Psoriasis is a rather common inflammatory skin disease that is characterized by the appearance of red scaly plaques and may affect any part of the body. There are certain factors that make psoriasis a challenge for physicians, these include: high prevalence, disability, chronicity, disfiguration, and associated comorbidities. The approach to the management of Psoriatic patients should also take into account the dermatological clinical features. This review would discuss and focus on recent updates in the management of Psoriatic patients and its common related issues as well as the clinical picture of psoriasis in order to understand and inform medical practitioners and develop their knowledge of the etiology of the condition, immune and environmental factors, has led to the development of precision-targeted therapies that alleviate patient morbidity. PubMed database was searched and screened for relevant observational studies, systematic reviews, randomized controlled trials, meta-journal articles, and journal articles containing the term used in the mesh “Psoriasis”, “Management” “Treatment trials” within the title or abstract. The physician should adhere to updated evidence-based guidelines in the management of psoriatic patients. New biologic modalities and alternative nature-based treatments for psoriasis should be studied. Pharmacodynamics profiles, administration modality, and dosing regimens for the currently available IL-17 and IL-23 inhibitors must be re-examined to improve the overall continuity of care of psoriasis patients.
1. Boehncke WH, Schön MP. Disease burden and epidemiology. Lancet. 2015;386:983-94.
2. Rendon A, Schäkel K. Psoriasis pathogenesis and treatment. Int J Mol Sci. 2019;20(6):1475. doi:10.3390/ijms20061475
3. Lim DS, Bewley A, Oon HH. Psychological Profile of patients with psoriasis. Ann Acad Med Singap. 2018;47(12):516-22.
4. Christophers E. Psoriasis− epidemiology and clinical spectrum. Clin Exp Dermatol. 2001;26(4):314-20.
5. Pezzolo E, Cazzaniga S, Colombo P, Chatenoud L, Naldi L. Psoriasis Incidence and Lifetime Prevalence: Suggestion for a Higher Mortality Rate in Older Age-classes among Psoriatic Patients Compared to the General Population in Italy. Acta dermato-venereologica. 2019;99(3),400-3. doi:10.2340/00015555-3130
6. Kimball AB, Wu EQ, Guérin A, Andrew PY, Tsaneva M, Gupta SR, et al. Risks of developing psychiatric disorders in pediatric patients with psoriasis. J Am Acad Dermatol. 2012;67(4):651-7.
7. Di Lernia V, Goldust M. An overview of the efficacy and safety of systemic treatments for psoriasis in the elderly. Expert Opin Biol Ther. 2018;18(8):897-903. doi:10.1080/14712598.2018.1504016
8. Fernandez-Torres RM, Paradela S, Fonseca E. Psoriasis in patients older than 65 years. A comparative study with younger adult psoriatic patients. J Nutr Health Aging. 2012;16(6):586-91.
9. Augustin M, Glaeske G, Radtke MA, Christophers E, Reich K, Schäfer I. Epidemiology and comorbidity of psoriasis in children. Br J Dermatol. 2012;162(3):633-6.
10. Becker L, Tom WL, Eshagh K, Benjamin LT, Paller AS. Excess adiposity preceding pediatric psoriasis. JAMA Dermatol. 2014;150(5):573-4.
11. Paller AS, Mercy K, Kwasny MJ, Choon SE, Cordoro KM, Girolomoni G, et al. Association of pediatric psoriasis severity with excess and central adiposity: an international cross-sectional study. JAMA Dermatol. 2013;149(2):166-76.
12. Icen M, Crowson CS, McEvoy MT, Dann FJ, Gabriel SE, Kremers HM. Trends in incidence of adult-onset psoriasis over three decades: a population-based study. J Am Acad Dermatol. 2009;60(3):394-401.
13. Tollefson MM, Crowson CS, McEvoy MT, Kremers HM. Incidence of psoriasis in children: a population-based study. J Am Acad Dermatol. 2010;62(6):979-87.
