Managing Psoriasis

This issue will bring you up to date on the impact of Psoriasis and recent developments in drug therapy.

Key Takeaways:
• Psoriasis is recognized as an immunemediated, chronic, systemic inflammatory condition.
• About 80% of patients with mild to moderate psoriasis can be managed well with topical medications.
• Corticosteroids are the cornerstone of topical therapy.
Psoriasis is the most common autoimmune condition in the US, affecting 7.5 million people. It is a complex, genetically linked disease; 1 in every 3 patients with psoriasis has a relative with the condition. The human and economic tolls are significant. Patients with psoriasis have lower quality of life scores, along with increased occurrences of depression, anxiety and suicidal ideation. In the US, more than $63 million is spent annually in direct healthcare costs for psoriasis.

Currently, there is no cure; however, a variety of treatments (topical, systemic, phototherapy) are available to manage symptoms, minimize disease progression, and improve quality of life. Since the early 2000s, research into the immunopathogenesis of psoriasis has led to the development of biologic agents that target specific components of the immune system. Despite the availability of multiple treatments, patients with psoriasis in the US are often under treated, or untreated. Untreated or under treated psoriasis leads to disseminated disease and potentially, to joint impairment in the form of psoriatic arthritis (PsA), which causes pain and stiffness of affected joints.

While psoriasis treatment guidelines recommend that trained specialty providers prescribe systemic therapies for patients with this disease, community practitioners should have a sufficient knowledge base to monitor treatment. Frequent patient interactions allow community practitioners, including pharmacists and nurse practitioners, to play an important role in psoriasis management. This issue will review basic information about cutaneous psoriasis and summarize various treatments so practitioners can better manage and educate patients.