Although there is no cure for psoriasis, there are multiple effective treatment options. Treatment guidelines for psoriasis are now used throughout the world. These guidelines can improve the quality of clinical decisions, and present options for improving the quality of care.
Treatment success is defined as a decrease in Psoriasis Area and Severity Index (PASI) score of 75% or greater that allows for treatment continuation; treatment failure is defined as a decrease in PASI score of less than 50% that necessitates a change in treatment regimen. For systemic therapy of plaque psoriasis two treatment phases were defined: (1) induction phase as the treatment period until week 16; however, depending on the type of drug and dose regimen used, this …show more content…
Calcipotriol and corticosteroids have been used as topical therapies in psoriasis vulgaris for many years. Topical corticosteroids are considered the cornerstone of topical treatment and well tolerated for the patients with mild psoriasis vulgaris. Salicylic acid or urea, keratolytic agents, can be combined with steroid therapy to help treat plaques with thicker scales, for better penetration of medication. The possible side effects of topical corticosteroids are local skin changes, tachyphylaxis, and hypothalamic-pituitary-adrenal axis suppression. Calcipotriol is a vitamin D3 analogue and reduces symptoms by modulating keratinocyte proliferation and differentiation, and by inhibiting T lymphocyte activity. Side effects of calcipotriol include mild irritant dermatitis and rarely hypercalcemia with excessive use. These agents should not be used in combination with salicylic acid or before phototherapy. Topical corticosteroids and calcipotriol may be used in combination to improve symptom control and tolerability (Akyol, …show more content…
Important parameters required for systemic treatment: Severity of psoriasis (PASI), life quality (DLQI), presence of psoriatic arthritis, pregnancy, man attempting to conceive a child, history of hematologic malignancy, immunodeficiency, alcohol use. Baseline laboratory workup before systemic treatment include comprehensive metabolic panel, complete blood count. Additionally, β-human chorionic gonadotropin, lipid panel, hepatitis markers (hepatitis B and C) and PPD or quantiferon test should be requested when necessary. In the case of using biological agents, including etanercept, infliximab, adalimumab, ustekinumab or secucinumab, investigations should be made according to the relevant treatment guidelines (Akyol,
Treatment success is defined as a decrease in Psoriasis Area and Severity Index (PASI) score of 75% or greater that allows for treatment continuation; treatment failure is defined as a decrease in PASI score of less than 50% that necessitates a change in treatment regimen. For systemic therapy of plaque psoriasis two treatment phases were defined: (1) induction phase as the treatment period until week 16; however, depending on the type of drug and dose regimen used, this …show more content…
Calcipotriol and corticosteroids have been used as topical therapies in psoriasis vulgaris for many years. Topical corticosteroids are considered the cornerstone of topical treatment and well tolerated for the patients with mild psoriasis vulgaris. Salicylic acid or urea, keratolytic agents, can be combined with steroid therapy to help treat plaques with thicker scales, for better penetration of medication. The possible side effects of topical corticosteroids are local skin changes, tachyphylaxis, and hypothalamic-pituitary-adrenal axis suppression. Calcipotriol is a vitamin D3 analogue and reduces symptoms by modulating keratinocyte proliferation and differentiation, and by inhibiting T lymphocyte activity. Side effects of calcipotriol include mild irritant dermatitis and rarely hypercalcemia with excessive use. These agents should not be used in combination with salicylic acid or before phototherapy. Topical corticosteroids and calcipotriol may be used in combination to improve symptom control and tolerability (Akyol, …show more content…
Important parameters required for systemic treatment: Severity of psoriasis (PASI), life quality (DLQI), presence of psoriatic arthritis, pregnancy, man attempting to conceive a child, history of hematologic malignancy, immunodeficiency, alcohol use. Baseline laboratory workup before systemic treatment include comprehensive metabolic panel, complete blood count. Additionally, β-human chorionic gonadotropin, lipid panel, hepatitis markers (hepatitis B and C) and PPD or quantiferon test should be requested when necessary. In the case of using biological agents, including etanercept, infliximab, adalimumab, ustekinumab or secucinumab, investigations should be made according to the relevant treatment guidelines (Akyol,