Psoriasis Help Organisation - Online Psoriasis Forum

DOVOBET 

What is it?
 
Dovobet is a topical ointment for plaque psoriasis. It is a stable combination of calcipotriol (as in Dovonex) and betamethasone dipropionate (a potent corticosteroid). It is available in 60gm and 120gm tubes and is manufactured by Leo Pharmaceuticals.
 
Who is it for?
 
For patients with severe plaque psoriasis covering no more than 30% if their body. It is NOT recommended for those with erythrodermic, pustular or guttate psoriasis. It is not licensed for pregnant women or for children under the age of 18. Due to the potency of the steroid, it is not advisable to use Dovobet on the face, genital areas or the scalp.
 
How does it work?
 
Both of the above ingredients are widely used, in their separate forms, for the treatment of psoriasis. Dovobet combines the two in a form that does not degrade either ingredient and allows both to work effectively together. The calcipotriol regulates and inhibits cell growth – therefore lessening the flaking of the psoriasis patches. The steroid part of the ointment has an anti-inflammatory property – therefore lessening the redness and raised look of the patch.
 
How do I use Dovobet?
 
Dovobet is applied directly to the psoriasis. 
 
Current guidelines recommend that:
 

It should not be used for any more than 4 weeks in one treatment

SJ July 2004

Climatotherapy

• Sunlight can have a beneficial effect on psoriasis. Climatotherapy has been used for many years in the Dead Sea, Israel, and the Canary Islands, Spain, with good results.
  

DEAD SEA ALTERNATIVE

History

Two thousand years ago, the historian Josephus Flavius wrote that "one should praise the Dead Sea; this salt brings healing to the human body." This is still true today as thousands of visitors flock to the area to sample the incredible natural healing powers of the Dead Sea. 

The Dead Sea at 400 meters below sea level is the lowest point on earth and part of the Great Rift Valley. The water has a 33% concentration of salt (3% in the ocean) and minerals such as calcium, potassium, sodium, magnesium and bromide. The high salt and mineral concentration allows everyone to float in its waters. Most visitors take home the "floating on the water reading the Jerusalem Post" photo. 

The sunshine in this area is unique. Due to the water evaporating quickly in the intense heat, the Dead Sea has its own ozone layer hanging over it. The haze helps to filter out more of the damaging ultraviolet rays that can cause skin cancer, burning and ageing. This allows the duration of exposure to be dramatically increased. Very few people will suffer sunburn if careful progressive exposure is practiced and the hours of 11am to 2pm are avoided. 

The air is extremely dry, unpolluted and pollen free. With the high levels of bromide in the air, and 10% more oxygen, this induces total relaxation and makes breathing much easier.

You have a choice of travelling to either Israel or Jordan.

Dithranol (also known as anthralin in certain parts of the world)

Dithranol can be effective for mild to moderate psoriasis and is often used with ultraviolet B (UVB) treatments for more severe psoriasis.

•  Dithranol Ointment BP in yellow soft paraffin with strengths between 01-2%. PO over 1% dithranol.
•  Dithranol Paste BP in zinc and salicylic acid (Lassar’s paste) with strengths between 01-1% dithranol.
  
• Dithrocream (Dermal)

Cream containing dithranol 0.1%. For skin and scalp application. Under 0.5% suitable for overnight treatment/over 0.5% maximum 1 hour contact. PO over 1% dithranol. 

• Micanol (Bioglan)

Cream containing dithranol 1%. A 3% version is used on an in-patient basis. NOTE: 30 minute maximum contact time. 

• Psorin (Ayrton Saunders)

Ointment containing dithranol 0.11%, coal tar 1% and salicylic acid 1.6% and scalp gel containing dithranol 0.25%, salicylic acid 1.6%.

Coal Tars

Topical coal tars have helped treat psoriasis for centuries and can be used by themselves or combined with UVB. By making the skin more sensitive to UV light, coal tar can cause a greater sensitivity to burning when combined with UV therapy. 

However, tars cause staining and coal is also a designated carcinogen (COSHH - Committee of Substances Hazardous to Health, UK).

Mycophenolate Mofetil/Cellcept – Roche Labs.

What is it?

Cellcept is a powerful immunosuppressant created initially for use in preventing the rejection of organ transplants.

It works by blocking the action of a compound within the body which is required for producing T and B lymphocytes – the immune cells responsible for regulating and triggering immune responses.

Who is it for?

Moderate to severe plaque psoriasis sufferers who are non-responsive to other lines of treatment. It is also used by dermatologists for the treatment of other skin conditions.

How is it taken and how much do I take?

MMF is available in 250mg capsules and 500mg tablets. The amount taken is derived partly by weight and partly by response. The average dose can lie anywhere between 1 and 3mg daily and is split into two doses – one AM and one PM and should be taken with water only.

As with all strong drugs, care should be taken by the patient to make sure they are taking the correct amount.

Tablets should not be crushed and capsules not opened. If the powdered form comes into contact with the skin, eyes or mucus membranes wash immediately.