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Prescribed Accutane for PRP
from Karppy

I will try to be brief.  I was first diagnosed having psoriasis.  I went on cyclosporine and then MTX.  These did not improve my condition.  Then I went to several specialists and was diagnosed having PRP (Pityriasis Rubra Pilaris).  Now I am going to be treated with Accutane.  How does Accutane improve this condition?  What actually do these drugs do?  How do they combat the illness?  What do you call  psoriasis and PRP?  Condition?  Illness?  Disease?  Also, why does my dermatologist say moisturize,  moisturize, moisturize?  Does the moisturizer break down the flakes?

The more I hear, the more confused I get. Thanks for your web site.  I know I am not alone when I get involved with your site.  -Karppy

*****

Ed’s Response:  I’m not going to be able to alleviate your confusion, Karppy, because I know nothing about PRP except what I read at WebMD (http://my.webmd.com/printing/article/4115.424).  The definition, reproduced from this page at WebMD is:

[A] mildly itchy chronic skin disorder that is possibly caused by an inherited metabolic defect.  Initially, the disorder is characterized by elevated spots (papules) on the skin.  These spots grow and become connected, producing red plaques over large areas.  

Note they use the term “disorder.”  You may also want to read Don’t Call It a Disease in the archives, here.

Accutane is a potentially dangerous drug that currently requires your signature on a patient consent form.  Click here for the story about this.  The active ingredient in Accutane is isotretinoin and, as I understand it (again, from WebMD), it works by “unclogging skin pores and shrinking oil glands to a very small size.”  It is a vitamin A derivative and is mostly used for stubborn acne.  I don’t know how the drug is supposed to help PRP or psoriasis.  For more information, read this article at WebMD.com.

There are several reasons why you are being told to moisturize.  Among them:

  • Lesions are less likely to dry out and crack.

  • Lesions tend to be good convective evaporators for skin moisture and this bad effect can be diminished by keeping them moist.  (Full body psoriasis — erythrodermic P — can cause so much moisture loss dehydration becomes life-threatening.)

  • Lesions are less likely to itch when they're kept moist and supple.

  • Lesions will slough off easier if they are moist (soft), although moisturizers aren’t usually considered “exfoliants” in and of themselves.  -Ed

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