Current and future management of psoriasis.
Management of psoriasis begins with identification of the extent of cutaneous disease. However, a holistic, contractual approach to treatment is encouraged, with particular reference to psychosocial disability and quality-of-life issues. The presence of psoriasis on palms, soles, body folds, genitals, face, or nails, and concomitant joint disease, are also important when considering treatment options. An evidence-based approach is essential in delineating differences between the many available treatments. However, archaic approaches, especially combinational ones, are routinely used by some clinicians, with inadequate prospective or comparative evidence. Treatments currently available are: topical agents used predominantly for mild disease and for recalcitrant lesions in more severe disease; phototherapy for moderate disease; and systemic agents including photochemotherapy, oral agents, and newer injectable biological agents, which have revolutionised the management of severe psoriasis. Other innovative treatments are undergoing clinical studies, with the aim of maintaining safe, long-term control of the condition.
Menter
Alan
A
Baylor Research Institute and Southwestern Medical School, Dallas, Texas, 75246, USA.
Griffiths
Christopher Em
CE
Dermatology Centre, Hope Hospital, University of Manchester, Manchester, UK. Electronic address: christopher.griffiths@manchester.ac.uk.
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002762:Cholecalciferol / Q000031:analogs & derivatives / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D011701:PUVA Therapy; D011565:Psoriasis / Q000188:drug therapy / Q000523:psychology / Q000532:radiotherapy
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D002762:Cholecalciferol; D000069285:Infliximab