requirements to study medicine in japan

Last Updated on January 23, 2022

Learning about studying medicine and why you should study medicine really boils down to what you want to do in the future. If you are considering going into a medical field it is important to make sure that you will be happy there once you start training.

To get more information on Vet Schools In Japan. You can also find up-to-date, related articles on Collegelearners.

Are you an international student? Are you interested in learning more about Psoriasis Medicine Courses? Do you get overwhelmed by the amount of conflicting information you see online? If so, you need not search further because you will find the answer to that question in the article below.

To get more information on Psoriasis Medicine Courses. You can also find up-to-date, related articles on Collegelearners.

Psoriasis is a common autoimmune disorder that causes red, thick, inflamed patches of skin. The patches are often covered in whitish silvery scales called plaques. In some cases, the affected skin will crack, bleed, or ooze. Many people feel burning, pain, and tenderness around the affected skin.

Psoriasis is a chronic condition. Even with treatment, psoriasis will never fully go away. Therefore, treatment aims to reduce symptoms and to help the disease enter remission. Remission is a period of little to no disease activity. This means there are fewer symptoms.

There are a range of treatment options available for psoriasis, including oral medications. Oral drugs are a form of systemic treatment, which means they affect your whole body. These drugs can be very strong, so doctors typically only prescribe them for severe psoriasis. In many cases, these drugs are reserved for people who haven’t had much success with other psoriasis treatments. Unfortunately, they can cause a variety of side effects and issues.

Read on to learn more about the most common oral medications and their side effects and risks.

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Option #1: Acitretin

Acitretin (Soriatane) is an oral retinoid. Retinoids are a form of vitamin A. Acitretin is the only oral retinoid used to treat severe psoriasis in adults. It can cause serious side effects. Because of this, your doctor may only prescribe this medication for a short time. When your psoriasis enters remission, your doctor may advise you to stop taking this drug until you have another flare-up.

Side effects of acitretin

The more common side effects of acitretin include:

  • chapped skin and lips
  • hair loss
  • dry mouth
  • aggressive thoughts
  • changes in your mood and behavior
  • depression
  • headache
  • pain behind your eyes
  • joint pain
  • liver damage

In rare cases, serious side effects can occur. Call your doctor right away if you experience any of the following:

  • a change in vision or a loss of night vision
  • bad headaches
  • nausea
  • shortness of breath
  • swelling
  • chest pain
  • weakness
  • trouble speaking
  • yellowing of your skin or the whites of your eyes

Pregnancy and acitretin

Be sure to discuss your reproductive plans with your doctor before you begin taking acitretin. This drug can cause problems with some birth control methods. You shouldn’t take acitretin if you’re pregnant or planning to become pregnant. After stopping acitretin, you shouldn’t become pregnant for the next three years.

If you’re a woman who could become pregnant, you shouldn’t drink alcohol while taking this medication and for two months after you stop taking it. Combining acitretin with alcohol leaves behind a harmful substance in your body. This substance could fatally harm future pregnancies. This effect lasts for up to three years after you finish treatment.

Get the facts on nearly 20 new and available psoriasis treatments for adults and kids. Also learn about others that are on the horizon.

Option #2: Cyclosporine

Cyclosporine is an immunosuppressant. It’s available as the brand-name medications Neoral, Gengraf, and Sandimmune. It’s used to treat severe psoriasis if other treatments don’t work.

Cyclosporine works by calming the immune system. It prevents or stops the overreaction in the body that causes symptoms of psoriasis. This drug is very strong and can cause serious side effects.

