidney functions and BP. Other commonly used oral treatment modalities are: -Oral Psoralens e.g 8-methoxypsoralen and UV A phototherapy (PUVA) -Narrow-Band phototharapy(NB-UVB) -Biologics response modifiers (Etanercept, Infliximab, Adalimumab etc) In general, in limited psoriasis only topical agents are used, whereas if the disease involves >20% body surface area, it is better to combine both topical and oral therapies. Humira is a biologic response modifier (Adalimumab) Indications of Humira are: -Moderate/severe psoriatic arthritis -Moderate/severe psoriasis -Adult and juvenile rheumatoid arthritis -Ankylosing spondylitis and crohn's disease. Dose is 40mg subcutaneously every other week. Safety considerations: -Serious infections have happened in people taking humira. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. -Humira may increase the chance of getting lymphoma. -Humira can cause serious side effects including hepatitis B infection in carriers of the virus, allergic reactions, nervous system problems, blood problems, heart failure, certain immune reactions including a lupus-like syndrome, liver problems, and new or worsening psoriasis. Since the disease needs to be assessed every 2-4 weeks to see how the medicines are working and watched for any side effects, therefore you need to follow it up with your dermatologist every 2-4 weeks. Of course, it sounds strange that i am asking you to see a dermatologist myself being one, because i can't write and sign a prescription for you and my job is just to give you pointers in the right direction and its ethically not right to prescribe without having a look at you. Therefore the need for follow up physically with your dermatologist I am here to guide you and to provide clarifications for any doubts that you might have about psoriasis. regards

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Brief Answer: Please go through the disclaimer Detailed Answer: Hi. I am sorry but please carefully go through the Disclaimer which says: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also. Regarding refund you can contact the website. regards take care and stay well!!

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