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Patrick Teer, M.D., practices with Mac Jones, M.D., at the Dermatology Clinic of Jackson, which they founded in September 2010. Before that, their practice was a part of Medical Specialty Clinic. Both physicians are board certified. For an appointment call 31.422.7999 or visit www.dermjax.com.


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New drugs, therapies make it easier to treat psoriasis

It’s a skin condition right out of a horror movie. Or just an inconvenient, scaly red plaque. Skin cells grow abnormally — too fast and stuck together — and cause red, raised, thick plaques on the skin. For some people, so much skin sheds from these plaques that they vacuum their home’s rugs two and three times a day. For others, the plaques are so thick on their hands, they find it hard to bend their fingers.

The inflammatory skin condition is psoriasis. Some three to five million people have it, and many of them are too embarrassed to let others know they have it.

“In a sense it’s a hidden condition,” says Dr. Patrick Teer, a board-certified dermatologist practicing at Dermatology Clinic of Jackson. Some find the thick, flaking plaques of psoriasis devastating, he explained.

“They won’t wear shorts, go swimming or go to the beach. They go to the grocery store at night so no one sees them. They change the way they live to cover up and mask it. It affects some patients’ lifestyles enough they may not even seek out a job.”

Red thick plaques of psoriasis can show up on any part of the body.

Psoriasis worse in cold weather
Psoriasis can hit all ages, but it mostly occurs in adults. It tends to flair up in the winter and get better in the summer when there is more humidity and sunlight. “Some people don’t get it every winter,” says Dr. Teer, “and for some people, psoriasis never goes away.”

The condition is not contagious, though it may be hereditary. About eight percent of the children whose parents have psoriasis are likely to develop it.

It’s common on elbows, knees and in the scalp, but it can show up anywhere on the body. Nails get thick and break away; the disease also shows up as little pits or holes in the nails. About 25 percent of people with psoriasis also get inflammation of the joints, an internal manifestation of the disease.

Unlike eczema or dermatitis, psoriasis usually doesn’t itch. It is unsightly and can be painful, though, which is why most people seek treatment, says Dr. Teer.

Normally, people replace skin cells and get a new set of skin every 90 days or so. With psoriasis, that normal rate speeds up, as if the skin cells are running amuck. Though scientists don’t exactly know what causes psoriasis, they have discovered that with psoriasis the signals between skin cells are elevated, Dr. Teer adds. “If we block the signal, we can change the cell back to growing normally.”

The good news
The good news is that advancements in medications, such as topical steroids, and other therapies are making it easier to treat psoriasis, he says.

Dr. Teer outlines two major kinds of treatment:
• Local therapies, which are aimed at specific areas of the body. These include topical therapies (steroids, vitamin D analogs and retinoids), injections into the psoriasis and light therapy with the EXTRAC UVB wavelength laser.
• Systemic treatments, which include light therapy for the whole body, oral medications and shots. When the topical therapies don’t work or if the patient has too much skin covered with psoriasis, Dr. Teer tries systemic treatments.

Patients have had great success with the topical therapies or a combination of them, says Dr. Teer. “Each (steroids, vitamin D analogs and retinoids) has an intranuclear or DNA receptor that re-regulates how the skin cells grow.”

“With local EXTRAC light therapy, we use the most beneficial wavelength of the sun in a very specific spot treatment,” he adds. “Patients come in two to three times a week. An average of 16 treatments will induce remission for up to six months.”

PUVA and UVB are the two forms of systemic light therapy. Patients come in three to five times a week and are typically in remission after 30 treatments.

“We’re the only clinic in town to have the EXTRAC laser and be able to give two forms of light therapy onsite,” Dr. Teer said. Because light therapy increases the risk of skin cancer and may cause wrinkles, this therapy is designed for patients who have a lot of psoriasis coverage.

Systemic medications to treat psoriasis include acitretin, cyclosporine and methotrexate. They also include a new type of drug, called biologics, which are protein based and interfere with the way the skin cells talk to one another. The biologics are given by injection at home by the patient, at the doctor’s office or at an infusion center.

Each form of treatment has its pros and cons, but each form also has seen great success in clearing the skin of psoriasis, said Dr. Teer. “For patients with psoriasis, this is good news. Their lives can really change after treatment.”