### How PDE-4 Inhibitors Help Manage Plaque Psoriasis Phosphodiesterase-4 (PDE-4) inhibitors are medications prescribed by doctors to treat mild to severe plaque psoriasis. These drugs work by reducing inflammation, which is the main cause of psoriasis flare-ups. Inflammation in the body is often triggered by an enzyme called PDE-4. This enzyme interferes with a chemical reaction involving cyclic adenosine monophosphate (cAMP), leading to increased inflammation and rapid skin cell growth, which results in plaque psoriasis. PDE-4 inhibitors block the production of PDE-4, thereby increasing cAMP activity and reducing inflammation. This helps to manage the symptoms of plaque psoriasis. ### Treatment Options Treatment for plaque psoriasis usually starts with topical treatments like steroids that you apply directly to your skin. Phototherapy, which involves exposing the skin to UV light, is another common treatment. If these methods are not effective, especially in moderate to severe cases, doctors may prescribe a PDE-4 inhibitor such as apremilast (Otezla). Sometimes, apremilast is used in combination with other treatments like topical medications or phototherapy. ### Who Can Use PDE-4 Inhibitors? PDE-4 inhibitors are generally prescribed for adults. They may not be suitable for everyone, so it's important to consult your doctor to see if this treatment is right for you. Apremilast is taken as a pill, starting with a lower dose and gradually increasing to minimize side effects. Common side effects include gastrointestinal issues, headaches, and weight loss. ### Availability and Cost Apremilast is not available at regular pharmacies; it must be obtained through specialty pharmacies. These pharmacies work with your insurance company to help cover the cost. If you don't have insurance, financial aid programs may be available to help you afford the medication. The list price for a 30-day supply of apremilast is around $3,950, but the actual cost to you will depend on your insurance plan. ### Conclusion PDE-4 inhibitors like apremilast can be effective in managing plaque psoriasis, but they are not suitable for everyone. Always consult your doctor to determine the best treatment plan for your condition.