Psoriasis

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.

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.

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.

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.

Unlike many other psoriasis treatments, tildrakizumab can be used in higher-risk populations, such as in the elderly or those with psoriasis in addition to other health conditions like inflammatory bowel disease (IBD) or psoriatic arthritis.

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.

Tildrakizumab (Ilumya) is a brand-name biologic medication that’s used to treat moderate to severe plaque psoriasis. This drug is an interleukin (IL-23) inhibitor that’s very effective and works long-term to control the symptoms of psoriasis.

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

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.

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.

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

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 novel topical corticosteroid, halobetasol propionate (HP) 0.01% lotion (Bryhali™), has recently been introduced for the treatment of plaque psoriasis and corticosteroid-responsive dermatoses in adults.

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.

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 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.

Psoriasis represents a potentially life-altering disease that can profoundly impact physical, emotional and social functioning, and overall quality of life. Part I of this 2-part series will focus on topical agents, their varying degrees of effectiveness, potential side-effects and applications in clinical practice.

Unlike many other psoriasis treatments, tildrakizumab can be used in higher-risk populations, such as in the elderly or those with psoriasis in addition to other health conditions like inflammatory bowel disease (IBD) or psoriatic arthritis.

Many aspects of psoriasis remain a mystery - but one that is slowly becoming revealed. Various immunobiological treatments for psoriasis are covered in this article.

The benefits of transitioning from Cal/BD ointment or gel to aerosol foam formulation in this Canadian patient population were similar to those reported in clinical studies and were seen consistently among patients with a range of treatment priorities and with differing history of psoriasis severity and treatment history.

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.

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.

Real-world evidence from 7 Canadian cases shows tildrakizumab effectively treats moderate-to-severe psoriasis with excellent safety profile and patient satisfaction.

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.

Explore two case studies of plaque psoriasis, treatment challenges, and novel therapeutic options, including topical roflumilast 0.3% cream. Learn how targeting PDE4 can improve psoriasis management, offering a non-steroidal, effective, and convenient solution for patients with different severities.

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.

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).

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).

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.

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.

Biologics are protein-based medications that target specific parts of the immune system. IL-23 inhibitor specifically targets a type of cytokine called IL-23 and blocks cellular activity, which results in reduced inflammation that causes psoriasis.

Psoriasis is a chronic, recurrent, immune-mediated, papulosquamous skin condition characterized by rapid proliferation of keratinocytes. This article focuses on the role of vitamin D analogues in the treatment of psoriasis.

Combination therapy is both commonly used and effective in treating psoriasis. Common combinations like acitretin+light therapy, methotrexate+UVB, and tar+anthralin are discussed.

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.

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.

People with psoriasis are frequently frustrated over treatments that are ineffective for them, such as tumor necrosis factor biologics, phototherapy, or systemic drugs (such as methotrexate). IL-23 inhibitors, like tildrakizumab, can be an important and effective therapeutic option when patients do not respond to other treatments.

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.

Dovobet®/ Daivobet®/ Taclonex® is a product combining two molecules, calcipotriol and betamethasone dipropionate, that may offer psoriatic patients with an option for maintenance therapy. The efficacy and safety of this combined formulation when used over a 4-week period is well documented.

Tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor offers a convenient dosing schedule. Treatment is administered by subcutaneous injection at start of treatment, after 4 weeks, followed by every 12 weeks thereafter.

Approximately 50% of patients with psoriasis have nail psoriasis but the life time chance of nail changes must be much higher. Nail changes in psoriasis include pitting, thickening, onycholysis, discoloration, oily spots, splinter hemorrhages and paronychia. Treatment of choice depends on the form the psoriasis takes.