The treatment in final stages of Psoriatic Arthritis is Surgery. The inflammation in the joint area, skin should be regularly withdrawn by using certain medications. If the inflammation does not lead to decrease in the complications then Joint replacement should be done by surgery.
The home medications for the Psoriatic arthritis include usage of NSAIDS which means Non Steroidal Anti Inflammatory Drugs. These drugs should be taken if morning joint pains occur or stiffness in the joints occurs. By using NSAIDS regularly the Excretion problems i.e free motions occur. This should be stopped by taking the medicines 1 and half hour before the lunch and 2 hours before bed time.
Weight should be constantly maintained improper planning of lunch and dinner may lead to several drastically changes the Posture. Soaking a cloth in warm water and applying them to the swelling area may lead to extreme comfort.
The major medical treatments for psoriasis are of 3 types:
1.Topical Therapy: In this treatment the drugs are used topically i.e. the drugs are administered over the skin in the forms of Gels, Liquids, and Creams etc.
2.Phototherapy: The name itself indicates the application of drugs in the light medium.
3.Systemic Treatment: This therapy is used in final stages when the both topical and Photo therapy does not show effect. The systemic treatment comprises of sending the drugs through the IV route or oral route.
TREATMENT OF PSORIASIS:
There is no cure for psoriasis. However, treatment is usually effective and will control the condition by clearing or reducing the patches of psoriasis. Most people with psoriasis can be treated by their GP. Your GP may refer you to a dermatologist (skin specialist) and their team based in a hospital if symptoms are particularly severe or have not responded well to previous treatments.
Treatments are based on the type and severity of your psoriasis and the area of the skin affected. treatment probably start with a mild treatment - such as topical creams - and then move on to stronger treatments if necessary.
There is a wide range of treatment options for psoriasis but identifying what treatment is most effective can be difficult. If the treatment is not working, or experiencing uncomfortable side effects. Treatments fall into three categories:
Topical - creams and ointments are applied to your skin, phototherapy - skin is exposed to certain types of light, andoral and injected medication - medicine is used to reduce the production of your skin cells. Different types of treatment are often used in combination.
TOPICAL TREATMENT:
Topical treatments are creams and ointments apply to the affected areas of skin. They are used to treat mild to moderate psoriasis. Topical psoriasis treatments include: Topical corticosteroids:
These are the most commonly used medicines for treating mild to moderate psoriasis. The treatment works by slowing the production of skin cells; this reduces the inflammation and relieves the symptoms of itching. Topical corticosteroids range in strength from mild to very strong. Stronger topical corticosteroids are normally only used on small areas of skin or on particularly thick patches. Topical corticosteroids should be used only when instructed by GP. Over-use can lead to developing a tolerance to the cream and it could damage skin. Vitamin D analogues - the Vitamin D in the cream has a suppressing effect on immune system, slowing the production of skin cells. The most widely used Vitamin D analogue is calcipotriol, which is used to treat mild to moderate psoriasis.
Calcipotriol has no side effects, provided do not use more than the amount recommended by your GP.Dithranol - this has been used for over 50 years in the treatment of plaque psoriasis. It is effective in suppressing the production of skin cells and has no side effects. However, it is typically only used as a short-term treatment under hospital supervision, as it stains everything it comes into contact with including your skin. It is normally only applied to skin for five minutes before being washed off to reduce the risk of staining skin. Dithranol is often used in combination with phototherapy. Tazarotene - this cream contains a chemical similar to Vitamin A - a retnoid - this slows the production of skin cells.
It is used in the treatment of moderate plaque psoriasis. The most common side effect is skin irritation. Tazarotene can cause birth defects so it should be strictly avoided during pregnancy or if breastfeeding. It is not recommended for children or teenagers. Coal tar - this is a thick heavy oil and is probably the oldest treatment for psoriasis. How it works is not exactly known, but it reduces scales, inflammation and itchiness. Coal tar does cause staining of clothes and bedding but it has a very strong smell. It is often used in combination with phototherapy.
