4.6 Article

Guidelines of care for the management of psoriasis and psoriatic arthritis

Journal

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY
Volume 65, Issue 1, Pages 137-174

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.jaad.2010.11.055

Keywords

adalimumab; alefacept; biologics; case studies; clinical guidelines for psoriasis; combination therapy; comorbidities; dermatology; etanercept; gaps in knowledge; gaps in research; golimumab; guidelines; inflammation; infliximab; methotrexate; narrowband; phototherapy; psoralen plus ultraviolet A; psoriasis; psoriatic arthritis; skin disease; systemic therapy; therapeutic recommendations; topical treatments; traditional systemic therapy; tumor necrosis factor-alfa; ustekinumab

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Psoriasis is a common, chronic, inflammatory, multisystem disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In the first 5 parts of the AmericanAcademy of Dermatology Psoriasis Guidelines of Care, we have presented evidence supporting the use of topical treatments, phototherapy, traditional systemic agents, and biological therapies for patients with psoriasis and psoriatic arthritis. In this sixth and final section of the Psoriasis Guidelines of Care, we will present cases to illustrate how to practically use these guidelines in specific clinical scenarios. We will describe the approach to treating patients with psoriasis across the entire spectrum of this fascinating disease from mild to moderate to severe, with and without psoriatic arthritis, based on the 5 prior published guidelines. Although specific therapeutic recommendations are given for each of the cases presented, it is important that treatment be tailored to meet individual patients' needs. In addition, we will update the prior 5 guidelines and address gaps in research and care that currently exist, while making suggestions for further studies that could be performed to help address these limitations in our knowledge base. (J Am Acad Dermatol 2011;65:137-74.)

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