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Psoriasis

What is Remission in Psoriasis?


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Summary & Participants

People with psoriasis are always trying to attain a time when their disease clears, a time known as remission. Learn what treatments are available to people with the moderate to severe form of this disease and what can be expected from the many types of treatments.

Medically Reviewed On: July 21, 2009

Webcast Transcript


ANNOUNCER: Everyone wants to feel and look good, which is why life can be difficult for the 6 to 7 million Americans who suffer from psoriasis, an unattractive and sometimes itchy, painful and even life-altering skin condition that results from a malfunction of the cells of the immune system.

ALAN MENTER, MD: Quality of life is tremendously impacted by this disease we call psoriasis. There are so many aspects of people's day-to-day activities: their personal interactions with their loved ones, their interactions in the workplace, their interactions socially. They're unable to wear the clothing they'd like to wear. Their skin is sore. Their skin is flaking. The emotional impact of psoriasis is as devastating as any other chronic disease.

The ultimate aim in psoriasis is obviously to get what we call remissions, which means clearance of psoriasis with as little psoriasis as possible.

ANNOUNCER: But exactly what does remission look like?

GERALD KRUEGER, MD: Remission to me means the disease is gone. I'll tolerate a dime-sized lesion, maybe two of them. That's remission.

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.

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