Psoriasis

Scalp psoriasis, especially around the hairline, can cause significant impairment in quality of life due to its visibility. This articles makes a case for a combination of 308 nm excimer laser with clobetasol spray for the treatment of scalp psoriasis.

Scalp conditions such as itchy scalp, dandruff, seborrheic dermatitis, and scalp psoriasis are common. The emotional effect these complaints cause are often ignored or trivialized, but as dermatologists we should appreciate the relief that appropriate advice and treatment will bring to our patients.

Oral treatments for treating psoriasis are discussed. This article focuses on methotrexate, acetretin, and cyclosporine.

This article discusses the role that dermatologists can play in recognizing the cutaneous manifestations linked with some systemic conditions. Identifying the underlying disorder will contribute to appropriate diagnosis and improved management.

Pregnancy is characterized by multiple physiologic changes. Herein, we review the complicated relationships between psoriasis and pregnancy.

Chronic palmoplantar pustular psoriasis is a disabling condition characterized by recurrent crops of sterile pustules on a background of erythema, fissuring and scaling. Genetic and environmental factors have been implicated in its etiology.

Topical agents for the treatment of psoriasis are indicated for patients whose affected area is < 10% of their skin. However, for long-term use, their effectiveness can be limited. Topical sequential therapy involves the application of a class I corticosteroid and calcipotriene in three different phases.

Psoriasis is a common chronic inflammatory skin disease that is mediated, in part by the body’s T-cell inflammatory response mechanisms. Current data regarding the efficacy of these agents show they may have the potential to become the new clinical gold standard for biologic therapy to treat psoriasis.

Recent advances in our understanding of the innate and adaptive immune systems have led to the identification of interleukin (IL)-17 as a key pro-inflammatory mediator in psoriasis. We review phase 1-3 clinical trials of ixekizumab, for treatment of moderate-to-severe plaque psoriasis.

Etanercept is a tumor necrosis factor antagonist with anti-inflammatory effects. It is currently approved in the US for psoriasis, psoriatic arthritis, ankylosing spondylitis, rheumatoid arthritis and juvenile rheumatoid arthritis. Clinical trials have shown this agent to have an excellent safety profile and to be well tolerated by both adult and pediatric patients.

Janus kinase inhibitors, also known as JAK inhibitors or jakinibs, represent a new class of medication that have broad potential to treat dermatologic disease.

Psoriasis is thought to arise from a combination of pathogenic factors including genetic susceptibility and environmental exacerbation. This article reviews the current status of guselkumab as a therapy for moderate-to-severe plaque psoriasis.

Topical therapy forms the cornerstone of treatment in the management of psoriasis. Topical options, vehicle advances, and treatment efficacy of several topicals are discussed for managing psoriasis.

Biologic compounds are being used more frequently to treat a multitude of systemic inflammatory conditions. This article discusses the increased risk of opportunistic infections of tuberculosis, herpes zoster, Legionella pneumophila, and Listeria monocytogenes.

When prescribing brodalumab, or any other biologic agent, physicians should screen patients for psychiatric comorbidities. Assessment of risk versus benefit, and having an honest conversation with patients regarding the label, will help provide better patient care for both physical and mental health.

With growing public reluctance to use systemic medications we can expect topical treatments for psoriasis and other skin conditions to become increasingly important in the future. These drugs are useful not only to control this disease, but also to limit the irritation caused by medications such as tazarotene and anthralin.

Scalp psoriasis occurs in 50%-75% of patients with plaque psoriasis. It may be the only area of the body affected, or it may be associated with disease elsewhere, including psoriatic arthritis. Most cases are treated topically, usually with steroids and/or calcipotriol.

Psoriasis is associated with comorbidities that include metabolic syndrome and increased cardiovascular risk. These conditions share etiologic features and health consequences that directly correlate with the severity of psoriatic disease.

Topical treatments are usually the first line therapies for psoriasis. Corticosteroids, calcipotriol/calcupotriene, tazarotene, tars, and anthralin are discussed.

Most people with mild-to-moderate psoriasis manage their disease with topical therapies. However, adherence to topical treatment remains a challenge.. Read about new topical therapeutic options.

Secukinumab demonstrates rapid and robust clinical improvement accompanied by a favorable short- term safety profile. The results of the phase III trials continue to reinforce the theory that the IL-17 pathway is an essential target in psoriasis and psoriatic arthritis treatment.

This new compound product containing 50µg/gm calcipotriol and 0.5mg/gm betamethasone dipropionate was recently introduced in Canada for the treatment of psoriasis. Clinical trials demonstrated that this compound was more active than either agent used alone.

Moderate-to-severe psoriasis is known to affect millions of people around the globe. This chronic disease substantially impacts patients by impairing their quality of life. The biologics are the newest and most effective therapeutic weapon in the treatment of moderate-to-severe psoriasis and psoriatic arthritis.

This review concentrates on those drugs which have been clearly shown, or are widely reputed, to make psoriasis worse. There is insufficient clinical evidence to justify the inclusion of many drugs which have been included in published lists of drugs said to exacerbate psoriasis.

In October 2004 Amevive® (alefacept) became the first biologic approved for psoriasis in Canada. It is used to treat moderate to severe psoriasis. This article discusses clinical trials, side effects, and drug interactions.

Research has shown high levels of effectiveness are maintained for 5 years and beyond with tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor.

Although PDT remains an investigational treatment modality in dermatology, several important areas of development may ultimately lead to official and practical acceptance of PDT for the skin. Various uses of PDT are evaluated.

Psoriasis and eczema, especially atopic eczema, are two of the most common cutaneous conditions seen by family physicians and dermatologists. This article discusses the etiology of psoriasis and eczema, immunologic abnormalities, and the role of immune mediators.

The choice of treatment for psoriasis in children, as in adults, is determined by disease acuity, morphology, distribution, and severity. Part II of this 2-part series features an overview of systemic and light therapies including their varying degrees of effectiveness, potential side-effects and applications in clinical practice.

After 12 weeks of treatment with tildrakizumab (Ilumya), over 50 percent of patients can be cleared of their psoriasis. This biologic drug was approved in Canada in October 2021.

Psoriasis remains a therapeutic challenge. Involvement of the scalp can be minimal (“dandruff”) or more significant and difficult to manage. Gentle treatment, reducing trauma, and treating the inflammation and pruritus will improve therapeutic results.