title: Inpatient management of severe psoriasis.
abstract: Historically, severe psoriasis frequently required inpatient hospitalization for several weeks to reduce symptoms and prevent morbidity and mortality, Despite declining hospitalization rates there remain patients who undergo severe, acute psoriasis exacerbations requiring inpatient care. The majority of the literature describes the treatment of psoriasis in the outpatient setting. We review the inherent differences between the inpatient and outpatient management of psoriasis along several dimensions and discuss an approach to the inpatient treatment of severe psoriasis based upon therapeutic rate of onset, efficacy, and safety. The inpatient setting benefits from and lends itself to use of rapid acting, highly effective agents. Given the acute nature of psoriasis inpatient episodes, the risks associated with long-term use of a treatment are far less important in inpatient setting treatment planning than they are in the outpatient setting.
authors.affiliation: Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1071, USA.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Nelson
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Pearce
authors.forename: Alan B
authors.initials: AB
authors.lastname: Fleischer
authors.forename: Rajesh
authors.initials: R
authors.lastname: Balkrishnan
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
mesh_terms: D001691:Biological Therapy; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007297:Inpatients; D010789:Phototherapy; D021864:Pleistophora; D011565:Psoriasis / Q000188:drug therapy / Q000191:economics / Q000628:therapy*
chemical_list: D007166:Immunosuppressive Agents