Fast Five Quiz: Systemic Treatments for Plaque Psoriasis

Chris G. Adigun, MD


May 21, 2020

Figure 1. Plaque psoriasis.

Disease severity, comorbidities, and treatment history should be considered when making treatment decisions for patients with plaque psoriasis. According to a consensus study from the National Psoriasis Foundation, the use of BSA to assess disease severity should be complemented by assessments of patient-reported measures of quality of life and symptoms, such as pruritus and pain, which have been shown to affect patients' perception of disease severity. Of note, disease severity is defined not just by the extent of BSA involved but also by the patient's perception and acceptance of the disease.

Systemic therapies should be considered for patients with extensive psoriasis, or > 3% BSA involvement. It may also be an option for patients whose daily functioning is adversely affected by psoriasis, who have psoriatic arthritis, and/or whose quality of life is impaired due to the disease. Additionally, systemic therapies may be appropriate for patients with mild psoriasis (ie, ≤ 3% BSA involvement) who have an inadequate response to topical therapy or phototherapy, in cases where phototherapy is unfeasible, or when quality of life is negatively affected to the degree that the benefits of systemic therapy outweigh its potential risks.

Learn more about the management of plaque psoriasis.


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