Psoriasis

Read articles about psoriasis and its management, as well as its treatment options.

Topical Treatment of Psoriasis in Children

Psoriasis is a common dermatosis, affecting children in North America. Many papers have stressed the treatments available for adult psoriasis, but few have dealt with this disorder in children. Topical treatment modalities continue to be the first line therapy for childhood psoriasis.

The Use of Alefacept in the Treatment of Psoriasis

Alefacept (AMEVIVE™ or LFA3TIP, Biogen) is the newest systemic therapy for chronic plaque psoriasis and was approved by the US FDA in January 2003. Clinical studies have shown that alefacept, given via weekly IM or IV injections for 12 weeks, was well tolerated, with no reported serious adverse events.

Infliximab (Remicade)

Infliximab is monoclonal antibody targeted against human tumor necrosis factor-alpha. Dosage, side-effects, and drug interactions are discussed.

Topical Antipsoriatics

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.

Photodynamic Therapy (PDT) in Dermatology: Sooner or Later?

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.

Combination Therapy of Biologics with Traditional Agents in Psoriasis

Biologics plays an important role in treating moderate to severe psoriasis. This article looks at combination treatment with traditional systemics and topicals, and the possible benefits of this approach.

Once Daily Application of a Combination of Calcipotriol and Betamethasone Dipropionate (Dovobet®, Daivobet®) for the Treatment of Psoriasis

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.

Alcohol and Skin Disorders: With a Focus on Psoriasis

Alcohol is a serious cause of morbidity and mortality in our society and is implicated in multiple health conditions, including hepatic failure, neurological damage, and hematological disorders. Herein, we review the evidence concerning the influences of alcohol in skin conditions.

Oral Treatment for Psoriasis

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

Etanercept (Enbrel)

Etanercept is a TNF-alpha receptor fused onto human IgG and inhibits TNF-alpha activity. Dosage, side-effects, and drug interactions are discussed.

Bimekizumab for Moderate-to-Severe Plaque Psoriasis

Bimekizumab is a novel treatment for moderate-to-severe plaque psoriasis that has shown promising efficacy and safety in clinical trials. By simultaneously targeting two components of the IL-17 pathway, IL-17A and IL-17F, the biologic can downregulate proinflammatory signaling and rapidly improve patients’ skin.

Drugs that may exacerbate psoriasis

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.

Treatment suggestions for different types of Psoriasis

Psoriasis types and subtypes can influence preferred treatment modality. This article discusses the symptoms specific to the psoriasis subtype, and considerations for selecting treatment.

New Systemic Treatments for Psoriasis

Biologics are one of the more effective and relatively safe options for long-term control of psoriasis. They have reduced the time needed to clear the signs of chronic disease, and are effective in maintaining a disease-free state for longer durations. Biologics can safely be used with other treatment modalities (i.e., methotrexate, cyclosporine, acitretin and hydroxyurea).

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.

A Review of Ixekizumab, an Anti-Interleukin-17A Monoclonal Antibody, for Moderate-to-Severe Plaque 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.

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.

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.

Psoriasis Vulgaris

Psoriasis has a greater mental and physical impact than myocardial infarction, hypertension, diabetes mellitus, arthritis, and cancer; only depression had a greater mental impact, and congestive heart failure a greater physical impact.

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.

A Review of Corticosteroids for the Treatment of Psoriasis

A review of corticosteroids, including use, adverse effects, vehicle, generic vs brand name drugs. Physicians and pharmacists alike should be aware of the importance and the difference of various vehicles when prescribing topical corticosteroids.

Selected Skin Diseases with Systemic Involvement

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.

Biologic Therapy and Risk of Infection

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.

Stress as an Influencing Factor in Psoriasis

Emotional stress may influence the development and exacerbation of psoriasis. This article review the evidence for stress and its effects, the challenges in accurate measurements, as well as management strategies.

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.

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.

Systemic and Light Therapies for the Management of Childhood Psoriasis: Part II

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.

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.

Psoriasis Education Tool for Patient-Physician Decision-Making About Biologics: A Pilot Study

Although biologics are well-studied, expertise regarding their use is often lacking. Many biologics have been added to the market in recent years with distinctive characteristics. This study was designed to create a tool to assist physicians involved in the care of patients with psoriasis undergoing biologic treatment.

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.

Etanercept (Enbrel®) – An Update

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.

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..

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.

A Closer Look at the Data Regarding Suicidal Ideation and Behaviour in Psoriasis Patients: The Case of Brodalumab...

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.

Update on Topical Approaches for Managing Scalp Psoriasis (Pharmacist Edition)

Patients suffering from scalp psoriasis frequently seek medical care because of the persistent discomfort due to itching and social embarrassment. This article explores some of the challenges that patients fact, current options and new advances in the topical management and strategies that may improve treatment outcomes.

Calcipotriol and Betamethasone Dipropionate (Dovobet®, Daivobet®): A New Formulation for the Treatment of Psoriasis

A new compound product containing calcipotriol 50μg/gm and betamethasone dipropionate 0.5mg/gm (Dovobet*, LEO Pharma) in an ointment base was recently introduced in Canada for the treatment of psoriasis.

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.

Secukinumab in the Treatment of Psoriasis and Psoriatic Arthritis: A Review of the Literature

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.

Etanercept for the Treatment of Psoriasis

Etanercept has recently been approved for the treatment of moderate-to-severe plaque psoriasis at a dose of 50mg twice per week for 12 weeks followed by a maintenance dose of 50mg once weekly thereafter. Clinical studies have shown excellent efficacy and a good safety profile in patients with psoriasis.

Psoriasis Treatments Under Development

A review of this list of agents that are presently undergoing clinical trial. Although only a few of the drugs on this list will gain regulatory approval, what is exciting is the likelihood that some new agents will be approved and will radically alter the way we treat psoriasis.

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