CME Part II Psoriasis: Which Therapy for Which Patient Focus on special populations and chronic infections

Publication date: Available online 11 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Shivani B. Kaushik, Mark G. Lebwohl

Abstract

Despite the availability of several new systemic agents for psoriasis treatment, it can be challenging to choose the right therapy in certain patient populations. There are few up-to-date reviews on systemic drugs for moderate to severe psoriasis in pregnant and pediatric patients and in patients with concomitant chronic infections such as hepatitis, HIV and latent tuberculosis. These groups are usually excluded from clinical trials and much of the available evidence is based on anecdotal case reports and case series. Being a chronic disease, psoriasis requires long-term treatment and there are concerns of adverse maternal-fetal outcomes, long term side-effects in children and reactivation of latent infections with use of systemic agents in these patients. Part 2 of this CME article will provide insights for choosing appropriate systemic agents for treating moderate-to-severe psoriasis in pregnant and pediatric patients and in the setting of chronic infections such as hepatitis, HIV and latent tuberculosis.