Current Management of Scalp Psoriasis
The scalp is involved in up to 80% of individuals with psoriasis. Topical treatment with corticosteroids with or without vitamin D3 analogues is the mainstay of treatment, but other therapies such as light treatment and systemic drugs including biologics are discussed.
The Evolution of Topical Formulations in Psoriasis
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.
A Dermatologist’s Guide to Infection Screening Prior to Initiating Immunosuppressive Therapy
In this review, we summarize the most common immunosuppressant medications currently used in dermatology, and provide recommendations for infection screening prior to
initiating treatment.
Methotrexate: Role of Treatment in Skin Disease
Methotrexate has been used for over half a century to treat a wide spectrum of skin conditions. This article delves into research on the pharmacogenetic properties of the drug as well as the variety of skin conditions that Methotrexate is used to treat.
Brodalumab: A Review of Safety
Interleukin (IL)-17 is important in the pathophysiology of psoriasis and has proven to be an effective therapeutic target. As brodalumab enters the marketplace, a review of this important biologic, its safety profile, and discussion of possible adverse effects is in order.
IL-12/IL-23 Inhibitors: The Advantages and Disadvantages of this Novel Approach for the Treatment of Psoriasis
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.
Psoriasis, Depression, and Suicidality
Psoriasis is a chronic condition that affects the well-being and quality of life of patients. The disease is associated with an increased risk of depression and suicidality, which may not be fully understood by the general population.
Topical Management of Recalcitrant Psoriasis and Eczema
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.
Sirolimus: A Therapeutic Advance for Dermatologic Disease
Sirolimus, also known as rapamycin (SRL, Rapamune®), was approved in 1999 by the US Food and Drug Administration to prevent graft rejection in renal transplantation. This articles reviews Sirolimus, its pharmacokinetics, mechanism of action, and indication.
Interleukin-17 (IL-17) Inhibitors in the Treatment of Plaque Psoriasis: A Review
Interleukin-17 (IL-17) is believed to be a potent driver of plaque psoriasis. This article reviews efficacy and safety results from Phase 2 and 3 trials with monoclonal antibodies targeting IL-17RA (brodalumab), and IL-17A (ixekizumab and secukinumab) for the treatment of plaque psoriasis.
Dermatologic Applications and Safety Considerations of Janus Kinase Inhibitors
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 of the Scalp
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.
Medicated Shampoos are Effective in Many Scalp Conditions
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.
Therapeutic Moisturizers in Eczema and Xerosis Management
Psoriasis and eczema, especially atopic eczema, are two of the most common cutaneous conditions seen by family physicians and dermatologists. This article focuses on corticosteroids of varying strengths and their suggested indications.
Brief Update on Dermatologic Uses of Methotrexate
Methotrexate has been an important agent in the management of dermatologic conditions for decades. Although first indicated for the treatment of psoriasis, MTX has been shown to be a successful treatment option for a wide array of skin diseases.
Update on Topical Approaches for Managing Scalp Psoriasis
Patients suffering from scalp psoriasis frequently seek medical care because of the persistent discomfort and social embarrassment caused by the visible flakes that are shed onto clothing. However, the presence of hair makes it challenging to apply medication to the scalp.
Treatments for Chronic Palmoplantar Pustular Psoriasis
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.
Treatments for Scalp Psoriasis with Emphasis on Calcipotriol Plus Betamethasone Dipropionate Gel (Xamiol®)
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.
Alefacept Treatment for Chronic Plaque Psoriasis
Biologic agents were introduced during the past decade as a new class of treatments for chronic psoriasis. This review will discuss data from clinical trials that have provided new insights into the efficacy, safety, and cost effectiveness of alefacept as a treatment for psoriasis.
Pediatric Psoriasis Comorbidities
While the association between psoriasis and various comorbidities is well documented in adults, questions remain as to whether the same relationships exist in the pediatric population.
A Closer Look at the Data Regarding Suicidal Ideation and Behavior in Psoriasis Patients: The Case of Brodalumab
There is no clear evidence that monoclonal antibodies influence neurological function and modulate behavior in humans. More research in this area is necessary in order to begin to understand the potential effects of..
A Review of Guselkumab, an IL-23 Inhibitor, for Moderate-to-Severe Plaque Psoriasis
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.
Excimer Laser Therapy for Hairline Psoriasis: A Useful Addition to the Scalp Psoriasis Treatment Algorithm
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.
