Why There Isn’t a Medical Procedure to Remove Psoriasis

From verywellhealth.com

No official surgery is available to remove the plaques and scales caused by psoriasis, but various treatments are available. People can choose from topical creams or emollients, phototherapy, and other medications to suit their preferences and needs.

This article discusses possible treatment options and the aim of medical procedures in treating psoriasis.

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A Psoriasis Medical Procedure Doesn’t Exist

No medical procedure exists to cure or treat the symptoms of psoriasis. The skin symptoms that develop do so because of issues with inflammation and an overproduction of skin cells.

Research from the 1980s shows that surgery was once used to remove the plaques in people with psoriasis. However, that method is no longer considered an option because systemic changes in the body are what causes the rash associated with psoriasis, and simply removing the plaques does not solve that.

Skin Treatment Seeks to Reduce Autoimmune Symptoms

Psoriasis is an autoimmune disease. The symptoms develop because the immune system mistakes healthy cells for harmful pathogens. When that happens, immune cells attack and damage healthy skin cells perceived as dangerous.

As a result, the deepest layer of skin, known as the hypodermis, begins to speed up skin cell production. This starts a cycle of more skin cell development, triggering an even stronger immune response. That cycle drives the symptoms of psoriasis.

Current treatments focus on the immune response instead of the physical skin symptoms. Medications can hinder the action of the immune system and the reproduction of skin cells lowering the rate at which plaques are formed.

Do Any Current Treatments Cure Psoriasis?

While current therapies for psoriasis can effectively help manage the condition, none can cure someone's symptoms completely. People with active treatment plans may go through periods with little to no signs of psoriasis. When that happens, it is referred to as remission. Psoriasis remission typically lasts anywhere from one to 12 months, but some people may experience clear skin free of plaques for years with the proper treatment.

Psoriatic Arthritis Medical Procedures

While the skin symptoms of psoriasis aren’t treated using surgery, psoriatic arthritis can be. Psoriatic arthritis is a progressive disease that occurs in roughly one-third of everyone with psoriasis. The skin symptoms are still present in psoriatic arthritis, but other signs of the disease can include:

• Joint pain
• Damage to the joints
• Pain in the back or feet
• Swollen fingers and toes
• Fatigue

Because of how the joints are affected, surgery for psoriatic arthritis may be an option for some with the condition. Surgery is typically reserved for people with severe joint damage. In the event someone does have a medical procedure, three possible surgical interventions are available:

• Total joint replacement, such as shoulder replacement or hip replacement 
• Joint fusion, which involves fusing bones to fix a joint
• Synovectomy, which consists of removing the membrane (synovium) that lines the joints to help ease any pain a person is feeling from the condition

How Often is Surgery Used for Psoriatic Arthritis?

According to research, as many as 60% of people with the condition will need to undergo some type of surgery to help relieve pain in the affected joints.

How Psoriasis Is Treated

There are several treatment options available for people with psoriasis. The effectiveness of each will depend on a person’s individual case. Treatment options include:

• Over-the-counter (OTC) remedies: Certain OTC creams and ointments can help with mild cases.
• Topical Corticosteroids: Corticosteroids are used to hinder inflammation and itching associated with skin conditions.
• Topical retinoids: Retinoids can help to slow down the growth of excess skin cells.
• Immunosuppressants: Medications designed to slow down the immune system's overreaction are often used in psoriasis. They can be taken orally, through an injection, or as a topical ointment or cream.
• Biologics: Biologics are often reserved for severe cases of psoriasis and work by blocking reactions that drive psoriasis plaque development.
• Phototherapy: Phototherapy uses ultraviolet (UV) light to help slow the production of skin cells while reducing inflammation.

Future Psoriasis Treatments on the Horizon

Medical researchers are working tirelessly toward new and effective medications for psoriasis. Some up-and-coming options for people with the condition include:

• Deucravacitinib, an oral, allosteric TYK2 inhibitor that works by blocking certain immune proteins for better disease management
• Tapinarof, a steroid-free biologic topical cream that works by hindering inflammation pathways within the body
• Roflumilast, a topical PDE4 inhibitor that works by increasing the number of pro-inflammatory mediators in the body to reduce inflammation

Other Types of Surgery: What’s Safe With Psoriasis?

If a person has psoriasis and needs surgery for another health affliction, they may wonder whether it's safe to have their plaques cut into during the procedure. While surgery with psoriasis is safe, some healthcare providers may suggest waiting until a flare has cleared up before proceeding. That is for a couple of reasons.

Some medications taken by people with psoriasis can increase the risk of developing complications after surgery, such as a severe infection. One specific drug, methotrexate, an immunosuppressant, is the most likely to be associated with adverse outcomes after surgery.

Surgery also comes with an added risk of a psoriasis flare in people who have controlled their condition using treatment. When that happens, it is referred to as the “Koebner phenomenon.” It essentially describes an injury to the skin that causes psoriasis symptoms to develop.

Summary

No surgery is dedicated to removing the plaques and scales associated with psoriasis. There are, however, other treatments, such as creams, lotions, phototherapy, and medications to suppress the action of the immune system.

That said, psoriatic arthritis is often treated using surgical methods. The future outlook for psoriasis treatment is positive, and new drugs are being developed to help further help those with the disease enter remission.

https://www.verywellhealth.com/psoriasis-medical-procedure-7099238