Before Taking This Medicine
You should not use Dovonex if you are allergic to calcipotriene, or if you have:
-
high levels of calcium in your blood or
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high levels of vitamin D in your body .
To make sure Dovonex is safe for you, tell your doctor if you are receiving phototherapy for your psoriasis.
Tell your doctor if you are pregnant or plan to become pregnant.
It is not known whether calcipotriene topical passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breastfeeding a baby.
Do not use this medicine on a child without medical advice.
Systemic Role For Vitamin D In The Treatment Of Psoriasis And Metabolic Syndrome
Ronald Vender
1Department of Medicine, McMaster University, 1200 Main Street West, Hamilton, ON, Canada
2Dermatrials Research, Dermatology Centre, 132 Young Street, Hamilton, ON, Canada
Abstract
The novel discovery of the systemic role of vitamin D in the modulation of the immune system especially the Type 1 helper T cell pathway reveals its potential for treating Th1 inflammatory diseases. Psoriasis has been recently established to be a systemic disease centered on inflammation and involvement of cytokines of the Th1 pathway. There is an increased prevalence of metabolic syndrome in patients with psoriasis. Metabolic syndrome also involves a proinflammatory state. This paper proposes the idea of the potential use of oral vitamin D to treat psoriasis and metabolic syndrome concurrently. We propose there is merit in more clinical trials investigating the use of vitamin D to treat both psoriasis and metabolic syndrome through its anti-inflammatory effects. On application to psoriasis management and prognosis, the goal is to decrease the risk for cardiovascular disease and decrease disease morbidity and mortality.
1. Introduction
Psoriasis is a common Th1-mediated inflammatory disease characterized by scaly plaques on the skin, which can be painful and pruritic. It is also associated with psoriatic arthritis, Crohns disease, diabetes mellitus , metabolic syndrome, depression, and cancer . It affects 13% of the general population .
2. Psoriasis Pathophysiology
8. Conclusion
Psoralen Plus Ultraviolet A
For this treatment, you’ll first be given a tablet containing compounds called psoralens. Psoralen may be applied to the skin. This makes your skin more sensitive to light.
Your skin is then exposed to a wavelength of light called ultraviolet A . This light penetrates your skin more than ultraviolet B light.
This treatment may be used if you have severe psoriasis that has not responded to other treatment.
Side effects include nausea, headaches, burning and itchiness. You may need to wear special glasses for 24 hours after taking the tablet. This is to prevent the development of cataracts.
Long-term use of this treatment is not encouraged. It can increase your risk of developing skin cancer.
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Vitamin D Regulation Of Apoptosis In Keratinocytes
Calcitriol stimulates the synthesis of ceramide by inducing the neutral Mg2+-dependent sphingomyelinase and in return, ceramide enhances the pro-differentiating effect of calcitriol on keratinocytes in a feedback loop . It has been demonstrated that physiological concentrations of calcitriol do not initiate apoptosis in cultured keratinocytes but, in contrast, pharmacological concentrations of calcitriol exert a pro-apoptotic effect on keratinocytes .
Medicated Creams For Psoriasis
Another important variety of psoriasis cream is the topical medicated treatment. These are products recommended for people with psoriasis either by a pharmacist or a doctor. You will often need a prescription to use the kinds of treatments below as they can be very potent.
The ingredients most commonly found in medicated psoriasis creams are:
- Topical corticosteroids
- Coal tar
- Dithranol
These ingredients primarily work by reducing skin cell production, however they can also have an anti-inflammatory effect, which helps to reduce soreness and itching.
Medicated psoriasis creams should be applied directly to affected areas when youre experiencing a flare-up of symptoms. They are suited to cases of mild or moderate psoriasis, and vary in potency.
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The Nutritionists Point Of View
Severe psoriasis has been associated with nutritional deficiencies because of an accelerated loss of nutrients, in particular of vitamin D, from the hyperproliferation and desquamation of the epidermal layer of skin . Vitamin D supplementation is of particular interest to Nutritionists for two important reasons. First, besides its topical use, oral vitamin D supplementation represents an important adjunctive treatment option for psoriatic patients second, vitamin D supplementation might be very important for the prevention of psoriasis-related comorbidity , hypertension and metabolic syndrome .
How Should I Use Dovonex
Use Dovonex exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Do not take by mouth. Dovonex is for use only on the skin. Do not use this medicine on open wounds or on sunburned, windburned, dry, chapped, or irritated skin.
Do not apply this medicine to your face.
Do not use Dovonex to treat any condition that has not been checked by your doctor.
Do not share this medicine with another person, even if they have the same symptoms you have.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
Wash your hands before and after applying Dovonex, unless you are using it to treat a hand condition.
Clean and dry the area of skin where you will apply Dovonex. Apply the medicine only to the affected area, not to the surrounding skin.
It may take up to 2 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 8 weeks of treatment.
Store at room temperature away from moisture and heat. Do not keep in a refrigerator or freezer.
Dovonex scalp solution is flammable. Avoid using near open flame, and do not smoke until the medicine has completely dried on your skin.
