What are the latest treatments for eczema and psoriasis?
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Latest Treatments for Eczema and Psoriasis
Introduction to Eczema and Psoriasis Treatments
Eczema and psoriasis are chronic inflammatory skin conditions that significantly impact patients' quality of life. Recent research has focused on developing new treatments that are both effective and have fewer side effects compared to traditional therapies. This article synthesizes the latest findings on treatments for these conditions.
Topical Treatments: Boswellic Acids and Herbal Creams
Boswellic Acids for Eczema and Psoriasis
A novel topical formulation containing boswellic acids (Bosexil®) has shown promising results in treating both psoriasis and erythematous eczema. In a double-blind study, Bosexil® significantly improved scales and erythema in psoriasis patients and reduced itch and erythema in eczema patients without any cases of worsening symptoms1. This suggests that boswellic acids could be a viable alternative to traditional treatments.
Herbal Creams with Dipotassium Glycyrrhizinate
Another study evaluated a cream containing dipotassium glycyrrhizinate (DPG-HERB), Vaccinium myrtillus, epigallocatechin gallatyl glucoside, and Tamarindus indica. This herbal cream demonstrated significant improvements in eczema severity and skin biophysics, comparable to 0.1% triamcinolone acetonide (TA) cream. However, it was less effective in treating psoriasis, particularly in reducing erythema and improving transepidermal water loss (TEWL)2. This indicates that while DPG-HERB is effective for eczema, it may not be as beneficial for psoriasis.
Systemic Treatments: Biologics and Small Molecules
Biologics and Eczematous Reactions
Biologic therapies, particularly IL-17 inhibitors like ixekizumab and secukinumab, are effective for moderate-to-severe psoriasis but can induce eczematous reactions in some patients. These reactions occur in up to 12.1% of patients and may necessitate discontinuation or switching of biologic therapy3 6 8. This highlights the need for careful monitoring and management of side effects in patients receiving biologics.
Dihydrochalcone Derivatives from Populus Balsamifera
Research on dihydrochalcone derivatives from Populus balsamifera L. buds has shown these compounds to be effective in slowing down cell growth and regulating key proteins involved in psoriasis. These derivatives also exhibit anti-inflammatory and antioxidant properties, making them a promising topical treatment for psoriasis4.
Traditional and Alternative Therapies
Coal Tar and PUVA Therapy
Despite concerns about carcinogenicity, coal tar remains a second-choice topical therapy for both eczema and psoriasis, particularly in the Netherlands and Belgian Flanders. PUVA (psoralen and ultraviolet A) therapy is also frequently prescribed, especially in Flanders, despite its known risks5. These traditional therapies continue to be relevant, although their use varies by region.
Corticosteroids Under Occlusive Dressings
A study demonstrated that a single application of corticosteroids under a hydrocolloid occlusive dressing for one week could effectively treat various dermatoses, including psoriasis and chronic lichenified eczema. This method showed significant improvement in lesions, making it a practical option for severe cases7.
Conclusion
The latest treatments for eczema and psoriasis include innovative topical formulations like boswellic acids and herbal creams, as well as systemic biologics and traditional therapies. While new treatments offer promising results, they also come with potential side effects that require careful management. Ongoing research and long-term studies are essential to fully understand the efficacy and safety of these treatments in real-world settings.
Sources and full results
Most relevant research papers on this topic
A cosmeceutical formulation based on boswellic acids for the treatment of erythematous eczema and psoriasis
A topical formulation of Bosexil® shows promising results for treating psoriasis and erythematous eczema, improving scales and itch without worsening.
RCT
Rigorous JournalEfficacy and Safety of Cream Containing Dipotassium Glycyrrhizinate, Vaccinium myrtillius, Epigallocatechin Gallatyl Glucoside, and Tamarindus indica Compared with Triamcinolone Acetonide Cream in Eczema and Psoriasis
DPG-HERB cream is safe and effective in treating eczema, but less effective in psoriasis compared to triamcinolone acetonide cream.
RCTIntegrated safety analysis of treatment‐emergent eczematous reactions in patients with moderate‐to‐severe psoriasis treated with ixekizumab, etanercept and ustekinumab
Ixekizumab is a safe treatment for moderate-to-severe psoriasis, but patients should be aware of treatment-emergent eczematous reactions and manage them appropriately.
Meta-AnalysisRigorous JournalDihydrochalcone Derivatives from Populus balsamifera L. Buds for the Treatment of Psoriasis
Dihydrochalcone derivatives from Populus balsamifera L. buds show promising antipsoriatic properties, potentially contributing to clinical improvement in psoriasis patients.
In Vitro StudyTreatment policy for psoriasis and eczema: a survey among dermatologists in the Netherlands and Belgian Flanders.
Topical corticosteroids are the mainstay for treating psoriasis and eczema, with coal tar as a second-choice therapy, and PUVA is frequently prescribed despite its carcinogenicity in Flanders.
Observational StudyPhenotypic switch to eczema in patients receiving biologics for plaque psoriasis: a systematic review
Biologics for chronic plaque psoriasis can cause a switch to atopic eczema, with atopic diathesis patients more at risk.
Systematic ReviewRigorous JournalTreatment of psoriasis and other dermatoses with a single application of a corticosteroid left under a hydrocolloid occlusive dressing for one week.
A single application of corticosteroid under a hydrocolloid dressing can effectively heal psoriasis and other dermatoses within a week, with betamethasone being the most effective treatment.
Non-RCTA Case Series of Patients With Eczematous Eruptions Following IL-17 Inhibitor Treatment for Psoriasis Vulgaris.
IL-17 inhibitor treatment for psoriasis may cause a paradoxical shift favoring an eczematous phenotype, potentially leading to eczematous eruptions in some patients.
Case ReportRecurrence of secukinumab‐induced eczematous eruptions after guselkumab treatment for pustular psoriasis
Secukinumab-induced eczematous eruptions can recur after switching to guselkumab for pustular psoriasis treatment, highlighting the need for careful monitoring of biologics.
Systematic ReviewSystemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis.
Systemic treatments for moderate to severe plaque psoriasis show mixed results, with biologics showing the most promise for long-term control.
Meta-Analysis
Very Rigorous Journal
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