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The Role Of Salicylic Acid In The Treatment Of Psoriasis

M. Lebwohl
Published 1999 · Medicine

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Psoriasis is a chronic, relapsing disorder in which the skin becomes scaly and inflamed; it affects 1–3% of the population of the U.S.A.1 In addition to classic plaque psoriasis, the condition can present in a variety of forms, including guttate, erythrodermic, inverse, and pustular psoriasis.1 Plaque psoriasis is characterized by hyperproliferation and poor differentiation of epidermal keratinocytes, by inflammation of the epidermis and dermis, and by profound alterations in the cutaneous vascular system.2 At one time, these changes were thought to be triggered by a dysfunction of keratinocytes, which then secondarily activated the delayed hypersensitivity response.3 Recent findings, however, suggest that the mechanism is primarily immunological. The observation that drugs such as cyclosporine and methotrexate can reduce the symptoms of psoriasis,4 combined with the discovery of activated, proliferating T-cell infiltration in epidermal plaques,5 strongly suggests that the disorder is due to alterations in the cell-mediated immune response. Psoriasis, however, is still not curable, and existing therapies focus on the control of its symptoms. Patients seek therapy to relieve pain and itching, which can be disabling, and to ameliorate cosmetic disfigurement. The goal of current psoriasis therapies, in short, is to minimize the severity and extent of the disease and its concomitant interference with quality of life.6 Today there are many therapies for psoriasis, all with varying degrees of effectiveness and safety. Salicylic acid is one commonly used topical agent;6 however, although salicylic acid has been known for more than a century,7 there is a remarkable lack of published data on its use in psoriasis. To assess the role of salicylic acid in the treatment of psoriasis, a consensus panel was convened at a roundtable discussion held in New York City on July 29, 1997. The results of this roundtable, including guidelines for the use of salicylic acid in psoriasis, will be presented in this review.
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