Fototerapia en combinación con otras terapias en psoriasis

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Artículo de revisión
Rev Asoc Colomb Dermatol. 2016; 24: 4 (Octubre-Diciembre), 264-276

Fototerapia en combinación con otras terapias en psoriasis

Phototherapy in combination with other therapies in psoriasis
Autor(es): 
Lina Tatiana Acosta
claugavi02@hotmail.com
Médica, residente de Dermatología, Universidad CES, Medellín, Colombia
Claudia Marcela Gaviria
Médica, residente de Dermatología, Universidad CES, Medellín, Colombia
Ana Paula Giraldo
Médica, residente de Dermatología, Universidad CES, Medellín, Colombia
Juliana Mariaca
Médica, residente de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
Melisa Montes
Médica, residente de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
Sol Beatriz Jiménez
Médica dermatóloga; jefe, Servicio de Dermatología, Grupo Dermatología CES, Universidad CES, Medellín, Colombia
Resumen: 

La psoriasis es una enfermedad crónica inflamatoria, multifactorial, que afecta del 1 al 3 % de la población mundial. Para su tratamiento se ha descrito un sinnúmero de esquemas terapéuticos, entre los cuales se encuentran los tratamientos tópicos combinados para la psoriasis leve a moderada, mientras que la psoriasis grave requiere un manejo más completo con fototerapia y tratamientos sistémicos, como retinoides orales, metotrexato, ciclosporina y medicamentos biológicos.
Aunque muchos datos apoyan la eficacia de la fototerapia en el tratamiento de la psoriasis, aún hay gran variabilidad en su aplicación en todo el mundo y cada vez más se apoya el concepto de tratamientos combinados, los cuales pueden aumentar la eficacia y la tolerabilidad, e inclusive, pueden disminuir los efectos secundarios de ciertos medicamentos aumentando el perfil de seguridad del tratamiento.
Sin embargo, a pesar de lo anterior, la manera como la fototerapia ha encajado en el uso combinado con otros agentes, tópicos o sistémicos, apenas está siendo dilucidada.

Palabras clave: 
psoriasis, fototerapia, retinoides, metotrexato, productos biológicos.

Summary: 

Psoriasis is a multifactorial chronic inflammatory disease that affects 1 to 3% of the world population. For treatment they have been described a number of therapeutic regimens in which are combined for mild to moderate psoriasis topical therapies, while for severe psoriasis requires more aggressive treatment with phototherapy and/or systemic treatments like oral retinoids, methotrexate, cyclosporine and biological medicines. Although many data support the efficacy of phototherapy in the treatment of psoriasis, there is still great variability in their application worldwide and increasingly the concept of combination therapies is supported; which can increase the efficacy, tolerability and can even reduce side effects of certain medications increase the safety profile of treatment. However, despite the above, how phototherapy conceded in the combined use with other agents, topical or systemic, just being elucidated.

Key words: 
Psoriasis, phototherapy, retinoids, methotrexate, Biologics.
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