Two new guidelines outlining best practices for managing psoriasis have been released by the American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) (Journal of the American Academy of Dermatology Feb. 13, 2019). The guidelines were created with the expertise of psoriasis experts including dermatologists, patient representatives, a cardiologist and a rheumatologist.
“It is critical for both patients and doctors to understand the complexity of psoriasis. It is not just a skin disease; it is a serious condition that can affect all aspects of a patient’s health,” says Randy Beranek, president and CEO of the NPF, in a press release. “Our goal in establishing these guidelines is to help health care professionals educate their patients on the best way to treat their disease and mitigate the effects psoriasis can have on a patient’s overall health and well-being.”
Awareness about psoriasis comorbidities (i.e., psoriatic arthritis, cardiovascular disease, metabolic syndrome, inflammatory bowel disease) is highlighted in the first guideline. It also focuses on the many potential extracutaneous manifestations of psoriasis in adult patients. The guideline addresses the increased risk of anxiety and depression in psoriasis patients. The effects of smoking and alcohol consumption, which can increase patient’s risk of developing psoriasis or make the condition worse in those who already have it, are also outlined.
"We believe this guideline will be a vital resource in the treatment of psoriasis,” said Dr. Craig A. Elmets, co-chair of the work group that developed the guidelines and professor in the department of dermatology at the University of Alabama in Birmingham, Ala. “Doctors should be aware of the conditions associated with this disease, educate patients accordingly, and work with those patients and other physicians to ensure that each patient receives the appropriate screening and treatment.”
The second novel guideline elaborates on pearls for treating the condition with biologics, with an overview of the biologic medications available for the treatment of moderate to severe psoriasis. In addition to outlining the research on the effectiveness of these medications and recommendations for their use, the guideline describes the potential adverse effects of each biologic.
“Before starting any psoriasis treatment, it is important for patients to understand its potential effects, both positive and negative,” said Dr. Alan Menter, co-chair of the guidelines work group, and founder of the International Psoriasis Foundation. “This guideline provides physicians with the information they need to discuss biologic medications with their patients and help them choose the treatment plan that’s best for them.”
The two novel guidelines are the first installments in a series of six. Four other psoriasis guidelines are scheduled for publication in JAAD in the coming months. These upcoming guidelines will address phototherapy, topical therapy, non-biologic systemic medications, and the treatment of pediatric patients.