Advances in Psoriasis

Psoriasis is an immune-mediated disease that often presents with scaling plaques on the elbows, knees, and scalp. Almost eight million people are affected by psoriasis. There is no known cure for psoriasis, but there have been many advances in the treatment of psoriasis. Our ever expanding arsenal of treatment options result in most patients being able to achieve clear or near-clear skin.

Biologic medications have been available to treat psoriasis for almost 20 years. Over the last few years, many new biologic medications have been FDA-approved, which target the immune system
differently than the older medications. These newer biologics yield unprecedented efficacy allowing most patients to achieve nearly clear skin. They also have unprecedented safety with less potential adverse events compared to older medications.

People with psoriasis have been shown to have higher levels of Interleukin-17 proteins in their bodies. Interleukin-17 is a cytokine, a protein that stimulates an immune response when it interacts with its receptor, which can result in inflammation in people with psoriasis. There are three biologic medications that inhibit IL-17 available, Cosentyx, Taltz, and Siliq. Another interleukin, IL-23, also promotes inflammatory responses. Three IL-23 blockers are currently available, Ilumya, Tremfya, and Skyrizi. Having many different medications to treat psoriasis is extremely helpful for patients. Sometimes one medication may work better than another for a patient, or a medication may stop working over time and need to be changed.

There have also been advances in oral therapy for psoriasis. Otezla is an oral medication FDA-approved for the treatment of psoriasis. It is a selective inhibitor of the enzyme phosphodiesterase 4 (PDE4) within your immune system that can affect certain cells and contribute to inflammation. It requires no routine blood draws to monitor safety. Otezla is an excellent treatment option for psoriasis patients in which prescription topical therapy alone is not enough to control their skin plaques, who have contraindications to other oral therapies, and who are unable to be treated with biologic medications.

XTRAC® excimer laser is a painless, FDA-approved therapeutic beam of UVB light which specifically targets areas of the skin affected by psoriasis without harming the surrounding skin. At Advanced Dermatology, we have the newest model of the XTRAC® laser. It achieves clearance of the skin faster and with fewer numbers of treatments compared to the older model. Treatments are now only once per week. XTRAC® laser treatments can be used alone as monotherapy or combined with other psoriasis treatments such as topical creams, oral medications, and even biologics. Any part of the body can be treated, and any age patient can be treated, even children.

Even though we are unable to cure psoriasis, these treatment advances have greatly improved patient outcomes. We are consistently able to provide psoriasis patients with mostly clear skin safely!