American Academy of Dermatology releases final guidelines of care for psoriasis

Building on the evidence-based findings of five previously published guidelines of care that examine the use of a variety of medical therapies for the management and treatment of psoriasis and psoriatic arthritis, the American Academy of Dermatology (Academy) has released its sixth and final guidelines of care for psoriasis. The guidelines detail the recommended approach to treating patients with mild to severe cases of this skin condition by recognized psoriasis experts.

Published online in the Journal of the American Academy of Dermatology, the latest section of the Academy's guidelines of care for psoriasis reviews key findings from the five previously published sections that focused on general recommendations for the treatment of psoriasis and psoriatic arthritis, as well as the use of biologic, topical, systemic and ultraviolet (UV) light therapies.

"There are many factors that dermatologists must consider when treating psoriasis, including the severity of the disease, overall health of the patient, tolerability of therapies and potential side effects, and the patient's level of satisfaction with the treatment regimen," said dermatologist Ronald L. Moy, MD, FAAD, president of the Academy. "These guidelines provide a very comprehensive assessment of the available therapies for psoriasis, while stressing the importance of tailoring treatments to meet individual patients' needs and monitoring the patient for any other commonly associated medical problems."

Psoriasis is a chronic skin condition that usually develops before age 35 and is characterized by thick, red, scaly patches that itch and bleed. Nearly 7 million Americans are living with this skin condition. Both genetic and environmental factors contribute to the development of this disease.

A related condition, psoriatic arthritis, is a chronic disease characterized by stiffness, pain, swelling and tenderness of the joints, surrounding ligaments and tendons. Nearly 85 percent of psoriatic arthritis patients develop psoriasis first. It generally takes about seven to 10 years for psoriasis patients to develop psoriatic arthritis and most commonly develops between the ages of 30 and 50.

"It is important for psoriasis patients to seek treatment for psoriatic arthritis early and to discuss any warning signs of this potentially debilitating condition with their dermatologist," said Dr. Moy. "If left untreated, psoriatic arthritis can result in persistent inflammation, joint damage, severe physical limitations and even disability in some patients."

Although psoriasis was previously thought to be a disease affecting primarily the skin and the joints, a growing body of research suggests that psoriasis patients are at an increased risk of developing serious medical conditions, including heart disease, type 2 diabetes, lymphoma and obesity. These medical conditions associated with psoriasis are troubling in that, if left unchecked, they can lead to serious health consequences for psoriasis patients. In fact, recent evidence suggests an overall increased risk of mortality in patients with severe psoriasis, especially those who have autoimmune and cardiovascular diseases.

"Regular health screenings and continual monitoring by their dermatologist can help psoriasis patients with the early detection of many of the associated medical conditions," said Dr. Moy. "Dermatologists can work together with patients and other specialist physicians to determine appropriate preventive steps and treatments based on a patient's medical history and known risk factors."

In addition, dermatologists recognize that complying with psoriasis treatment - particularly when using topical medications that often require daily application - remains a major issue for many patients. For that reason, dermatologists may alter treatments based on the strength of therapies to achieve a favorable response and long-term management of the condition.

Patients play a key role in improving outcomes of their individual treatment plans. Dermatologists encourage psoriasis patients to adhere to their treatment plans and discuss any concerns with them. Patients should ask questions to ensure that they understand how to follow their treatment plan, avoid common triggers such as stress, smoking and consuming alcohol, and monitor their health for signs of associated medical conditions.

"Research in the causes and treatments of psoriasis continues to expand our knowledge of this complex skin disease, which will help ensure more successful treatment outcomes in the future and, as a result, improve the quality of life for our patients," said Dr. Moy. "These guidelines provide a wealth of information on psoriasis and are an invaluable resource for dermatologists and physicians as they address the specific challenges of their patients."