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Vitamin D Cream For Skin Problems
Vitamin D, as a topical treatment, is most commonly used for psoriasis, a hereditary skin condition. Proper application of vitamin D to the affected spot may help relieve the symptoms commonly associated with psoriasis and also may help to prevent scarring. However, continued medical research is required to accurately test the efficacy of vitamin creams, so consult with a health care professional before relying on any topical creams as a treatment.
Vitamin D Based Creams And Ointments
There are prescribed creams which contain vitamin D as the main active ingredient. These creams contain vitamin D in its biological active form. Hence, they are quite effective in managing symptoms of mild to moderate psoriasis.
Other sources of vitamin D- sunlight or dietary supplements- provide you inactive form of vitamin D which is converted into biologically active form by the liver and kidney .
As we have discussed a number of times before, psoriasis is an internal body metabolism related problem, hence, its actual healing would also be from inside-out. But, if you are looking for topical creams to manage the psoriasis symptoms, then these creams can be tried. At least they are far better than the light therapy.
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Start Your Day With Fortified Cereal
Fortified cereal is another easy way to get your daily fill of vitamin D. Look for a low-calorie fortified hot or cold cereal, and read the package label to determine how much vitamin D you will get and whats considered a serving size.
Bonus points if you top your bowl of cereal with fortified milk and pair it with a glass of fortified OJ.
Effects Of Vitamin D On The Cutaneous Immune System
Psoriasis pathogenesis implicates the innate and adaptive segments of the immune system. In particular, it is centrally controlled by T cells, in which an important role is played by T-helper 1, Th17 and Th22, interplaying with numerous cell types via different cytokines, including tumour-necrosis factor- , IL-6 and IL-17 . The activity of these cells is modulated by specific T lymphocytes, named regulatory T cells . Regulatory T cells are able to inhibit the immunological response and to preserve the cutaneous immunological homeostasis, preventing autoimmune response against self-antigens .
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What Form Of Vitamin D Is Best For Psoriasis
Before we dive into exactly how Vitamin D is effective for dealing with psoriasis, we need to understand the type of Vitamin D that has got the power!
There are only two forms of Vitamin D that one can get: Vitamin D3 or D2.
Vitamin D2 is a common additive in dairy products and other popular commodities, but it is actually a form of calcium that our bodies cannot easily process and ends up causing more harm than good!
Vitamin D3 on the other hand is excellent for us and is known as the active form of Vitamin D, readily available for our bodies to use instantaneously. Other names for the correct form of Vitamin D3 are 1,25-dihydroxycholecalciferol or 1,25- dihydroxyvitamin D3.
Yes, thats ridiculous long but thanks to your copy-and-paste functions, at least you wont need to know how to spell it. And yes, thats the one you should get.
Treatment Of Genital Psoriasis In The Pediatric Population
A total of 12 articles examined treatments for genital psoriasis in infants and children . Three of these articles were open-label studies , while the remaining ten were case reports describing the effects of treatment on pediatric patients. Treatment outcomes were described for a total of 126 patients. Mild, topical coal tar preparations were effective in clearing genital lesions among 91 pediatric patients from two case series .
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Vitamin D Treatments Target Psoriasis
Study Helps Explain How Ultraviolet Light Therapy and Vitamin D Creams Treat Psoriasis
May 12, 2011 — Ultraviolet light therapy and vitamin D creams are widely prescribed treatments for psoriasis, and now a new study may help explain why they work for so many patients.
Researchers say the vitamin D-based treatments increase the binding of a peptide called cathelicidin to DNA, which, in turn, inhibits the inflammatory response that triggers psoriasis.
The finding may one day lead to better treatments for the painful skin condition that specifically target cathelicidin, study researcher Jurgen Schauber, MD, of Ludwig-Maximillian University in Munich, Germany, tells WebMD.
âWe were able to identify a novel, pro-inflammatory signaling pathway which helps us understand why treatments work,â he says.
Topical Vitamin D In Psoriasis Treatment
The therapeutic effects of topical vitamin D occur via a VDR mediated genomic mechanism resulting in inhibition of keratinocyte proliferation and mediated non-genomic mechanisms inducing keratinocyte differentiation by increasing intracellular calcium levels . The anti-inflammatory effects may also result from inhibition of production of IL-2, IL-6, and interferon-gamma . Further, topical calcipotriol inhibits human beta defensin and proinflammatory cytokines which are found in increased levels in psoriatic lesions . Allelic variations in individual VDR genes may determine a different response to treatment: the isoform A of VDR is associated with a greater therapeutic response in psoriatic patients .
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The Sitch With Supplements: How Much Vitamin D Should You Take For Psoriasis
An easy way to get a daily dose of D are supplements that come in both liquid and pill forms. Just make sure you chat with your doctor before adding a supplement to your routine. They can test your vitamin D levels and help you pick the right dosage.
For adults, the daily recommended dietary allowance for vitamin D is 15 micrograms .
Its best to opt for a lower dose at first and gradually increase your amount over time with your docs blessing. Just make sure youre not exceeding the upper limit of 100 micrograms a day. Too much vitamin D can be toxic.
