Gary W. Cole, MD, FAAD
Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Psoriasis facts
- What is psoriasis?
- What causes psoriasis?
- What does psoriasis look like? What are psoriasis symptoms and signs?
- Can psoriasis affect only my nails?
- Can psoriasis affect my joints?
- How do health-care professionals diagnose psoriasis?
- How many people have psoriasis?
- Is psoriasis curable?
- Is psoriasis contagious?
- Can I transmit the gene for psoriasis to my children?
- What kind of doctor treats psoriasis?
- What is the treatment for psoriasis?
- What creams, lotions, and home remedies are available for psoriasis?
- What oral medications are available?
- What injections or infusions are available for psoriasis?
- What about light therapy for psoriasis?
- Where can people get more information on psoriasis?
- Is there a national psoriasis support group?
- What is the long-term prognosis with psoriasis? What are complications of psoriasis?
- What does the future hold?
- Pictures of Psoriasis - Slideshow
- Take the Psoriasis Quiz
- Psoriasis FAQs
- Find a local Dermatologist in your town
What oral medications are available?
Oral medications include acitretin, cyclosporine, methotrexate, mycophenolate mofetil, apremilast (Otezla), and others. Oral prednisone (corticosteroid) is generally not used in psoriasis and may cause a disease flare if administered.
- Acitretin (Soriatane) is an oral drug used for certain types of psoriasis. It is not effective in all types of the disease. It may be used in males and females who are not pregnant and not planning to become pregnant for at least three years. The major side effects include dryness of skin and eyes and temporarily elevated levels of triglycerides and cholesterol (fatty substance) in the blood. Blood tests are generally required before starting this therapy and are needed periodically to monitor triglyceride levels. Patients should not become pregnant while on this drug and usually avoid becoming pregnant for at least three years after stopping this medication.
- Cyclosporine is a potent immunosuppressive drug used for other medical uses, including organ transplantation. It may be used for severe, difficult-to-treat cases of widespread psoriasis. Improvement and results may be very rapid in onset. It may be hard to get someone off of cyclosporine without flaring their psoriasis. Because of the potential cumulative toxicity, cyclosporine should not be used for more than one to two years for most psoriasis patients. Major possible side effects include kidney and blood-pressure problems.
- Methotrexate is a common drug used for rheumatoid arthritis, and it has been used effectively for many years in psoriasis. It is usually given in small weekly doses (5 mg-15 mg). Blood tests are required before and during therapy. The drug may cause liver damage in some patients, particularly if there is preexisting liver disease or if given for prolonged periods of time. Close physician monitoring and monthly to quarterly visits and labs are generally required.
- FDA has recently approved a new oral drug, apremilast (Otezla), to treat psoriatic arthritis, and it seems to have an entirely novel mode of action.
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