Psoriasis

Question 1

Calcitriol, Calcipotriene

Answer 1

Psoriasis
Vit D3 agents
INDICATIONS
Calcitriol
─ Psoriasis plaques (mild-moderate)
─ Vitamin D deficiency
Calcipotriene
─ Plaque Psoriasis (mild-moderate)
MOA
• Unknown – may inhibit production from cytokines from skin-infiltrating T-cells
ADE
- Calcitriol - Lab abnormalities, urine abnormalities, hypercalciuria, and pruritus
- Calcipotriene -	Burning, itching, and mild irritation
─ Dryness and erythema of treatment area

Question 2

Acitretin

Answer 2

Psoriasis
Retinoid Agents
INDICATIONS
─ Severe intractable Psoriasis, particularly pustular forms
MOA
• Binds RAR and RXR ⇒regltn of genes ⇒ 
modulates the proliferation of keratinocytes 
ADE
─ Dry skin, pruritus, erythema, rash
C/I
─ **Pregnancy

Question 3

Tazarotene

Answer 3

Psoriasis
Retinoid Agents
INDICATIONS
─ Plaque Psoriasis
─ Acne
MOA
• UNK in psoriasis 
• **metabolites binds RAR & RXR →modifies gene expression
ADE
─ Pruritus, erythema, and burning
C/I
─ **pregnancy

Question 4

Tacrolimus, Pimecrolimus

Answer 4

Psoriasis
INDICATIONS
─ *Plaque, Inverse Psoriasis (face and genitals)
─ Atopic dermatitis
MOA
─ Inhibit calcineurin, blocks T-cell activation
ADE
─ Burning or feeling of warmth
Precautions, not C/I.
─ Pregnancy (teratogenic effects in animals

Question 5

Etanercept

Answer 5

Psoriasis
Tumor Necrosis Factor (TNF) Inhibitors
INDICATIONS
─ Psoriatic Arthritis/ Plaque Psoriasis
- SC
MOA
• Bind *TNF-α,β ⇒ prevents TNF receptor interaction
ADE
─ Serious infections i.e. sepsis and pneumonia
C/I
- sepsis

Question 6

Infliximab

Answer 6

Psoriasis
Tumor Necrosis Factor (TNF) Inhibitors
INDICATIONS
─ Psoriatic Arthritis/ Plaque Psoriasis
- IV
MOA
• binds TNF-α to soluble/transmembrane form ⇒ prevents binding to TNF-α receptors
ADE
─ Serious infections i.e. sepsis and pneumonia
C/I
- mod~severe heart failure