Systemic Psoriasis Treatment
For more severe forms of
psoriasis, doctors sometimes prescribe medicines that are taken internally by pill or injection. This is called systemic psoriasis treatment. Some psoriasis medications used in systemic psoriasis treatment can include:
- Methotrexate
- Retinoids
- Cyclosporine
- 6-Thioguanine
- Hydroxyurea
- Biologic response modifiers
- Antibiotics.
Methotrexate
Like cyclosporine, methotrexate slows cell turnover by suppressing the immune system. For psoriasis treatment, it can be taken by pill or injection. Patients taking methotrexate must be closely monitored because it can cause liver damage and/or decrease the production of oxygen-carrying red blood cells, infection-fighting white blood cells, and clot-enhancing platelets.
As a precaution, doctors do not prescribe this medication for psoriasis in people who have had liver disease or anemia (an illness characterized by weakness or tiredness due to a reduction in the number or volume of red blood cells that carry oxygen to the tissues). It is sometimes combined with PUVA or UVB treatments. Methotrexate should not be used by pregnant women, or by women who are planning to get pregnant, because it may cause birth defects.
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 treatment may also cause birth defects, women must protect themselves from pregnancy beginning one month before and continuing through 3 years after treatment with acitretin. Most patients experience a recurrence of psoriasis after these products are discontinued.
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