The following information if from the National Institute of Health website1.
Systemic Treatment
For more severe forms of psoriasis, doctors sometimes prescribe medications that are taken internally by pill or injection. This is called systemic treatment.
Methotrexate. Like cyclosporine, methotrexate slows cell turnover by suppressing
the immune system. It can be taken by pill or injection. Patients taking
methotrexate must be closely monitored because it can cause liver damage and/or
decrease the production of oxygen-carrying red blood cells, infection-fighting white
blood cells, and clot-enhancing platelets. As a precaution, doctors do not
prescribe the drug for people who have had liver disease or anemia (an illness
characterized by weakness or tiredness due to a reduction in the number or
volume of red blood cells that carry oxygen to the tissues). It is sometimes
combined with PUVA or UVB treatments. Methotrexate should not be used by
pregnant women, or by women who are planning to get pregnant, because it may
cause birth defects.
Retinoids. A retinoid, such as acitretin, is a compound with vitamin A-like
properties that may be prescribed for severe cases of psoriasis that do not respond
to other therapies. Because this treatment also may cause birth defects, women
must protect themselves from pregnancy beginning 1 month before through 3
years after treatment with acitretin. Most patients experience a recurrence of
psoriasis after these products are discontinued.
Cyclosporine. Taken orally, cyclosporine acts by suppressing the immune system
to slow the rapid turnover of skin cells. It may provide quick relief of symptoms,
but the improvement stops when treatment is discontinued. The best candidates
for this therapy are those with severe psoriasis who have not responded to, or
cannot tolerate, other systemic therapies. Its rapid onset of action is helpful in
avoiding hospitalization of patients whose psoriasis is rapidly progressing.
Cyclosporine may impair kidney function or cause high blood pressure
(hypertension). Therefore, patients must be carefully monitored by a doctor.
Also, cyclosporine is not recommended for patients who have a weak immune
system or those who have had skin cancers as a result of PUVA treatments in
the past. It should not be given with phototherapy.
6-Thioguanine. This drug is nearly as effective as methotrexate and
cyclosporine. It has fewer side effects, but there is a greater likelihood of
anemia. This drug must also be avoided by pregnant women and by women who
are planning to become pregnant, because it may cause birth defects.
Hydroxyurea. Compared with methotrexate and cyclosporine, hydroxyurea is
somewhat less effective. It is sometimes combined with PUVA or UVB
treatments. Possible side effects include anemia and a decrease in white blood
cells and platelets. Like methotrexate and retinoids, hydroxyurea must be
avoided by pregnant women or those who are planning to become pregnant,
because it may cause birth defects.
Biologic response modifiers. Recently, attention had been given to a group of
drugs called biologics, which are made from proteins produced by living cells
instead of chemicals. They interfere with specific immune system processes which
cause the overproduction of skin cells and inflammation. These drugs are injected
(sometimes by the patient). Patients taking these treatments need to be
monitored carefully by a doctor. Because these drugs suppress the immune
system response, patients taking these drugs have an increased risk of infection,
and the drugs may also interfere with patients taking vaccines. Also, some of
these drugs have been associated with diseases (like central nervous system
disorders, blood diseases, cancer, and lymphoma) although their role in the
development of or contribution to these diseases is not yet understood. Dome
are approved for adults only, and their effects on pregnant or nursing women
are not known.
Antibiotics. These medications are not indicated in routine treatment of
psoriasis. However, antibiotics may be employed when an infection, such as
that caused by the bacteria Streptococcus, triggers an outbreak of psoriasis, as
in certain cases of guttate psoriasis.
Topical Treatment
Light Therapy
Combination Therapy and Psychological Support
Promising areas of Psoriasis research
1 http://www.niams.nih.gov/Health_Info/Psoriasis/default.asp
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