14. Capon F. The genetic basis of psoriasis. Int J Mol Sci. 2017;18(12):2526.
15. Gladman DD, Anhorn KA, Schachter RK, Mervart H. HLA antigens in psoriatic arthritis. J Rheumatol. 1986;13(3):586-92.
16. Hugh JM, Weinberg JM. Update on the pathophysiology of psoriasis. Cutis. 2018;102(5S):6-12.
17. Søyland E, Heier I, Rodríguez‐Gallego C, Mollnes TE, Johansen FE, Holven KB, et al. Sun exposure induces rapid immunological changes in skin and peripheral blood in patients with psoriasis. Br J Dermatol. 2011;164(2):344-55. doi:10.1111/j.1365-2133.2010.10149.x
18. Kim WB, Jerome D, Yeung J. Diagnosis and management of psoriasis. Can Fam Physician. 2017;63(4):278-85.
19. Zampetti A, Tiberi S. Inverse psoriasis. Clin Med. 2015;15(3):311.
20. Dupire G, Droitcourt C, Hughes C, Le Cleach L. Antistreptococcal interventions for guttate and chronic plaque psoriasis. Cochrane Database Syst Rev. 2019(3). doi:10.1002/14651858.CD011571.pub2
21. Hoegler KM, John AM, Handler MZ, Schwartz RA. Generalized pustular psoriasis: a review and update on treatment. Journal of the European Acad Dermatol Venereol. 2018;32(10):1645-51.
22. Engin B, Aşkın Ö, Tüzün Y. Palmoplantar psoriasis. Clin Dermatol. 2017;35(1):19-27.
23. Arellano J, Yagnam M, Vidal M, Corredoira Y. Eritrodermia psoriática en un hombre joven: sospechar infección por VIH. Rev Chilena Infectol. 2017;34(6):603-6.
24. Valenzuela F, Fernández J, Sánchez M, Zamudio A. Erythrodermic psoriasis and human immunodeficiency virus: association and therapeutic challenges. An Bras Dermatol. 2018;93:438-40.
25. Pasch MC. Nail psoriasis: a review of treatment options. Drugs. 2016;76(6):675-705.
26. Alinaghi F, Calov M, Kristensen LE, Gladman DD, Coates LC, Jullien D, et al. Prevalence of psoriatic arthritis in patients with psoriasis: a systematic review and meta-analysis of observational and clinical studies. J Am Acad Dermatol. 2019;80(1):251-65.
27. Cruz NF, Brandão LS, Cruz SF, Cruz SA, Pires CA, Carneiro FR. Ocular manifestations of psoriasis. Arq Bras Oftalmol. 2018;81(3):219-25.
28. Mrowietz U, Kragballe K, Reich K, Spuls P, Griffiths CE, Nast A, et al. Definition of treatment goals for moderate to severe psoriasis: a European consensus. Arch Dermatol Res. 2011;303(1):1-0.
29. MacDonald A, Burden AD. Psoriasis: advances in pathophysiology and management. Postgrad Med J. 2007;83(985):690-7.
30. Kim HJ, Lebwohl MG. Biologics and psoriasis: the beat goes on. Dermatol Clin. 2019;37(1):29-36.
31. Egeberg A, Ottosen MB, Gniadecki R, Broesby‐Olsen S, Dam TN, Bryld LE, et al. Safety, efficacy and drug survival of biologics and biosimilars for moderate‐to‐severe plaque psoriasis. Br J Dermatol. 2018;178(2):509-19.
32. Wang TS, Tsai TF. Biologics switch in psoriasis. Immunotherapy. 2019;11(6):531-41.
33. Loft ND, Vaengebjerg S, Halling AS, Skov L, Egeberg A. Adverse events with IL‐17 and IL‐23 inhibitors for psoriasis and psoriatic arthritis: a systematic review and meta‐analysis of phase III studies. J Eur Acad Dermatol Venereol. 2020;34(6):1151-60.
34. Kamata M, Tada Y. Efficacy and safety of biologics for psoriasis and psoriatic arthritis and their impact on comorbidities: a literature review. Int J Mol Sci. 2020;21(5):1690. doi:10.3390/ijms21051690
35. Kazandjieva J, Grozdev I, Darlenski R, Tsankov N. Climatotherapy of psoriasis. Clin Dermatol. 2008;26(5):477-85. doi:10.1016/j.clindermatol.2008.05.001
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