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.
The Role of the Dermatologist in Identification and Treatment of the Early Stages of Psoriatic Arthritis
Early diagnosis of psoriatic arthritis (PsA) is essential for preventing disease progression and joint destruction. We will review the presentation and temporal relationship of psoriasis and PsA, the diagnosis, classification, and management and the role of the dermatologist.
This article discusses the main objectives of psoriatic arthritis treatment and management. Expectations, as well as specific symptoms like joint stiffness are discussed.
Methotrexate, originally an anti-cancer drug, has been used to treat psoriasis and psoriatic arthritis effectively. This article discusses methotrexate, including side-effects drug interactions, and tests, as well as efficacy in the context of treating psoriatic arthritis.
To date, the US FDA has approved three tumor necrosis factor (TNF)-a inhibitors for use in dermatology. The distinct and targeted mechanism of action of the TNF inhibitors allows dermatologists to customize therapy to match the individual needs and characteristics of patients who are candidates for systemic therapy.
Advancements in topical antipsoriatic therapies have provided safer and more effective treatment options, especially when used in combination. Consequently, much research is underway to investigate novel treatment combinations for psoriasis in the hope that it will provide further enhancements in efficacy.
Etanercept (Enbrel®, Amgen and Wyeth), a tumor necrosis factor (TNF) antagonist, was approved in January 2002, for the treatment of psoriatic arthritis (PsA). Etanercept was evaluated for the treatment of PsA and psoriasis in a preliminary study of 60 patients and in a confirmatory phase III study of 205 patients.
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.