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FRIDAY, Sept. 5, 2014 (HealthDay News) -- A growing knowledge of the skin disease called psoriasis is leading to greater treatment choices, including personalized therapies, the U.S. Food and Drug Administration reports.
Psoriasis is an immune system disorder that causes overproduction of skin cells, resulting in scaling, pain, swelling, redness and heat. The condition affects about 7.5 million Americans.
"As we better understand the disease, researchers know more about what specific factors to target in order to develop effective treatments," FDA dermatologist Dr. Melinda McCord said in an agency news release.
There is no cure for psoriasis, so the main goals of treatments are to stop skin cell overproduction and reduce inflammation. Current therapies include medicines applied to the skin (topical), light treatment (phototherapy), or drugs taken by mouth or given by injection.
Doctors used to take a step-by-step approach, starting patients with mild to moderate psoriasis on topical therapy. If that was ineffective, doctors moved on to phototherapy or drug treatment.
Treatment is now more patient-specific, with doctors and patients selecting a treatment based on its effectiveness, disease severity, lifestyle, risk factors and other health issues, according to the FDA.
"Tomorrow's treatments will become even more personalized because the drugs in development now are targeting different aspects of the immune system," McCord said.
"As we learn more about the immune pathways that lead to the development of psoriasis, we can target specific molecules for treatment and make more therapeutic options available to patients," she explained.
Patients need to educate themselves about their condition and treatment options.
"Psoriasis has a great emotional impact on some patients. But it doesn't have to, given the right care and treatment," McCord said.
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People who suffer from psoriasis know how aggravating it can be, but treatments for the persistent skin condition are improving.
As we better understand the disease, researchers know more about what specific factors to target in order to develop effective treatments, Melinda L. McCord, M.D., a dermatologist at the Food and Drug Administration, told the FDAs Consumer Updates page.
Psoriasis is a condition in which skin becomes red and irritated, often developing thick silver flakes called scales, according to the National Library of Medicine. An estimated 7.5 million people in the United States have psoriasis. There is no cure for psoriasis, although symptoms can be managed with the right therapy.
Traditionally, treatment has been gradual, the FDA says, with patients starting with from creams and ointments all the way to phototherapy and systemic medicines. But now, the FDA says, doctors often try to optimize treatment i.e. start at a higher level right from the beginning. And treatments will become more tailored to the needs of each patient.
Tomorrows treatments will become even more personalized because the drugs in development now are targeting different aspects of the immune system, McCord noted. Psoriasis is an autoimmune disorder, meaning that the immune system mistakenly believes it is being attacked and then damages or inflames tissue that is actually healthy.
Therapies for psoriasis include topical treatments (i.e. those applied to the skin; light treatment (phototherapy) and medicines taken orally or via injection.
In the past, the FDA says, doctors treated psoriasis using a step-wise approach. Patients who had only mild to moderate psoriasis would start with topical treatments and, if necessary, move on to phototherapy or systemic drugs. People who had moderate to severe psoriasis were immediately treated with phototherapy or systemic drugs before being offered biologic therapies, a treatment that works with your immune system. But that strategy is changing, the FDA says. Today, patients can choose a treatment based on a number of conditions include lifestyle considerations, risk factors, and other diseases.
Most recently, the FDA approved a biologic product called Stelara (ustekinumab). This contains an antibody thats designed to bind to a specific target in the immune system. When given to patients, this antibody blocks the action of two proteins (interleukin 12 and 23) that contribute to the inflammation and the overproduction of skin cells, McCord said. By targeting these proteins, ustekinumab can interrupt the inflammatory pathway.
Researchers are also exploring medicines that target another protein, interleukin 17, McCord said. Looking forward, she added, the drugs in development are targeting different pathways in the immune system.
For the best treatment, McCord recommends a team approach in treating psoriasis, saying that different health-care providers need to work with patients to address the other diseases that might occur at the same time as psoriasis. These conditions can include lymphoma, heart disease and/or depression. We do not completely understand the relationship of theseto psoriasis, but it is an area of active research, she said.
