Not all biologics are the same, and the newer biologics tend to be more effective and tolerable and may act more rapidly. These may include interleukin (IL)-17 inhibitors (such as brodalumab or ixekizumab) and the IL-23 inhibitors such as guselkumab or tildrakizumab. Brodalumab has been associated with rare cases of suicidal ideation and completed suicide and so should not be taken by this patient, who reports being depressed.
Methotrexate or retinoids such as acitretin should not be used by the patient because his alcohol consumption is fairly high, and it may increase the risk for liver abnormalities.
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Cite this: David T. Robles. Skill Checkup: A 32-Year-Old Man With an Acute Flare of Psoriasis - Medscape - May 11, 2022.
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