Side effects of cyclosporine

The more common side effects of cyclosporine include:

  • headache
  • fever
  • stomach pain
  • nausea
  • vomiting
  • unwanted hair growth
  • diarrhea
  • shortness of breath
  • slow or fast heart rate
  • changes in urine
  • back pain
  • swelling of your hands and feet
  • unusual bruising or bleeding
  • excessive tiredness
  • excessive weakness
  • increased blood pressure
  • shaky hands (tremor)

Other risks of cyclosporine

Cyclosporine can cause other problems as well. These include:

  • Drug interactions. Some versions of cyclosporine can’t be used at the same time or after other psoriasis treatments. Tell your doctor about every drug or treatment you’ve ever taken and are currently taking. This includes medications to treat psoriasis, as well as treatments for other conditions. If you have trouble remembering which drugs you’ve taken, which many people do, ask your pharmacist for a list of those medications.
  • Kidney damage. Your doctor will check your blood pressure before and during your treatment with this drug. You’ll likely also need to have regular urine tests. This is so your doctor can check for possible kidney damage. Your doctor may pause or stop your treatment with cyclosporine to protect your kidneys.
  • Infections. Cyclosporine raises your risk of infections. You should avoid being around sick people so you don’t pick up their germs. Wash your hands often. If you have signs of an infection, call your doctor right away.
  • Nervous system problems. This drug can also cause nervous system problems. Tell your doctor right away if you have any of these symptoms:
    • mental changes
    • muscle weakness
    • vision changes
    • dizziness
    • a loss of consciousness
    • seizures
    • yellowing of your skin or the whites of your eyes
    • blood in your urine

Option #3: Methotrexate

Methotrexate (Trexall) belongs to a drug class called antimetabolites. This drug is given to people with severe psoriasis who have not had much success with other treatments. It can slow the growth of skin cells and stop scales from forming.

Side effects of methotrexate

The more common side effects of methotrexate include:

  • tiredness
  • chills
  • fever
  • nausea
  • stomach pain
  • dizziness
  • hair loss
  • eye redness
  • headaches
  • tender gums
  • loss of appetite
  • infections

Your doctor may recommend a folic acid (vitamin B) supplement to help protect against some of these side effects.

In rare cases, this medication can cause serious, life-threatening side effects. The risk of having these side effects increases with higher doses of the medication. Call your doctor right away if you experience any of the following:

  • unusual bleeding
  • yellowing of your skin or whites of your eyes
  • dark-colored urine or blood in your urine
  • dry cough that doesn’t produce phlegm
  • allergic reactions, which may include trouble breathing, rash, or hives

Other risks of methotrexate

Methotrexate can cause other problems as well. These include:

  • Drug interactions. You shouldn’t combine this drug with certain other drugs due to the risk of serious side effects. These may include anti-inflammatory drugs that are available over the counter. Talk to your doctor about other serious interactions that could occur if you take certain medications.
  • Liver damage. If this drug is taken for a long time, it can cause liver damage. You shouldn’t take methotrexate if you have liver damage or a history of alcohol abuse or alcoholic liver disease. Your doctor may recommend a liver biopsy to check for liver damage.
  • Effects with kidney disease. Talk to your doctor before taking this drug if you have kidney disease. You may need a different dosage.
  • Harm to pregnancy. Women who are pregnant, breastfeeding, or planning to become pregnant shouldn’t use this drug. Men should not get a woman pregnant during treatment and for three months after stopping this drug. Men should use condoms throughout this time.
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Option #4: Apremilast

In 2014, the U.S. Food and Drug Administration (FDA) approved apremilast (Otezla) to treat psoriasis and psoriatic arthritis in adults. Apremilast is thought to work within your immune system and decrease your body’s response to inflammation.

Side effects of apremilast

According to the FDA, the more common side effects people experienced during clinical trials included:

  • headache
  • nausea
  • diarrhea
  • vomiting
  • cold symptoms, such as a runny nose
  • stomach pain

People who were taking this drug also reported depression more frequently during clinical trials than people taking a placebo.

Other risks of apremilast

Other possible concerns related to the use of apremilast include:

  • Weight loss. Apremilast can also cause unexplained weight loss. Your doctor should monitor your weight for unexplained weight loss during treatment.
  • Effects with kidney disease. Talk to your doctor before taking this drug if you have kidney disease. You may need a different dosage.
  • Drug interactions. You shouldn’t combine apremilast with some other drugs, because they make apremilast less effective. Examples of these drugs include the seizure medications carbamazepine, phenytoin, and phenobarbital. Talk to your doctor about other medications you’re taking before you start apremilast.

