ALAN MENTER, MD: The score that we as dermatologists use in assessing our psoriasis patients is the PASI score, the Psoriasis Area Severity Index, which is a composite of the amount of area involved, the severity of the psoriasis which is the thickness, redness and scaling within the patches of psoriasis.
The patient definition of remission may be different from what we as physicians look at. In other words, for a patient, some patients would like their psoriasis totally clear, where they don't have a single patch left. For others, a remission for them may be clearing their arms and legs so they can wear short pants and short sleeves in the summer time. For others, one patch is devastating to them. So remission for patients is really very much individualized to what their own desires may be.
ANNOUNCER: For people with moderate to severe forms of the disease a form of light therapy called PUVA and oral medications like cyclosporine and methotrexate can induce periods where there is little to no evidence of disease.
GERALD KRUEGER, MD: With PUVA it can be in the four to six month range, and with methotrexate it is less than three months. And with cyclosporine it's less than three months.
ANNOUNCER: But their long-term use can create problems.
GERALD KRUEGER, MD: If you are on the photo-augmented so-called PUVA, that treatment you increase your risk of skin cancer substantially the more treatments you get.
With methotrexate there comes a time where you simply have your "tank" full and to take more is hazardous to your health. Cyclosporine is a drug that is not safe for long periods of time.