Magan Medical Clinic, Dermatology
We provide quality dermatology care with compassion. Our specialty is medical dermatology, including:
If you have hair thinning or psoriasis, Dr. Chiang possesses special expertise. He completed fellowships in both fields at University of California, San Francisco where he saw a wide spectrum of patients (including the most severe), performed clinical trials, and published research.
We take pleasure in serving our community including Covina, West Covina, San Dimas, Rancho Cucamonga, Baldwin Park, Azusa, Glendora, Upland, El Monte, Duarte, Monrovia, Arcadia, La Puente, and Diamond Bar.
Same day appointments often available. No referral is necessary for PPO insurance plans. Please call (626) 331-6411. We look forward to serving you!
"What’s New in..."
A monthly column by Dr. Chiang
What’s New in Psoriasis
Similar to last month’s column for eczema, one of the most common questions I am asked is how to control psoriasis other than using medications. I usually answer that medications, especially topical steroids, are the mainstay of therapy for limited psoriasis. We consider systemic options (phototherapy, injections, pills) for more severe psoriasis. However, a recent study indicates oral curcumin, an ingredient in Indian curry spice mixes and specifically a component of tumeric, may be helpful as additional treatment for patients already on topical steroids. The study was of 60 patients in Italy, randomly assigned to 3 grams per day of curcumin versus placebo. Patients who took curcumin had 4 times the chance of reaching 75% improvement in their psoriasis. In addition to clinical improvement, patients had decreased inflammation on blood testing (patients who took curcumin had about half the level of IL-22, a marker of inflammation, after 12 weeks of treatment). Only one side effect (nausea) was seen in the treated patients. Interestingly, there were two side effects in the placebo group. Overall, curcumin is considered well tolerated up to 12 grams per day, far above the recommend psoriasis dosage of 3 grams per day.
I do wish to specifically state I do not recommend patients simply stop their psoriasis treatment, especially their topical steroids, and simply take curcumin. This was a relatively small study only verbally presented and, even with both curcumin and topical steroids, only half of the patients reached 75% reduction in psoriasis (PASI75), which is approximately where my patients need to reach before they feel happy about their improvement. Also, most over-the-counter preparations are 500 mg, which means patients have to take 6 capsules a day, which is quite a lot. Also, the formulation used is, to my knowledge, not available in the United States and used “nanopartical liposomes.” Last, in the United States, we pretty much have no guarantee what’s in our supplements (see NYTimes where 4 out of 5 of the supplements sold by national retailers that were tested by the New York State attorney general’s office did not contain any of the herbs on the labels). Unfortunately, I do not know any better than my patients which over-the-counter supplements are genuine or not.
If you have psoriasis, of whatever severity, I look forward to seeing you. Please make an appointment for a dermatology consultation at (626) 331-6411.
Charles Chiang, MD, FAAD
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