Your patients may seek freedom from their disease, and it begins with tailoring the management of their psoriasis, based on its severity. Avoiding psoriasis flares can have a significant impact on patients' quality of life. Early skin clearance can lead to a lower risk of flares and longer treatment persistence in patients with psoriasis. Hence, early intervention is key.
Depending on the needs of your patients, you may want to prescribe different treatments or refer them to a specialist to ensure they receive the most appropriate therapy for their condition.
Psoriasis is one of the world's most effectively treated immune-mediated disease, with clinical improvements possible in 90% of patients.
Have a look at recommended treatment options based on the severity of psoriasis here:
Topical therapies are helpful and important in most psoriasis treatment regimens.
However, they are generally insufficient to obtain and maintain skin clearance.
Phototherapy is an effective treatment option for patients requiring more than topical medications. It may be insufficient for patients with moderate-to-severe psoriasis; however it can be combined with biologics.
Most sessions must be done at a medical facility, which may be a limiting factor for patients. However, patients can also use home-based equipment.
The vast majority of systemic non-biologic treatments target the immune system.
Although the introduction of biologics has fundamentally changed the management of psoriasis, non-biologics are still used, either as monotherapy or in combination with biologics.
However, long-term use may be associated with a higher risk of adverse events.
For many people, biologics (such as TNFα, IL-17, IL-12/23, and IL-23 inhibitors) are life-changing as they can help control symptoms where other treatments have failed.
Unlike other treatments, they target the inflammatory cascade underlying psoriasis. As a ‘master regulator’ of autoimmune inflammation, IL-23 is a potent target for the treatment of psoriasis and psoriatic arthritis.
Psychological support can help reduce stress and decrease the risk of flare-ups. However, some patients may focus on their condition and on stress avoidance, leading to a worsening of their condition.
Cognitive behavioural therapy aims to break this cycle. Other adjunctive psychological intervention such as mindfulness-based therapy or motivational interviewing may improve patients’ condition.
Patients with moderate to severe psoriasis are more sedentary than the general population and may face barriers to exercise due to their skin disease.
However, being physically active to lose weight can reduce the severity of the disease, especially in overweight patients.
Children and young persons with symptoms of psoriasis should be referred to a dermatologist:
Adults should be referred to a dermatologist as soon as:
Psoriasis has a big impact on your patient's physical, psychological or social wellbeing
Psoriasis is severe or widespread
Psoriasis is not improving with topical treatments
You suspect acute guttate psoriasis
Nail psoriasis impacts your patient's appearance or use of their hands
Patients with generalised pustular psoriasis or erythroderma should be referred to a specialist immediately
Every type of psoriasis is different.
Psoriasis has a deep impact on patients' physical and mental health.