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What is it?
Methotrexate (MTX) is a folate acid antagonist. It basically blocks an essential step in DNA synthesis and causes a reduction in cell reproductive abilities. This is why it is commonly used alongside other drugs in cancer treatment (chemotherapy) because it can reduce cancerous cell growth and tumours.
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What is it?
Hydro is a drug known as an 'antineoplastic'. The chemicals in it help stop the growth of abnormal tissue, which may be benign (non-cancerous) or malignant (cancer). It is most commonly used to treat leukaemia, but can also be used for non-malignant disorders, incuding psoriasis and has been used as a secondline treatment alongside the other systemics since the 1970s. The exact way in which hydro works in psoriasis is unclear, but it appears to interfere with the synthesis of genetic material (DNA) inside cells. It therefore stops cells from growing and multiplying, which stops the growth of the abnormal skin cells. |
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DOVOBET What is it?
Dovobet is a topical ointment for plaque psoriasis. It is a stable combination of calcipotriol (as in Dovonex) and betamethasone dipropionate (a potent corticosteroid). It is available in 60gm and 120gm tubes and is manufactured by Leo Pharmaceuticals.
Who is it for?
For patients with severe plaque psoriasis covering no more than 30% if their body. It is NOT recommended for those with erythrodermic, pustular or guttate psoriasis. It is not licensed for pregnant women or for children under the age of 18. Due to the potency of the steroid, it is not advisable to use Dovobet on the face, genital areas or the scalp.
How does it work?
Both of the above ingredients are widely used, in their separate forms, for the treatment of psoriasis. Dovobet combines the two in a form that does not degrade either ingredient and allows both to work effectively together. The calcipotriol regulates and inhibits cell growth – therefore lessening the flaking of the psoriasis patches. The steroid part of the ointment has an anti-inflammatory property – therefore lessening the redness and raised look of the patch.
How do I use Dovobet?
Dovobet is applied directly to the psoriasis.
Current guidelines recommend that:
It should not be used for any more than 4 weeks in one treatment
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No more than 100gm to be applied per week.
What side effects could I suffer using Dovobet?
In trials, 5-10% of patients suffered pruritus (itchiness).
However, as with any steroid-based topical preparation, extreme caution should be used when stopping treatment. Although no official research has been published, some patients posting on the PHO Forums have experienced mild to severe flare-up of their psoriasis when they have finished using Dovobet. With these experiences in mind, please discuss any concerns in this area with the prescribing GP or dermatologist.
There are threads and posts on Dovobet and the experiences of PHO UK members in the forums. SJ July 2004 |
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This lotion which originally came into this country as a herbal over-the-counter product, has recently become available on prescription It contains some Coal Tar and has fatty acids similar to those found in banana skin. There are other products under this tradename which are not on prescription, but can be purchased in Pharmacies.
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Climatotherapy Sunlight can have a beneficial effect on psoriasis. Climatotherapy has been used for many years in the Dead Sea, Israel, and the Canary Islands, Spain, with good results.
DEAD SEA ALTERNATIVE History Two thousand years ago, the historian Josephus Flavius wrote that "one should praise the Dead Sea; this salt brings healing to the human body." This is still true today as thousands of visitors flock to the area to sample the incredible natural healing powers of the Dead Sea. The Dead Sea at 400 meters below sea level is the lowest point on earth and part of the Great Rift Valley. The water has a 33% concentration of salt (3% in the ocean) and minerals such as calcium, potassium, sodium, magnesium and bromide. The high salt and mineral concentration allows everyone to float in its waters. Most visitors take home the "floating on the water reading the Jerusalem Post" photo. The sunshine in this area is unique. Due to the water evaporating quickly in the intense heat, the Dead Sea has its own ozone layer hanging over it. The haze helps to filter out more of the damaging ultraviolet rays that can cause skin cancer, burning and ageing. This allows the duration of exposure to be dramatically increased. Very few people will suffer sunburn if careful progressive exposure is practiced and the hours of 11am to 2pm are avoided. The air is extremely dry, unpolluted and pollen free. With the high levels of bromide in the air, and 10% more oxygen, this induces total relaxation and makes breathing much easier. Combined, these natural elements offer an excellent alternative treatment for psoriasis and other skin problems, breathing and joint problems. You have a choice of travelling to either Israel or Jordan. |
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Dithranol (also known as anthralin in certain parts of the world) Dithranol can be effective for mild to moderate psoriasis and is often used with ultraviolet B (UVB) treatments for more severe psoriasis. - Dithranol Ointment BP in yellow soft paraffin with strengths between 01-2%. PO over 1% dithranol.
- Dithranol Paste BP in zinc and salicylic acid (Lassar’s paste) with strengths between 01-1% dithranol.
- Dithrocream (Dermal)
Cream containing dithranol 0.1%. For skin and scalp application. Under 0.5% suitable for overnight treatment/over 0.5% maximum 1 hour contact. PO over 1% dithranol.
Cream containing dithranol 1%. A 3% version is used on an in-patient basis. NOTE: 30 minute maximum contact time.
Ointment containing dithranol 0.11%, coal tar 1% and salicylic acid 1.6% and scalp gel containing dithranol 0.25%, salicylic acid 1.6%.
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