From the FDA Drug Label
To treat moderate to severe chronic (lasting a long time) plaque psoriasis (Ps) in adults who have the condition in many areas of their body and who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet light alone or with pills). The treatment for knuckle psoriasis may include adalimumab (SQ), as it is used to treat moderate to severe chronic plaque psoriasis in adults. However, it is essential to consult a doctor to determine the best course of treatment, as knuckle psoriasis is not explicitly mentioned in the drug label 1.
- Key points:
- Adalimumab (SQ) is used to treat plaque psoriasis.
- Consult a doctor to determine the best treatment for knuckle psoriasis.
- Clobetasol (TOP) is a topical corticosteroid that may be used to treat psoriasis, but its use for knuckle psoriasis is not explicitly stated in the drug label 2.
From the Research
Treatment for knuckle psoriasis typically involves a combination of topical medications, such as topical corticosteroids like betamethasone or clobetasol, and vitamin D analogs like calcipotriene, to reduce inflammation and itching, as well as lifestyle modifications to manage symptoms and prevent flares 3.
Key Treatment Components
- Topical corticosteroids, such as betamethasone or clobetasol, are often the first-line treatment, applied twice daily for 2-4 weeks to reduce inflammation and itching.
- Vitamin D analogs, like calcipotriene (Dovonex), can be combined with topical corticosteroids to enhance effectiveness while minimizing steroid side effects.
- For persistent cases, topical retinoids like tazarotene may be prescribed.
- Keeping the affected skin moisturized with fragrance-free creams is essential, applied multiple times daily, especially after washing hands.
- Protecting knuckles from trauma and cold weather is important as these can trigger flares.
Systemic and Phototherapy Options
- For moderate to severe cases that don't respond to topical treatments, oral medications like methotrexate (starting at 7.5-15mg weekly) or biologics such as adalimumab or secukinumab may be necessary.
- These treatments work by targeting specific parts of the immune system that drive psoriasis.
- Phototherapy using UVB light can also be effective for knuckle psoriasis, typically administered 2-3 times weekly for several weeks.
Importance of Consistent Treatment and Protection
- Since knuckle psoriasis can be particularly challenging due to frequent hand washing and exposure, consistent treatment and protection are crucial for managing symptoms.
- A study on the efficacy and safety of clobetasol propionate spray in the treatment of plaque-type psoriasis found it to be effective and safe in reducing scaling, erythema, plaque elevation, and overall disease severity 4.
- Another study on the mechanisms of action of topical corticosteroids in psoriasis highlights the importance of tailoring treatment to the individual patient's needs and expectations 5.