PHOTOTHERAPY:
Phototherapy uses natural and artificial light to treat psoriasis. Sunlight:
Brief, daily exposure to small amounts of sunlight can improve symptoms, but too much sun can cause a worsening of your condition and cause skin damage. UVB phototherapy :
This uses awavelength of light that is invisible to human eyes - ultraviolet B light. The light slows down the production of skin cells and is an effective treatment against guttate or plaque psoriasis that has not responded to a topical procedure. Treatment takes place at a hospital under the supervision of a dermatologist. Psoralean plus ultraviolet A (PUVA):
For this treatment, a tablet called psoralean will be given. This makes the skin more sensitive to light. skin is then exposed to a wavelength of light called ultraviolet A. This light penetrates skin more deeply than ultraviolet B light. This treatment may be used if severe psoriasis that have not responded to other treatment. Common side effects of the treatment include nausea, headaches, burning and itchiness. Long-term use of this treatment is not encouraged as it can increase risk of developing skin cancer. Combination light therapy:
Combining phototherapy with other treatments often increases the effectiveness of
phototherapy. Some doctors use UVB phototherapy in combination with coal tar, as the coal tar
makes the skin more receptive to light. Combining UVB phototherapy with Dithranol cream has also
proved effective.
Oral and injected medication:
A patient will normally only be prescribed tablets or injections if psoriasis is severe and is resistant to other treatments. Oral medications can be very effective in treating psoriasis but they all have potentially seriously side effects - so they are only used for short periods of time. Methotrexate:
methotrexate is a medicine that decreases the production of skin cells and suppresses inflammation. It is useful in treating pustular psoriasis, psoriatic erythoderma and extensive plaque psoriasis. It has no short-term side effects, but long-term use can cause serious liver damage. People who have previous liver disease should not take methotrexate. Patient should not drink any alcohol when taking methotrexate. Methotrexate can cause serious birth defects. Women should take adequate contraceptive precautions to avoid falling pregnant during therapy and for three months afterwards. Methotrexate can affect how sperm cells develop,so men should avoid fathering a child during therapy and for three weeks afterwards. Aciterin:
Aciterin is an oral retnoid that reduces the production of skin cells. It is used to treat severe psoriasis that has not responded to other treatments. It has a wide range of side effects including dryness and cracking of the lips, dryness of the nasal passages, loss of hair, and in rarer cases, hepatitis. Acitretin causes serious birth defects, and women should avoid pregnancy during treatment, and for two years after. Ciclosporin:
ciclosporin is an immuno suppressant - a medicine that suppresses your immune system. It has proved effective in the treatment of all types of psoriasis, but as it stops your immune system from working normally, it can make you more at risk from infection. Ciclosporin also increase chances of kidney disease and high blood pressure.All of the oral and injected medicines for psoriasis come with both benefits and risks. Before starting a treatment of oral medication.
COMPLICATION:
Between 10% and 20% of people with psoriasis develop psoriatic arthritis, which causes tenderness, pain and swelling in the joints and connective tissue with associated stiffness. It commonly affects the ends of the fingers and toes. In some people it affects the lower back, neck and knees. About 80% of those affected develop psoriatic arthritis after the onset of psoriasis, but in about 20% the arthritis occurs before the onset of psoriasis.
There is no single test for psoriatic arthritis. It is normally diagnosed using a combination of methods - looking at your medical history, physical examinations, blood tests, X-Rays and MRI scans.
Psoriatic arthritis can be treated with anti-inflammatory or anti-rheumatic medicines. Psychological complicationsDue to the unpleasant effects psoriasis can have on physical appearance, feelings of low self-esteem and anxiety are common amongst people living with this condition. These feelings can then trigger depression, especially if the psoriasis worsens.
Psoriasis has a psychological and emotional impact, so do not be afraid to discuss any concerns or anxieties you may have.
Many people living with psoriasis have found getting involved in support groups may help.
Support groups can help increase your self-confidence and reduce any feelings of isolation,
while offering practical advice about living with the condition
