Advances in Psoriasis

South Med J. 2017 Jan;110(1):65-75. doi: 10.14423/SMJ.0000000000000596.

Abstract

Psoriasis treatments range from topical treatments and phototherapy to oral systemic medications and injections. Despite good control of the disease when applying appropriate treatments (according to disease severity, insurance parameters, patient preference, and patients' ability to adhere), continued advancements will allow even better symptomatic control, reduced adverse effects, and patient satisfaction. This review aims to assess traditional and new psoriasis treatments and how to apply them in clinical practice. A literature review on psoriasis treatments and clinical applications was performed using PubMed. Mild-to-moderate psoriasis treatments include topicals, localized phototherapy, and newer therapies combining two types of topicals, phototherapy with topicals, and easy-to-use foam and spray vehicles. Moderate-to-severe psoriasis therapies include monotherapy or various combinations of generalized phototherapy, oral treatments, and biologic agents, with new oral and biologic agents on the horizon. Dermatologists and primary care providers share roles in screening for associated comorbidities (including cardiovascular disorders, chronic kidney disease, Crohn disease, dyslipidemia, diabetes mellitus/insulin resistance, depression, metabolic syndrome, obesity, and psoriatic arthritis), managing patients' treatments, and reevaluating treatment needs as new therapies are approved. Continued advancements in psoriasis treatment and improvement in coordinated care will allow better overall care of patients with psoriasis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acitretin / therapeutic use
  • Administration, Topical
  • Adrenal Cortex Hormones / therapeutic use
  • Cyclosporine / therapeutic use
  • Dermatologic Agents / therapeutic use
  • Humans
  • Interleukins / antagonists & inhibitors
  • Methotrexate / therapeutic use
  • PUVA Therapy / methods
  • Phototherapy / methods
  • Psoriasis / drug therapy
  • Psoriasis / therapy*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Vitamin D / analogs & derivatives

Substances

  • Adrenal Cortex Hormones
  • Dermatologic Agents
  • Interleukins
  • Tumor Necrosis Factor-alpha
  • Vitamin D
  • Cyclosporine
  • Acitretin
  • Methotrexate