Retinoids
A retinoid, such as acitretin (Soriatane
®), is a compound with vitamin A-like properties; it may be prescribed for severe cases of
psoriasis that do not respond to other therapies. Because this psoriasis medication also may cause birth defects, women must protect themselves from pregnancy beginning one month before and continuing through three years after treatment with acitretin. Most patients experience a recurrence of psoriasis after these products are discontinued.
Cyclosporine
Taken orally, cyclosporine acts by suppressing the immune system to slow the rapid turnover of skin cells. It may provide quick relief of symptoms, but the improvement stops when treatment is discontinued.
The best candidates for this therapy are those with severe psoriasis who have not responded to, or cannot tolerate, other systemic psoriasis medication. Its rapid onset of action is helpful in avoiding hospitalization of patients whose psoriasis is rapidly progressing.
Cyclosporine may impair kidney function or cause
high blood pressure (
hypertension). Therefore, patients must be carefully monitored by a doctor. Also, this type of psoriasis medication is not recommended for patients who have a weak immune system or those who have had
skin cancers as a result of PUVA treatments in the past. It should not be given with phototherapy.
6-Thioguanine
This psoriasis medication is nearly as effective as methotrexate and cyclosporine.
It has fewer side effects, but there is a greater likelihood of anemia. It must also be avoided by pregnant women and by women who are planning to become pregnant, because it may cause birth defects.
Hydroxyurea (Hydrea)
Compared with methotrexate and cyclosporine, hydroxyurea is somewhat less effective as
psoriasis treatment. This psoriasis medication is sometimes combined with PUVA or UVB treatments.
Possible side effects include anemia and a decrease in white blood cells and platelets. Like methotrexate and retinoids, hydroxyurea must be avoided by pregnant women or those who are planning to become pregnant, because it may cause birth defects.
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