Our Psoriasis Treatment Center is one of the most highly regarded in the United States. The center includes specialized clinics for psoriasis sufferers with all forms of psoriasis, with over 1,000 patients currently receiving systematic (internal) therapies through our dedicated team of psoriasis specialists (doctors, physician's assistants, and nurses). In addition, we also provide specialized light and laser treatment facilities.

Our staff are very knowledgable in the use of the various systemic and biologic medications and therapy protocols used for moderate to severe psoriasis. Dr. Alan Menter and members of the Texas Dermatology staff have been deeply involved during the past 25 years with clinical research studies for a host of new medications that are revolutionizing psoriasis treatment today.

A webcast program "The New World of Psoriasis Treatment: Could This Be the Answer for You?" aired on www.healthtalk.com on October 9, 2002. Dr. Alan Menter participated in this program with Dr. Alice Gottlieb, Professor of Medicine at the University of Medicine of New Jersey, regarding the introduction of biologic drugs, 5 of which are currently approved in the USA.

Patients with the milder forms of the disease may have only a few localized small patches. However, many patients suffer from more extensive disease covering larger parts of the body surface. In addition, up to 25% of patients with the skin form of psoriasis will also develop psoriatic joint disease (arthritis), which again may affect only a few areas (e.g. fingers or toes) or produce more severe joint disease affecting multiple joints, both small and large.

Tremendous strides have been made in the last 10 years in our understanding of the causes of psoriasis, including the role of the immune system, as well as the finding of the genes associated with a susceptibility to develop psoriasis. In fact, our staff played a major role in this psoriasis research with the finding of the first gene for psoriasis, published in Science in 1994. (reference: Tomforhde J, Bowcock A, Menter A, et al. Gene for familial psoriasis: susceptibility mapped to the distal end of human chromosome 17q. Science 1994; 264:1141-1145). Along with this understanding has come the development of several biologic drugs. Our research and clinical staff have played a significant role in the development of all the new biologics currently in clinical use and in both early and advanced stages of clinical trials.

Psoriasis Treatment

1. For milder forms of psoriasis involving only discrete, localized patches of psoriasis, a number of topical preparations are available. These include

   a. topical steroid creams, lotions, gels, foams, sprays and ointments
   b. topical tar preparations
   c. topical vitamin D3 preparations and cominations
   d. topical vitamin A preparations and cominations

   These may be used either singly or more frequently in combination with each other. Our expert nursing staff will explain all the details of how these should be applied and used.

2. For more moderate forms of psoriasis, where the use of topical agents would be difficult on a daily basis, or where topical agents have proved disappointing in maintaining long-term control, various forms of psoriasis light treatments are available. These include the new Narrow Band UVB unit that has proven significantly more effective than the older "Broad Band" UVB unit, as well as PUVA therapy in which an oral medication (oxsoralen) is taken 1-hour and 15 minutes prior to exposure to a specialized UVA light unit. Both these treatments are given up to 3 times a week, initially, and are likely to significantly improve the majority of patients with the moderate forms of psoriasis. Topical medications may be utilized in combination with these light treatments to clear resistant areas such as scalp and body folds that would not be exposed to the lights.

3. Individuals with mild to moderate psoriasis, who have tried topical treatments and/or other therapies without success, may benefit from our XTRAC Excimer Laser treatment. The laser emits a carefully focused beam of light concentrated only on the psoriasis lesion. This allows the care provider to deliver high doses of light to the exact lesion spot, minimizing exposure of healthy skin to random ultraviolet rays.

4. For moderate to severe forms of psoriasis, we currently have a number of FDA-approved systemic medications:

a. Systematics (by oral route)
	- Methotrexate	(approved since 1971), given weekly
	- Cyclosporine	(used in short courses), also utilized in transplant patients as an anti-rejection drug
	-Soriatane	(a vitamin A – derived medication)
b. Systematics (by oral route)
	- Remicade	(an IV - administered therapy)
	- Enbrel	(self-injectable)
	- Raptiva	(self-injectable)
	- Humira	(self-injectable)
	- Amevive	(injectable biologic - given in our clinic)

In our psoriasis treatment clinic we currently utilize these drugs, either singularly or in combination with light treatments in over 1,000 patients from a wide geographic area, particularly in the Southwestern states. These drugs must be utilized carefully accordingly to protocols established by our staff with laboratory (blood tests) evaluations at intervals of 1 to 3 months to ensure optimal clinical response and to ensure safety, both in the short-term and the long-term. The majority of patients using these drugs will experience significant improvement, both in the clearing of their psoriasis patches, as well as in the improvement in their quality of life, which can certainly be impacted negatively by this chronic, life-long disease.

Our Commitment to Psoriasis Research and New Treatments

Dr. Alan Menter is the President of the International Psoriasis Council, comprising the major “thought-leaders” in psoriasis around the world. We have investigated both the genetics of psoriasis, as well as the therapy of psoriasis for the past 25 years. The National Psoriasis Gene Bank was originally based at the clinic at Baylor, Dallas with Alan Menter, M.D. as Clinical Director. Families with psoriasis were assembled from all over the U.S. and blood samples taken to research the genetic basis for psoriasis. The first International Consortium meeting for the Genetics of Psoriasis was held in Dallas, sponsored by the National Psoriasis Foundation in 1994.

For more information about Psoriasis, please visit: www.psoriasis.org

Research

We are closely affiliated with the Baylor Research Institute where Alan Menter, MD is the Director of the Psoriasis Research Unit and Dan McCoy, MD is the Assistant Director. All patients will be provided the opportunity to discuss various research opportunities and to participate in new research programs as appropriate and desired.

Publications

Our staff has contributed over 223 articles in prestigious medical journals, nationally and internationally, written books about Psoriasis, as well as lecturing extensively teaching their colleagues about psoriasis worldwide.