Supplements not your thing? You can also get that sweet D through foods, like:
- tuna or other fatty fish
- gels
- lotions
According to the American Academy of Dermatology topicals in general can be helpful in treating psoriasis for those with less than 5 percent of the body affected. If you have more severe psoriasis, they suggest combining topicals with other psoriasis treatments.
Vitamin D For Psoriasis: How To Get More This Winter
People with plaque psoriasis often have lower than normal levels of vitamin D. Heres how to get all the D you need safely.
Nadine Greeff/Stocksy
Vitamin D is best known for its power to build and strengthen bone. Thats because its chief job is to help the body absorb calcium, one of the main building blocks of bone.
But vitamin D is crucial for many other reasons, including helping the immune system function, according to the National Institutes of Health.
This may explain the connection between vitamin D and psoriasis, a disorder of the immune system. Researchers have found that people with plaque psoriasis often have lower than normal levels of vitamin D, says the Mayo Clinic.
Not having enough vitamin D doesnt necessarily cause psoriasis, says Suzanne Olbricht, MD, the chief of dermatology at Beth Israel Deaconess Medical Center in Boston. But vitamin D deficiency may be a contributing factor, because it impairs the immune systems ability to keep skin healthy.
One way to get more vitamin D, the so-called sunshine vitamin, is to get outside for 10 minutes at midday, according to the National Psoriasis Foundation , since enzymes in skin can convert UV rays to vitamin D.
Fortunately, there are multiple ways for people with psoriasis to get the recommended daily dose of vitamin D, which according to the American Academy of Dermatology is 600 international units for people ages 1 through 70 and 800 IU for adults 71 and older.
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Is Vitamin D Good For Psoriasis
You can get vitamin D from food or supplements, but your body mainly creates Vitamin D from the sun .
Unfortunately, its pretty easy to develop a vitamin D deficiency if you live in a cloudy climate . Its estimated that about 41 percent of Americans have a vitamin D deficiency, which can lead to a weak immune system.
Research also suggests psoriasis may be linked to vitamin D deficiency. Those with psoriasis often have low levels of vitamin D. And because vitamin D helps keep your immune system in tip-top shape, not getting enough can leave you vulnerable to skin and health probs.
Fortunately, boosting your vitamin D intake may help relieve or eliminate psoriasis symptoms.
Heal With Vitamin D Medication For Psoriasis
Very often, treatment starts with topical creams and ointmentsproducts you put on your skin. Studies show that vitamin D ointment works as well as strong anti-inflammatory topical medications called corticosteroids. In fact, a combination of the two types of prescription medications is even more effective. One example of a vitamin D ointment is calcipotriene . Its usually applied twice a day to psoriasis plaques, the red areas of skin covered by silvery scales.
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Why Dermatologists Prescribe Synthetic Vitamin D To Treat Psoriasis
Synthetic vitamin D can:
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Slow rapidly growing skin cells
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Flatten thick psoriasis
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Synthetic vitamin D is considered safe for most patients, including children
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It clears psoriasis in some patients, including patients who have scalp psoriasis
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Most people notice an improvement after using it for two weeks
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If a patient needs stronger medicine, synthetic vitamin D can be safely combined with a strong corticosteroid
Studies show that using both tends to be more effective than using either medication alone.
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Using both synthetic vitamin D and a corticosteroid can also reduce the possible side effects that come with using a strong corticosteroid
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The combination can be used for much longer than a strong corticosteroid alone
When To Change Things Up
Many topical treatments can bother your skin. So over time, your doctor may suggest that you switch to different types of creams. You may also use them along with other kinds of treatments, like or medications you take by mouth or with shots.
And don’t be surprised if something that was working stops — or something thatâs never helped before starts to do some good. Let your doctor know what makes a difference and what doesnât. Together, you can find the treatment that’s right for you.
Before using topical treatments, make sure you understand the directions and the side effects they can cause. And stick with your treatment plan once you start. If you don’t use your medication regularly, your psoriasis could get worse.
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Buying Psoriasis Creams Over The Counter
You can readily buy emollients in a pharmacy, but medicated creams will typically require a conversation with the pharmacist or a prescription from your doctor.
Coal tar shampoos, including polytar shampoo, which are a treatment for scalp psoriasis, are usually available to buy without speaking to a pharmacist.
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Vitamin D And Psoriasis Linkage
In psoriasis, vitamin D is involved in the maintenance of cutaneous barrier homeostasis. Several studies identified an association between polymorphisms of vitamin D receptor and psoriasis susceptibility . Richetta et al., have found that the A-1012G promoter polymorphism of the VDR gene is associated with psoriasis risk through a lower expression of VDR mRNA, favoring conditions that may alter cutaneous barrier and the development of psoriatic lesions . In addition, in psoriatic skin a decreased expression of VDR and reduced tight-junction proteins is associated . Tight junctions are fundamental to regulate adhesion and permeability of keratinocytes, and to polarize cutaneous cell differentiation, to regulate extracellular calcium gradient, interacting with nuclear and cytoplasmic proteins and influencing the regulation of specific genes involved in keratinocytes differentiation and proliferation . Different studies have focused on the possible role of low vitamin D status in the pathogenesis of psoriasis .
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