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San Diego startup Skylit Medical is developing a phototherapy device for private home use to treat conditions like psoriasis, eczema and vitiligo.Its one of thosenecessitys the mother of inventionish stories founder Martyn Grosshimself has eczema and psoriasis.
We are a frustrated group, because this is an inflammatory condition for which there is no cure so we spend $10 billion per year to solve this problem, Gross said, adding that most of these dollars go to systemic and biologic drugs, which are costly out-of-pocket for patients.
Indeed, onecommon therapy for these autoimmune skin conditions is UVB therapy but the problem for many patients, Grosssaid, is that it takes a significant time investment to regularly go to a phototherapy clinic.
Skylits concept is todevelop its handheld device, setting up an out-of-pocket subscription service for patients to essentially lease it and use it at home. The patient would receive a prescription from a dermatologist, and then the doctor-programmed device would do the rest of the work. Itd turn on the UVB light in, say, 30-second increments whatever and whenever the doctor orders and then automatically shut off once the days sufficient therapy has been administered.
The goal is ultimately to build a camera into the device, so that the skin conditions progression can be tracked by a derm. In the near-term, the device will at least have WiFi and Bluetooth capabilities to transmit prescription data from the doc to the patient, Gross said.
Phototherapy has, by the way, a range of benefits for skin conditions, according to the National Eczema Association reducing itch, working as an anti-inflammatory agent, increasing vitamin D production and increasing bacteria-fighting systems in the skin. For psoriasis and even vitiligo, it shows similar benefits.
Skylit isnt the only device, it should be noted, that is working in the at-home phototherapy business. But thecompanys in the midst of a $2 million seedround, having raised about $150,000 by the end of July, according to a regulatory filing. Gross said it hopes to raise $3.4 million, however, in its Series A round.
The goal with the Skylit device was to make it as easy as possible, Gross said.
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Skylits handheld device could bring psoriasis, eczema phototherapy home
Tampa dermatologist Dr. Seth Forman has begun a clinical trial for the advancement of plaque psoriasis treatment.
The new medication, which is currently unnamed, is a topical steroid that is applied to the surface of the skin, with the ability to help widely affected areas on the body.
Plaque psoriasis can be painful, unsightly and overall hard to live with, says Dr. Forman, a board-certified Tampa dermatologist. We are excited about the prospects of this new treatment, and hopefully we will have an answer to this condition.
According to the National Psoriasis Foundation, plaque psoriasis appears as raised, red patches covered with a silvery white buildup of dead skin cells or scale that is most common on the scalp, knees, elbows and lower back.
The clinical trial being conducted by the Tampa dermatologist began last month and will continue for the next several months until enough research is accrued.
The hope is this drug can revolutionize plaque psoriasis treatment and make it easier to live with, says Dr. Forman.
Dr. Forman is the founder of Forman Dermatology and Skin institute, located in Tampa, Fla. and has appeared on TV shows across the country, including the nationally syndicated show The Doctors, to provide sun-protection tips and to demonstrate his breakthrough skin cancer treatments.
If interested in being a part of the clinical trial for plaque psoriasis, or for more on Dr. Seth Forman, Tampa dermatology or Forman Dermatology and Skin Cancer Institute, please visit http://www.FormanDerm.com.
About Dr. Seth Forman:Dr. Forman is a board-certified dermatologist practicing in Tampa, Florida. He was voted the Best Dermatologist in Carrollwood the past three years by the Carrollwood News and Tribune. In December 2011, he opened his newTampa dermatologyoffice, Forman Dermatology and Skin Cancer Institute, where he gives psoriasis sufferers access to the latest treatment options, including topical and oral medications, as well as biological and phototherapy. Dr. Forman is one of the few Tampa dermatologists to offer narrowband light therapy, which uses pharmaceutical grade light to suppress psoriasis. Hes also one of the few board-certified dermatologists in the U.S. to use the SRT-100 radiotherapy to treat basal cell carcinoma, the most common form of skin cancer.
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Tampa dermatologist announces clinical trial for plaque psoriasis
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