How else is psoriasis treated?

Systemic treatments also include injected prescription drugs. As with oral drugs, injected drugs called biologics work throughout your entire body to slow the disease’s progress. Still other treatments include light therapy and topical medications.

Biologics

Some injected drugs alter the immune system. These are known as biologics. Biologics are approved for treating moderate to severe psoriasis. They’re typically used when your body hasn’t responded to traditional therapy or in people who also experience psoriatic arthritis.

Examples of biologics used to treat psoriasis include:

  • etanercept (Enbrel)
  • infliximab (Remicade)
  • adalimumab (Humira)
  • ustekinumab (Stelara)

Light therapy

This treatment involves controlled exposure to natural or artificial ultraviolet light. This can be done alone or in combination with other medications.

Potential therapies include:

  • UVB phototherapy
  • narrowband UVB therapy
  • psoralen plus ultraviolet A (PUVA) therapy
  • excimer laser therapy

Topical treatments

Topical medications are applied directly to your skin. These treatments generally work best on mild to moderate psoriasis. In more severe cases, topical treatments may be combined with oral medication or light therapy.

Common topical treatments include:

  • moisturizers
  • salicylic acid
  • coal tar
  • corticosteroid ointment
  • vitamin D analogues
  • retinoids
  • anthralin (Dritho-Scalp)
  • calcineurin inhibitors, such as tacrolimus (Prograf) and pimecrolimus (Elidel)

Treating Psoriasis: 5 Reasons to Consider Switching to a Biologic

Psoriasis treatment isn’t a one-size-fits-all approach. If your goal is total clearance of your psoriasis, you’ll probably have to try out many different treatments before finding one that works best for you. One option: biologic drugs.

Biologics for psoriasis

Biologics are medications that target specific proteins within the immune system to slow down disease activity at the source. They’re administered in one of two ways: via intravenous infusion at a clinic or via an auto-injector you can use yourself at home.

There are currently 13 biologics on the market to treat psoriasis:

  • abatacept (Orencia)
  • adalimumab (Humira)
  • brodalumab (Siliq)
  • certolizumab pegol (Cimzia)
  • etanercept (Enbrel)
  • golimumab (Simponi and Simponi Aria)
  • guselkumab (Tremfya)
  • infliximab (Remicade)
  • ixekizumab (Taltz)
  • risankizumab (Skyrizi)
  • secukinumab (Cosentyx)
  • tildrakizumab (Ilumya)
  • ustekinumab (Stelara)

Your doctor can help you decide which may work best for your particular situation. It may take some trial and error to find the right biologic for you.

Here’s how to know whether switching to a biologic agent for psoriasis might be a good next step for you, along with some advice on how to overcome any hesitation you may have about making the switch.

1. Traditional treatments aren’t working

Traditional treatment options for psoriasis include topical creams, corticosteroids, cyclosporine, retinoids, methotrexate, and phototherapy. People with mild to moderate psoriasis can usually manage their disease well with topical treatments.

However, these traditional treatment options may lose effectiveness over time, and they often don’t work well enough for those with moderate to severe cases.

The American Academy of Dermatology suggests taking a biologic agent if you have moderate to severe psoriasis that hasn’t improved using more traditional systemic agents or if you can’t tolerate those treatments because of side effects

2. Your psoriasis is ‘mild’ but really bothers you

Biologics are typically reserved for those with moderate to severe psoriasis, but they could be an option if your psoriasis is greatly affecting your quality of life.

Even if your psoriasis is considered mild, you may have painful plaques on the soles of your feet, your palms, your face, or your genitals. The pain may prevent you from doing your usual activities. In these cases, a switch to a biologic may be justified.

