Psoriasis Flashcards
Psoriasis
- Causes
- Stress
- Trauma
- Medications
Psoriasis
- Risk Factors
- Smoking
- Obesity
- Alcohol
Psoriasis
- Medications Causes
Anti Malarias
B-Blockers
Lithium
NSAIDs
Systemic Steroids
Psoriasis
- Impacts
- Brain (Depression)
- Heart (CV)
- Fat (Obesity)
- GI (Crohn)
- Joint (Arthralgia)
Psoriasis
- Treatment
Topical
Systemic
Salicylic Acid
Inhibits inflammation
Coal Tar
Suppresses keratinocyte
Increases chances of sun burns, leaves stains
Corticosteroids
Use for only short term
- Low potency on face
- High potency on thick skin
- Can be used in pregnancy
Calcineurin Inhibitors
Tacrolimus
- Not powerful but does not cause skin thinning
Vitamin D3 Analogues
Calcipotriol
- Mild and moderate involving less than 35% BSA
- NOT use in pregnancy
Do apply within 2 hours of UVB
Phototherapy
Stand up sun-tan booth
- Pretty effective
- Can be used in pregnancy
- No increased risk of skin cancer
Methotrexate
Adverse Effects: Hepatotoxicity, Pulmonary fibrosis,
- Need folic acid
- Stop 3 months before pregnancy
- Do not administer live vaccine
- Monitor CBC, liver, renal and function
Cyclosporine
Used to bridge therapies
- Only use for 1-2 years of therapy maximum
- Do not administer live vaccine
Acitretin
Systemic Therapy (Moderate to Severe)
USE CONTRACEPTION
- 3 months before, during, and 3 months after
Apremilast
Systemic Therapy (Moderate-Severe)
No blood work monitoring is required
Titrate up to prevent GI symptoms
NO pregnancy
NO live vaccines
Deucravacitinib
NO pregnancy
NO Hepatic impairment
Prescreen TB
Biological Injectables Therapy
- Prescreen for Hep B/C, HIV, TB, Blood Test
- No live vaccines
TNF-Alpha Inhibitors
Ada, Certo, Peg, Etan, Inflix
- Contraindication: MS, HF
Results in weight gain
Certolizumab is pegylated and can not cross placenta
Interleukin 17 Inhibitors
Bim, Bro, Ixe, Secu
Contraindications: IBD
Interleukin 23 Inhibitors
Guse/Risan/Tildrak
Longest injection interval
Interleukin 12/23 Inhibitors
Ustekinumab
- Not used as often now
