Psoriáza

Antipsoriatika:

Rp:

• Ac. salicylici
• Ol. cadini aa 5,0
• Ambidermani 80,0
• M.f. ung.
• D.s. do kštice [1]

Rp:

• Chrysarobini 2,0
• Sulfuris praec.
• Zinici oxydati
• Tct. carbonis det. aa 4,0
• Vaselini fl. 35,0
• M.f. ung.
• D.s. na postižené místa. [1]

Rp:

• Chrysarobini 5,0-20,0
• Ac. salicylici 10,0
• Ol. cadini 20,0
• Saponis kalini
• Cerae lanae aa 25,0
• M.f. ung.
• D.s. na postižená místa [1]

Rp:

• Tinct. carbonis detergentis 5,0
• Zinci oxydati
• Talci aa 20,0
• Glycerini
• Magmatis bentoniti aa ad 100,0
• M.f. susp.
• D.s. tekutý zásyp...
• Před upotřebením zatřepat. [1]

Rp:

• Acidi salicylici 2,5-5,0
• Vaselini flavi (seu macrogoli)ad50,0
• M.f. ung.
• D.s. mast k odstranění šupin [1]

Rp:

• Chrysarobini 0,25-0,5-1,0
• Vaselini flavi ad 50,0
• M.f. ung.
• D.s. mast. [1]

Rp:

• Picis lithanthracis
• Ichthamoli aa 25,0
• M.f. ung.
• D.s. mast. [1]

Rp:

• Picis lithanthracis 2,5-5,0
• Acidi salicylici 2,5
• Vaselini flavi ad 50,0
• M.f. ung.
• D.s. mast. [1]

Rp:

• Hydrocortisoni 10,0
• Ung. leniens ad 100,0
• Mf. ung
• D.s. lokálně [1]

Dehty

• Delatar ung
• Ichtoxyl ung
• Pityol ung
• Saloxyl ung
• Teer-linola-fett N crm
• Unguentum acidi borici 10% masťový základ
• Unguentum Ichthamoli 10% léčiva

Metoxalen

• Oxsoralen sol [1]

Antipsoriatika k vnitřnímu použití

• Metoxalen
• Oxsoralen cps
• Retinoidy pro léčbu psoriázy
• Etretinát
• Tigason Roche cps [1]

Dále

• Calcium biotika iv
• Sedativa
• Antipruriginosa
• Viataminy [1]

U kloubní formy:

• Metortrexát
• Acitretin
• Cyklosporin A [1]

Vyhýbáme se

• Antimalarikům
• Přípravkům zlata
• Salicylátům
• Jiným nesteroidním antirevmatikům
• Beta-blokátorům
• Lithiu
• Antibiotikům (Tetracyklin)
• Protitetanové injekci [1]

Literatura:

[1] MUDR. BĚRSKÝ, Kamil. MUDr. Kamil Běrský : Psoriáza [online]. Listopad 2008 [cit. 2011-03-20]. Nemoci Kůže. Dostupné z WWW: < www.bersky.cz/index.php?option=com_content&view=article&id=144:kuze&catid=45:farmacie&Itemid=65 >. [webová stránka]

