RESUMO
Psoriasis is a chronic, inflammatory, multisystem disease that affects up to 3.2% of the United States population. This guideline addresses important clinical questions that arise in psoriasis management and care and provides recommendations based on the available evidence. The treatment of psoriasis with topical agents and with alternative medicine will be reviewed, emphasizing treatment recommendations and the role of dermatologists in monitoring and educating patients regarding benefits as well as risks that may be associated. This guideline will also address the severity assessment methods of psoriasis in adults.
Assuntos
Terapias Complementares/métodos , Fármacos Dermatológicos/administração & dosagem , Dermatologia/métodos , Psoríase/terapia , Academias e Institutos/normas , Administração Cutânea , Terapia Combinada/métodos , Terapia Combinada/normas , Terapias Complementares/normas , Dermatologia/normas , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/normas , Fundações/normas , Humanos , Educação de Pacientes como Assunto/normas , Psoríase/diagnóstico , Índice de Gravidade de Doença , Resultado do Tratamento , Estados UnidosRESUMO
Psoriasis is a chronic inflammatory disease involving multiple organ systems and affecting approximately 3.2% of the world's population. In this section of the guidelines of care for psoriasis, we will focus the discussion on ultraviolet (UV) light-based therapies, which include narrowband and broadband UVB, UVA in conjunction with photosensitizing agents, targeted UVB treatments such as with an excimer laser, and several other modalities and variations of these core phototherapies, including newer applications of pulsed dye lasers, intense pulse light, and light-emitting electrodes. We will provide an in-depth, evidence-based discussion of efficacy and safety for each treatment modality and provide recommendations and guidance for the use of these therapies alone or in conjunction with other topical and/or systemic psoriasis treatments.
Assuntos
Dermatologia/normas , Fototerapia/normas , Guias de Prática Clínica como Assunto , Psoríase/terapia , Academias e Institutos/normas , Fundações/normas , Humanos , Metanálise como Assunto , Fototerapia/instrumentação , Fototerapia/métodos , Revisões Sistemáticas como Assunto , Resultado do Tratamento , Estados UnidosRESUMO
Traditional medicine uses cultural knowledge and practices to promote health maintenance as well as diagnose and treat disease. In developing countries, the majority of people rely on traditional medicines; however, many of these practices have not been rigorously and systematically studied or reported. We review the current understanding and research behind traditional therapies prevalent in the Indian subcontinent, including mind-body and energy-based healing, botanical medicine, and herbal remedies. Topics covered include Ayurveda, yoga, naturopathy, Unani, Siddha, Sowa-Rigpa, homeopathy, and medicinal plants such as neem, guggul, tulsi, amla, and turmeric.
Assuntos
Etnobotânica , Fitoterapia , Preparações de Plantas/uso terapêutico , Dermatopatias/tratamento farmacológico , Azadirachta , Curcuma , Humanos , Índia , Medicina Tradicional , Ocimum sanctum , Phyllanthus emblicaRESUMO
INTRODUCTION: Nail psoriasis is challenging to treat. The few currently available therapies are limited in efficacy, and often produce unfavorable side effects. A plant extract widely used in Traditional Chinese Medicine, indigo naturalis (Qing Dai), is presented in this review as an alternative topical treatment for skin and nail psoriasis. The purpose of this article is to present information on a viable alternative treatment with a favorable side effect profile for a difficult disease to treat. METHODS: A PubMed search for the term "indigo naturalis" was performed, and literature from 2006 to the present relevant to indigo naturalis and treatment of psoriasis and nail psoriasis was reviewed. RESULTS: Indigo naturalis shares several therapeutic mechanisms with current psoriasis treatments, such as regulation of keratinocyte proliferation and differentiation, restoration of epidermal barrier function, and reduction of inflammatory processes. Clinically, it is well tolerated. CONCLUSION: Recent research of indigo naturalis suggests that it is a safe, inexpensive, and effective alternative topical treatment for skin and nail psoriasis.
Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Doenças da Unha/tratamento farmacológico , Fitoterapia/métodos , Psoríase/tratamento farmacológico , Administração Tópica , Proliferação de Células/efeitos dos fármacos , Citocinas/efeitos dos fármacos , Citocinas/metabolismo , Medicamentos de Ervas Chinesas/efeitos adversos , Medicamentos de Ervas Chinesas/economia , Epiderme/efeitos dos fármacos , Humanos , Indigofera , Indóis/efeitos adversos , Indóis/uso terapêutico , Queratinócitos/efeitos dos fármacos , Óleos/efeitos adversos , Óleos/uso terapêutico , Pomadas/efeitos adversos , Pomadas/uso terapêutico , Fitoterapia/efeitos adversos , Fitoterapia/economia , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Transdução de Sinais/efeitos dos fármacos , Pele/efeitos dos fármacos , Resultado do Tratamento , Molécula 1 de Adesão de Célula Vascular/efeitos dos fármacos , Molécula 1 de Adesão de Célula Vascular/metabolismoRESUMO
A needle-free system that delivers lidocaine to the dermis using pressurized gas is often used as an alternative anesthetic for venipuncture and intravenous catheterization in children. This case report illustrates the potential histologic artifacts that may arise when using a needleless device for a cutaneous punch biopsy. We suggest against using a needleless system for pediatric skin biopsies.