Dr. Irina Turchin
Dr. Turchin has a Bachelor of Science degree from the University of Alberta. She did her medical training at the University of Calgary and completed Dermatology residency at McGill University. Dr. Turchin is board certified in Dermatology in both, Canada and United States. Dr. Turchin holds memberships with Canadian Dermatology Association, American Academy of Dermatology and European Academy of Dermatology. She continuously keeps herself up-to-date with the latest medical discoveries by frequently attending national and international conferences and presenting at scientific meetings. Dr. Turchin is interested in medical innovation and is involved in clinical trials.
Dr. Turchin is committed to medical education as Assistant Professor at Dalhousie and Memorial Universities. She preceptors medical students and residents and commonly presents on dermatology topics to other physicians. She also partakes in public education forums for patients.
Pso Let’s Talk: “The Trouble with Topicals"
Chronic plaque psoriasis (PsO) is an auto-immune mediated inflammatory skin diseases that varies in severity affecting over 1 million people in Canada.1 The majority of patients present with mild to moderate disease as determined by objective measures used by clinicians, but it is increasingly recognized, disease severity experienced by the patient is more than just a body surface area or PASI score calculation as evidenced by decreased quality of life and higher risks for depression, anxiety and suicide.1,2,3 Although topical corticosteroids (TCSs) remain the foundation of treatment and are used across the spectrum of plaque PsO, there has been a paucity of clinical innovation in comparison to the advances in biologic therapies made in the past decade.3,4
Despite good treatment responses with TCSs, they can be limited for long-term use due to local (e.g., stria, skin atrophy, and telangiectasia) or systemic (e.g., hypothalamic-pituitary-adrenal [HPA] axis suppression) adverse events (AEs).5 Topical retinoids and vitamin D analogs, originally introduced in the latter part of the 20th century, have their own troublesome AEs with skin irritation (e.g., redness, itching, stinging or burning, peeling and dryness) as a common cause for a patients’ dissatisfaction and/or lack of adherence.3,5 Topical calcineurin inhibitors and the only currently available topical phosphodiesterase- 4 inhibitor in Canada, are indicated for atopic dermatitis, but have been used for PsO with some success in the sensitive intertriginous and facial areas.6 There is limited access for these latter drugs depending on patients’ private insurance coverage.
PsO is a heterogeneous disease with varied clinical presentations with almost 90% of patients experiencing PsO in more than one location.4,6 Due to the limitations of today’s topical armamentarium, dermatologists often need to prescribe during one patient visit 2 or 3 different topicals of varying potencies and/or formulations. This can be troublesome for patients as they tend to forget or misunderstood the instructions provided by their dermatologist which can be confounded by further troubling instructions from the dispensing pharmacist.3,4 As such, the trouble with topicals today remains and there continues a large unmet need to develop a simplified regimen that is better tolerated with a cosmetically pleasing formulation which is steroid-sparing yet has a fast onset of action with an effectiveness comparable to mid-high potency TCSs. The trek towards this goal will be explored as new developments in topical non-steroid therapy will be presented.