Psoriasis is a common skin disorder that affects ~2% of the population in the Unites States. Psoriasis vulgaris can be characterized as a chronic inflammatory dermatosis with varying degrees of severity that seldom manifests into a debilitating condition. 

 Chronic psoriasis can be the result of a genetically determined susceptibility to triggers, environmental antigens, or autoantigens in addition to a defect in downregulation of the acute inflammatory  regulators.  The intent of treatment consists of decreasing exposure to trigger agents, selectively inhibiting the immune system initiation process, and limiting production of amplification factors. 

 Traditionally, therapy has targeted cell proliferation, the role of  arachidonic acid and its metabolites in the inflammatory pathways, and recently, focal immunosuppression. Due to the extensive immunologic involvement in patients with psoriasis, immunosuppression has gained popularity. 

The macrolide tacrolimus is an effective systemic therapy. It is also effective when used topically after the lesions have been descaled and the skin has been occluded.

Agents that target the arachidonate cascade include nutritionals , such as Omega-3 Fish Oils, and Vitamin  E , along with glucocorticoids.  It has been shown that Vitamin D3 is significantly decreased in psoriatic     patients and that use of a 3ยตg/gm 1,25 dihydroxy vitamin D3 ointment is also effective as a topical treatment for psoriasis.*  

Other psoriatic agents include fumaric acid and capsaicin. In a double-blind study, capsaicin was used to treat pruritic psoriasis effectively and appropriate neurogenic pathways have been implicated.*

*International Journal of Pharmaceutical Compounding  Vol 4  No. 5 Sept/Oct 2000

Additional information on treating psoriasis can be found by clicking (here).