Psoriasis

Aloe vera (Aloe vera), which is Class 1 internally and Class 2d externally (McGuffin et al. 1997), has been used for centuries in wound healing and was recently found to be a potential treatment for psoriasis. In a double-blind placebo-controlled study, 60 patients with slight to moderate plaque psoriasis were treated topically with either 0.5% hydrophilic aloe cream or placebo. The aloetreated group showed statistically significant improvement (83.3%) compared with the placebo group (6.6%). There were no adverse effects reported in the treatment group (Syed et al. 1996).
Capsaicin is the main ingredient in cayenne pepper (C. frutescens), which is Class 1 internally but Class 2d externally (McGuffin et al. 1997); it has also been studied for the treatment of psoriasis. In vitro, capsaicin was found to inhibit phorbol ester-induced activation of transcription factors NF-?B and AP-1 (Surh et al. 2000). Two trials showed that 0.025% cream used topically is effective in treating psoriasis. The first study showed a significant decrease in scaling and erythema during a 6-week period in 44 patients with moderate and severe psoriasis (Bernstein et al. 1986). The second was a double-blind study of 197 patients in whom psoriasis was treated with the capsaicin cream four times daily for 6 weeks, with a significant decrease in scaling, thickness, erythema, and pruritus (Ellis et al. 1993). The main adverse effect reported was a brief burning sensation at the application site. Capsaicin is contraindicated on injured skin or near the eyes, and the German authority Commission E suggests it should not be used for more than 2 consecutive days, with a 14-day lapse between applications.
A survey of patients with psoriasis at a large university dermatology practice revealed that 51% of patients used one or more alternative therapeutic modalities (Fleischer et al. 1996). This is consistent with previous Norwegian surveys of patients with psoriasis (Jensen 1990). Herbal therapy is one of the most frequently chosen alternative therapies. Psoriasis has been treated for centuries with herbal preparations, both topical and oral. There are many herbal preparations composed of furocoumarins, which act as psoralens when combined with ultraviolet A (UV-A, 320–400 nm). Furocoumarins derived from Ammi majus and related plants that produce 8-methoxy-psoralen when applied topically or taken orally intercalate with DNA. Further, when coupled with exposure to UV-A from the sun or a an ultraviolet light-box, the photoactivation causes cross-linkages with the thymine in the DNA, inducing cell death (van Wyk and Wink 2004). This, in turn, inhibits hyperproliferation in psoriatic lesions.
One commonly used TCM, Radix Angelicae dahurica, included in Class 1 (McGuffin et al. 1997), contains the furocoumarins imperatorin, isoimperatorin, and alloimperatorin. In a study involving 300 patients with psoriasis, this TCM, taken orally, was combined with UV-A therapy and was compared with the standard treatment of psoralen—UV-A with methoxsalen. The efficacy of the two treatments was equivalent; however, there were fewer adverse effects such as nausea and dizziness in the group treated with TCM and UV-A (Koo and Arain 1998). In addition, there are topical preparations made from herbs that show systemic efficacy against psoriasis, but are too toxic when given systemically (Ng 1998). Topical TCM of the plant Camptotheca acuminata in an open trial including 92 patients with psoriasis found that this TCM was statistically more effective than 1% hydrocortisone. A disadvantage was that allergic contact dermatitis was seen in 9–15% of the patients in the TCM group. Comparison of TCM mixtures in clinical trials is difficult, because the mixture of herbs prescribed varies individually depending on the subtype of psoriasis (“blood-heat” type, “blood deficiency dryness” type, and “blood stasis” type), which is determined in TCM by many findings, including lesions of psoriasis, the pulse, and the condition of the tongue (Koo and Arain 1998). Some types of TCM may act in part on the microcirculation of the psoriatic lesion (Zhang and Gu 2007). Additional TCM herbal mixtures for psoriasis are listed by Xu (2004).
About 5% curcumin is present in turmeric (Curcuma longa), which is included in Classes 2b and 2d (McGuffin et al. 1997; see also Chapter 13 on turmeric). Turmeric has been used for centuries in India to provide glow and luster to the skin. It has antimicrobial, antioxidant, astringent, and other useful effects that help to heal wounds and reduce scarring (Chaturvedi 2009). In vitro, the purified turmeric extract curcumin has been found to inhibit phorbol ester-induced activation of transcription factors NF-?B and AP-1 (Surh et al. 2000). The resulting suppression of phosphorylase kinase activity correlates with the resolution of psoriasis when curcumin is applied topically to the lesions (Heng et al. 2000). Microencapsulation of curcumin reduces the yellow staining produced by application of topical curcumin on the skin, while prolonging the bioavailability of curcumin (Aziz, Peh, and Tan 2007).
Tars have been used for centuries to treat psoriasis. Tars derived from birch (Betula spp.), beech (Fagus spp.), or juniper (Juniperus spp.) trees (van Wyk and Wink 2004) are antipruritic and antiproliferative. They are used in a 5–10% concentration in creams, gels, and soaps. They are photosensitizing compounds, so judicious exposure to sunlight can be beneficial, or they can be used in conjunction with ultraviolet B (UV-B; 250–320 nm) or narrowband UV-B (311 nm).https://www.ncbi.nlm.nih.gov/books/NBK92761/