Pediatric Psoriasis
Several variants of psoriasis are seen in children, the most prevalent types include plaque, guttate, and psoriatic diaper rash; pustular and erythrodermic psoriasis are less frequently observed. This article discusses genetic susceptibility, and environmental triggers are discussed.
Apremilast in the Treatment of Psoriasis and Psoriatic Arthritis
Apremilast, a selective PDE4 inhibitor, has been shown to reduce the production of pro-inflammatory cytokines. A review of clinical trial data treating psoriasis, considering adverse effects, efficacy and tolerance.
Efficacy of Acitretin in Severe Psoriasis
Acitretin (SORIATANE®, Roche Pharmaceuticals) is an aromatic retinoid, effective in the treatment of severe psoriasis. This study highlights data from two existing clinical trials to capture PASI 50 and PASI 75 responder rates which represent a common metric used in current psoriasis clinical trials.
Psoriasis as the Marker of Underlying Systemic Disease
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.
Certolizumab Pegol in Plaque Psoriasis: Considerations for Pregnancy
Certolizumab Pegol appears to offer a safe and effective psoriasis treatment for patients who are considering pregnancy, pregnant, or lactating based on its pharmacokinetics and available safety data.
Interleukin-23 in the Pathogenesis and Treatment of Psoriasis
In the past three decades, major advances have been made in understanding the pathogenesis of psoriasis. This review focuses on the role of IL-23 in psoriasis pathogenesis and the current therapies targeting IL-23 that are being studied in clinical trials.
Review of Conventional Systemic Therapies for Severe Psoriasis
Psoriasis is a chronic inflammatory cutaneous disorder that can significantly affect patient quality of life (QoL). This article discusses immunologic abnormalities, immune mediators, and the possible pathogenesis of psoriasis.
A Review of Brodalumab, an IL-17 Receptor Antagonist, for Moderate-to-Severe Plaque Psoriasis
Psoriasis is a chronic immune-mediated inflammatory disease with epidermal hyperplasia. Interleukin (IL)-17 signaling has a central role in its pathogenesis, and is being looked at as a target. The rationale for IL-17 inhibitors, clinical trial results of new drugs like Brodalumab are included.
Risankizumab, an IL-23p19 Inhibitor for Psoriasis: A Review of the Current Literature
The addition of biologics that target IL-23p19 (Risankizumab) to our therapeutic armamentarium has succeeded in improving outcomes in patients with moderate-to-severe plaque psoriasis.
Small Molecules: An Overview of Emerging Therapeutic Options in the Treatment of Psoriasis
While biologics changed the way psoriasis is treated by providing effective targeted therapy, they are not without limitations. Small molecules are emerging therapeutic options for the treatment of psoriasis.
The Impact and Treatment of Psoriasis in Manitoba Dermatology Clinics: The Case for Calcipotriol-Betamethasone Dipropionate Foam Formulation
In a small real-world patient case review study, dermatologists tested the efficacy, safety and patient preference of Enstilar®, a calcipotriol-betamethasone dipropionate (Cal/BD).
Tildrakizumab for Moderate-to-Severe Plaque Psoriasis
Tildrakizumab is a promising therapeutic option for patients with moderate-to-severe chronic plaque psoriasis. The specificity of the drug in targeting the p19 subunit of IL-23 allows for the high efficacy and safety of long-term treatment as demonstrated in clinical trials.
Current Effective Topical Therapies in the Management of 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.
Tofacitinib in the Treatment of Rheumatoid Arthritis and Chronic Plaque Psoriasis
Tofacitinib is an oral immunosuppressant approved for the treatment of rheumatoid arthritis (RA) and is currently undergoing investigation (Phase III trials) for treating chronic plaque psoriasis.
New Developments in Topical Sequential Therapy for Psoriasis
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.
Biologic Drugs and How They Work
Biologics represent a new type of treatment that shows promise. This article provides a quick overview of how they work, and what makes these classes of drugs promising.
The Evolving Role of Biologics in the Treatment of Pediatric Psoriasis
The exact role of biologics in the treatment of pediatric psoriasis remains undefined but evolving. This article will provide a summary of the cumulative pediatric safety and efficacy data for the anti-tumor necrosis factor-alpha (TNF-α) agents and interleukin (IL)-12 and IL-23 (IL12/23) pathway inhibitor.