3. You’d prefer to take fewer doses

Many psoriasis treatments have to be taken daily to be effective. It can be hard to remember to take your medication on time, especially if you’re busy or you travel often. Biologics, on the other hand, are usually taken less frequently.

Some biologics have to be injected once per week, but others, like ustekinumab (Stelara), need to be injected only once every 12 weeks after the first 2 doses.

You can also give yourself most biologics at home after being trained by a medical professional.

4. Your current therapy is causing side effects

Psoriasis treatments like cyclosporine, corticosteroids, and methotrexate are known to cause side effects like mouth sores, nausea, upset stomach, and even skin cancer.

Biologics work in a more selective way than other psoriasis treatments. They target specific proteins in the immune system that have been proven to be associated with psoriasis. For this reason, they have fewer side effects than less-targeted treatments.

Biologics still come with side effects, but they tend to be less severe. The most common side effects are minor irritation, redness, pain, or a reaction at the injection site. There’s also a slightly higher risk of serious infections while taking a biologic drug.

You can also add a biologic to your existing psoriasis treatment plan. Combining treatments can improve the efficacy of your regimen, often at a lower dose. This helps decrease side effects.

Options including certolizumab pegol (Cimzia), etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade) have been shown to be safe and effective when taken with methotrexate.

5. You have new insurance

Biologics are expensive. Most cost more than $20,000 per year. Not all insurance plans will cover enough of the costs.

If you’ve recently changed insurance, check how the new insurance company covers biologics. Your out-of-pocket expenses may have gone down considerably with the new insurance company, making it easier for you to afford biologic therapy. If so, work with your doctor to determine whether you should make the switch.

Tips for overcoming your hesitation

Biologics aren’t new. The first biologic for psoriasis was approved in 2003. Over the last couple decades, researchers have gathered quite a bit of evidence to support the safety and effectiveness of these medications.

You may be hesitant to talk with your doctor about biologics because you’ve heard they’re “stronger” drugs. Or perhaps you’re worried they’re too expensive.

It’s true that biologics are considered a more aggressive treatment option. They also have a high price point. But they’re more targeted drugs, which means they work very well. And they tend to have fewer side effects than other psoriasis treatments.

Still, you shouldn’t take a biologic if:

  • your immune system is significantly compromised
  • you have an active infection
  • you recently received a live vaccine such as shingles, MMR (measles, mumps, and rubella), or flu mist
  • you’re pregnant or nursing (though biologics can still be prescribed if there is a clear medical need)

If you’re afraid of needles, ask your doctor about a new treatment for psoriasis known as apremilast (Otezla). Otezla is taken as a pill twice per day. It isn’t considered a biologic. Rather, it’s in a new class of drugs known as PDE4 inhibitors. Otezla is FDA-approved to treat moderate to severe plaque psoriasis when phototherapy or systemic therapy is appropriate.

Drugs Commonly Prescribed for Psoriasis

Psoriasis is a chronic skin condition that can occur anywhere, but tends to affect the elbows, knees and scalp. If you are one of the 7.5 million Americans who have it, you know how uncomfortable it can be. Symptoms typically include red patches with silvery scales and small scaly spots that can bleed and crust. Skin can itch and become sore. Some people also notice changes in their nails.

Psoriasis is an autoimmune disease, meaning your immune system mistakenly attacks healthy tissue. In the most common form of psoriasis, your immune system causes skin cells to grow faster than your body can shed them. This leads to an accumulation of skin cells into plaques or patches.

In most cases, psoriasis cycles through periods when symptoms worsen and then resolve. These flares can last for weeks to months. Between flares, your disease may go into remission. Medications can help manage symptoms when they occur and decrease the frequency of flares.

