Terapijski pristup psorijazi – prvi dio: lokalni pripravci. (Croatian)

Therapeutic Approach to Psoriasis – Part One: Topical Drugs. (English)

Psoriasis is an immune-mediated chronic inflammatory skin and joint disease. Psoriasis vulgaris, also known as chronic plaque psoriasis, is the most common type of psoriasis and is characterized by the appearance of erythematous squamous plaques accompanied by itching. Guttate psoriasis, erythrodermic and pustular psoriasis, and psoriasis associated with psoriatic arthritis are less common forms of psoriasis. Clinical scoring systems are used to assess the severity of the disease, which is important for selecting the appropriate therapy. Local therapy is the first line of treatment for mild to moderate psoriasis, while systemic therapy is indicated for more severe forms of the disease and patients who do not respond to local therapy or phototherapy. Combining local and systemic therapy, as well as phototherapy, is an option in some cases. According to the Croatian Dermatovenerological Society’s guidelines, the first line of topical treatment for psoriasis is a fixed combination of calcipotriol and betamethasone propionate once daily, with the option of proactive treatment twice a week. A fixed combination of calcipotriol and betamethasone propionate once or twice a week is recommended in maintenance therapy. Topical corticosteroids, followed by topical calcineurin inhibitors, are the treatment of choice for psoriasis of the face and intertriginous regions. Topical psoriasis treatment is essential in the treatment of mild to moderate psoriasis, but it also complements systemic therapy in patients with severe psoriasis [ABSTRACT FROM AUTHOR]

Psorijaza je imunološki posredovana kronična upalna bolest kože i zglobova. Najčešći oblik psorijaze jest vulgarna ili kronična stacionarna psorijaza, a očituje se pojavom eritematoznih plakova prekrivenih srebrnkastim ljuskama, praćenih svrbežom. Rjeđi oblici psorijaze jesu kapljičasta, eritrodermijska i pustulozna psorijaza te psorijaza praćena psorijatičnim artritisom. Procjena težine bolesti vrši se pomoću kliničkih bodovnih sustava, a važna je zbog odabira prikladne terapije. Prvu liniju liječenja blage do srednje teške psorijaze čini lokalna terapija, dok je kod težih oblika bolesti te pacijenata koji nemaju adekvatan odgovor na lokalnu terapiju ili fototerapiju, indicirana sustavna terapija. Postoji mogućnost kombiniranja lokalne i sustavne terapije, a u određenim slučajevima i fototerapije. U skladu sa smjernicama Hrvatskog dermatovenerološkog društva prva linija lokalnog liječenja psorijaze jest fiksna kombinacija kalcipotriola i betametazon propionata jednom dnevno uz mogućnost proaktivnog liječenja dva puta tjedno. U terapiji održavanja prvenstveno se preporučuje fiksna kombinacija kalcipotriola i betametazon propionata jednom ili dva puta tjedno. U slučaju psorijaze lica i intertriginoznih regija preporučuje se započeti liječenje lokalnim kortikosteroidima, a potom nastaviti s lokalnim inhibitorima kalcineurina. Lokalni pripravci u liječenju psorijaze neizostavan su dio liječenja blage do srednje teške psorijaze, ali i potpora liječenju težih oblika psorijaze uz sustavnu terapiju. [ABSTRACT FROM AUTHOR]

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