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Psoriasis
Psoriasis is a chronic systemic immune related inflammatory disease with comorbidities affecting various organs. Skin is the most prominent organ of involvement, patients typically presented with well defined silver scaly plaques affecting scalp, extensor surfaces of joints, lower back and genital areas. Other clinical features include pustular eruptions, guttate eruptions, flexural surface involvement or erythroderma.
Psoriasis is considered as a systemic disease because it is clearly linked with a number of systemic and psychological comorbidities besides skin involvement. Up to 30% of psoriasis patients also suffered from psoriatic arthritis. The affected joints may not only become painful and swollen, but also possibly deformed. The chronic inflammatory nature of psoriasis also increased the risks of metabolic syndrome, ischaemic heart disease and cerebrovascular accidents.
Medical Therapy for Psoriasis - Topical agents and Biologics
Treatment options depend on multiple factors including clinical severity, patient's comorbidities, underlying diseases and preference. The clinical disease severity is usually graded by the degree of skin involvement and the impact on quality of life.
With the recent advancement in new medication development, currently there are more treatment options available.Topical agents such as vitamin D analog, tar, steriod are used for patients with mild disease.
Biologics treatment should be considered in patients with moderate-to-severe psoriasis, or suffer from psoriatic arthritis or failed topical medication. Biologics are protein based medication derived from living cells, targeting specific part of the immune system to exert their treatment effects. TNF-alpha inhibitor was the first biologics used for psoriasis, followed by IL-12/23 inhibitor. The latest biologics agents invlude IL-17 and IL-23 inhibitors, these highly effective agents became more commonly used.
With the current available biologics, patients with psoriasis are having much more unprecedented improvement. However, not all patients are suitable to use biologics treatment, please consult your dermatologist for details.
Public Education - Psoriasis Treatment and Management
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