Psoriasis Drug Classes

There is currently no cure for psoriasis. However, medications can relieve symptoms and maintain your quality of life and self-confidence. The goal of treatment is to slow skin cell growth. To achieve this goal, doctors follow expert practice guidelines to choose psoriasis medicines. Classes of psoriasis drugs include:

  • Biologic response modifiers (BRMs) target specific parts of the immune system to suppress it. This stops the process of skin cell overproduction and brings about remission of symptoms. Side effects include injection site reactions and flu-like symptoms.
  • Systemic medications are oral or injectable medicines that work throughout the entire body. The side effects vary depending on the specific drug.
  • Topical medications are medicines you apply directly to the skin. They do not affect the rest of your body, which minimizes side effects. This class includes both over-the-counter and prescription products.

A complete treatment plan for psoriasis may also include light therapy—or phototherapy—and self-care. Self-care primarily involves regular moisturizing, stress reduction, and quitting smoking.

Common Psoriasis Drugs

About 80% of people with psoriasis have mild to moderate disease. They may only require topical treatments and light therapy to control their symptoms. However, the 20% of psoriasis sufferers with moderate to severe disease require a combination of medications. Finding the right treatment for you may involve some trial and error. Here are 10 drugs commonly prescribed for psoriasis:

  1. Adalimumab (Humira) is a biologic medication for injection under the skin—or subcutaneously. You will get the first dose in your doctor’s office. After that, the typical dose is every other week.
  2. Apremilast (Otezla) is a PDE4 inhibitor, which is a systemic medication. It is a tablet you take twice a day. You usually start on a low dose and increase the dose over the first several days of treatment.
  3. Calcitriol (Vectical) is a topical vitamin D analog. This synthetic form of vitamin D slows skin cell growth. Vectical may be less irritating than other topical vitamin D analogs.
  4. Cyclosporine (Gengraf, Neoral, Sandimmune) is an oral systemic medication. It suppresses your immune system, but is not specific like the BRMs. It comes in different dosage forms and brands with different dosing. Be sure you understand how to take your particular form of cyclosporine. Ask your doctor or pharmacist if you have questions.
  5. Etanercept (Enbrel) is a BRM for injection under the skin. Like Humira, you will get the first dose in your doctor’s office. For the first three months, your doctor may prescribe Enbrel for twice weekly use. After that, the usual dose is once a week.
  6. Hydrocortisone (Cortaid and others) is a topical corticosteroid that reduces inflammation and itching. It comes in both an over-the-counter and prescription strength. Corticosteroids are the most common treatment for mild to moderate psoriasis.
  7. Methotrexate (Rheumatrex, Trexall) is systemic medication that reduces skin cell turnover and inflammation. It is available as a tablet and an injection. Doctors usually prescribe a weekly dose to decrease side effects.
  8. Mometasone (Elocon) is a prescription topical corticosteroid. You usually apply it once daily.
  9. Tazarotene (Tazorac) is a topical retinoid—a vitamin A derivative. Skin irritation and increased sensitivity to sunlight are common side effects. It’s important to use a daily sunscreen with topical retinoids.
  10. Triamcinolone acetonide (Aristocort, Kenalog) is another topical corticosteroid. You usually apply it a few times each day.

Psoriasis Treatments: How To Get Rid of Psoriasis

There’s no cure for psoriasis. But treatment can help you feel better. You may need topical, oral, or body-wide (systemic) treatments. Even if you have severe psoriasis, there are good ways to manage your flare-ups. You may be able to get rid of your symptoms completely.

Topical Treatments for Psoriasis

These are drugs you rub directly on your skin. Along with a good moisturizer, they’re usually the first thing your doctor will suggest, especially for mild to moderate psoriasis. There are over-the-counter (OTC) and prescription options.

Topical treatments for psoriasis come as ointments, creams, or foam and include:

Steroid creams. These slow down immune cells in your skin. They can ease swelling and redness. Mild steroid creams are available over the counter. You’ll need a prescription from your doctor for something stronger. Steroids come with side effects and shouldn’t be used on sensitive areas like your face or genitals. They can burn or thin the skin. Use them exactly the way your doctor tells you.

