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  Anthralin is a synthetic compound that is used for severe psoriasis. It will help those with stable plaque type psoriasis. On the other hand, acute guttate psoria­sis, which is characterized by small pink macules or discolored spots on the skin that look like drops of paint, does not respond well to this type of treatment. There are two ways of using anthralin. The first is called the Ingram Regimen which is done in a hospital or day care center. This method combines anthralin paste, a coal tar bath and ultraviolet irradiation to treat wide areas of psoriasis. A thick paste is first applied on the affected areas and left for hours before the patient is irradiated with ultraviolet light and gets coal tar baths. This regimen normally takes three weeks and clears up plaques in about 20 days. Symptoms disappear for several months to a year. For those who prefer being treated at home, the same regimen can be used. After anthralin paste is applied, the entire body is powdered with talcum or cornstarch to keep the anthralin in place. The paste is left on the skin from four hours to overnight. Then, the paste is removed with a light oil and the person may shower afterwards. This makes the lesions disappear for three to six months. Another variation of the anthralin treatment can be done at home. Called Short Contact Anthralin Therapy or S.C.A.T., this involves treating the skin for a much shorter period of time starting with low concentrations of anthralin. In this method, the paste is left on the skin from 10 minutes to an hour and can help patients with localized areas of psoriasis Compared to other methods, the topical use of anthralin is generally safe. There are, however, two common side effects: skin irritation and staining. People react differently to anthralin. Some may not tolerate low doses while others respond well to high doses. To avoid burning normal skin, careful supervision by a doctor is required with the Ingram Regimen. The risk of skin irritation is reduced with the S.C.A.T. method which uses less irritating formulations of anthralin and is the treatment of choice for outpatient use. "Anthralin's main problem is its tendency to burn and irritate normal skin. In a hospital, this is prevented by applying the paste and protecting the surrounding skin with a rim of Vaseline. At home this is difficult to do safely and the recommended regimen for outpatient use is the short contact method. Here the anthralin is in contact with the skin for a maximum of only 30 minutes, during which it can penetrate the abnormal epidermis over a psoriatic plaque but not the healthy epidermis of normal skin; thus it treats psoriasis but avoids the burning and irritation,” wrote Dr. S.M. Going, clinical assistant, department of dermatology at the Royal Infirmary in Edinburgh, in The British Medical Journal. “Compliance is excellent as patients do not have to keep the cream on for longer than half an hour a day before their bath or shower. Provided the cautions are noted this is one of the most useful outpatient treatments," Going added. (Next: Dealing with anthralin stains.) You can read also generics clarithromycin