Magan Medical Clinic, Dermatology
We provide quality dermatology care with compassion. Our specialty is medical dermatology, including:
Note: Cosmetic treatments are not performed in Dermatology but instead by Magan's Medical Aesthetics Laser Center.
If you have psoriasis or hair questions, 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 if you have PPO insurance. We accept a wide range of insurance plans (unfortunately, we do not accept Medi-Cal as primary insurance, only as secondary insurance).
For appointments, please call (626) 251-1500. We look forward to serving you!
"What's New in..."
A monthly column by Dr. Chiang
What's New in Psoriasis
My moderate to severe psoriasis patients often ask how long they will be on systemic therapy (injections and/or pills). This is a very reasonable question. Unfortunately, the answer varies with each patient. As psoriasis usually flares when the medication is stopped, the end point is often when the patient is clear or almost clear, which does not always occur.
That being said, there is emerging research that it may be okay to at least reduce the medication dosage if the patient is doing well, but not completely cleared of their psoriasis. The CONDOR study was performed by the Dutch as a 1 year open label study of 111 patients. The patients were stable with low disease activity (defined by dermatology scales called Psoriasis and Severity Index ‘PASI’ and Dermatology Life Quality Index ‘DLQI’ being 5 or less). To my knowledge, the data has not yet been fully published as a journal article. It has only been reported at a conference, the annual congress of the European Academy of Dermatology and Venereology.
First, there was a randomized dose reduction of 1/3 (67% of normal dosing), performed by reducing medication frequency (ie, if a medication was being taken once every 2 weeks, it would be taken once every 3 weeks). If patients maintained low disease activity, they were reduced further to 50% of their original dose frequency. The average patient worsened by 1.1 PASI points at 12 mo, which is indeed a worsening of their disease, but not a substantial worsening. There was no significant decrease in DLQI score. The final result was, at 12 months, 50% of patients were well maintained on 50% of their original dosage and another 17% were doing well at 67% of their former dosage. Since 1 in 3 were not able to maintain reduction of their dosage, Dr. van den Reek did clarify they were able to resume their previous dosage without any loss of treatment efficacy.
Further analyses and a long-term extension study are planned.
If you have psoriasis or another skin condition, consider making an appointment for dermatology consultation at (626) 251-1500 to discuss your options.
Charles Chiang, MD, FAAD
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