Salicylic acid. This can soften and thin scaly skin. But it can also irritate your skin if you leave it on too long. It might weaken your hair follicles and cause temporary hair loss, too. The body can absorb salicylic acid if you put it on large patches of skin.

Calcipotriol (Calcipotriene). This is a strong form of synthetic vitamin D. It’s known to control overactive skin cells. Your doctor might pair it with a steroid cream.

Tazorac (Tazarotene) is available gel or cream and applied one and twice daily. it is ot recommended for those who are pregnant or breast-feeding or intending to become pregnant.

Immunosuppressants. These aren’t steroids, but they change how your immune cells work. Options include pimecrolimus and tacrolimus. Your doctor might give you these to use on sensitive areas such as your face, groin, or skin folds.

Psoriasis remission occurs when the symptoms of psoriasis disappear temporarily. There is no cure for psoriasis, so remission is the primary goal of treatment.

Psoriasis develops when the immune system mistakenly attacks the skin cells, causing red, scaly, or painful patches to appear. During remission, the immune system stops these attacks, and the skin has time to heal.

Psoriasis treatments and lifestyle changes can bring about remission, but when and how it occurs is different for everyone. Read on to learn more about achieving and maintaining psoriasis remission.

What to expect with psoriasis remission

Young woman could be in psoriasis remission
Finn Hafemann/Getty Images

Cycles of remission and symptom flare-ups are commonTrusted Source with psoriasis.

Psoriasis remission may occur as a result of treatment. However, it is difficult to predict how a person’s psoriasis will behave over time and how it will respond to treatment.

Some people may experience spontaneous remission, which happens for no apparent reason.

During remission, some people will notice a marked reduction in symptoms, while others may find that their skin becomes completely clear. However, symptoms usually come back at some point, even for those who continue their treatment program.

How long does remission last?

Psoriasis is an unpredictable condition. The duration of remission can vary from a few weeks to a few months or, in some cases, years.

However, most remission periods last for between 1 month and 1 year.

Several factors can affect the onset and length of a psoriasis remission. For example, some people may have a remission during summer and experience a flare-up during the colder months.

How to prevent psoriasis from returning

Psoriasis is a chronic, long-term condition, so flares will usually return even after remission. However, certain treatments and lifestyle changes may help people prolong their remission periods.

Experts believe that psoriasis occurs due to a combination of genetic factors and external triggers, but not everyone who inherits one or more of the specific psoriasis-causing genes goes on to develop the skin condition.

Therefore, avoiding triggers may be key to reducing the risk of psoriasis development and the return of symptoms following remission. Triggers vary from person to person, but some of the most common are:

Medication

The following medicines may trigger psoriasis flares:

  • antimalarial drugs
  • propranolol (Inderal), for high blood pressure
  • indomethacin (Indocin), a nonsteroidal anti-inflammatory drug
  • lithium, for certain psychiatric disorders
  • quinidine, a heart medication

Skin damage

Psoriasis often develops on injured areas of skin. Picking or scratching the skin, receiving a bug bite, and severe sunburn can all cause symptoms to appear.

Stress

Stress is a potential trigger for many chronic and autoimmune conditions, and psoriasis is no exception. Stress reduction techniques may lessen or even prevent symptoms.

Infection

Infections weaken the immune system, and this affects psoriasis in turn. Streptococcus infection, or strep throat, may trigger a type of psoriasis called guttate psoriasis.

Other infections that may cause psoriasis flares include:

  • bronchitis
  • respiratory infections
  • skin infections
  • tonsillitis

Lifestyle choices

Both smoking and heavy alcohol use may cause the onset of psoriasis.

Dietary factors

Some individuals believe that their diet and food allergies can affect their symptoms. It is possible that a vitamin D deficiency may contributeTrusted Source to psoriasis and other autoimmune disorders.

Weather

One common psoriasis cycle is for symptoms to improve during the summer and get worse during the winter. Cold weather is a common trigger for psoriasis flares.

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