Contents
Treatment Guidelines for Chronic Plaque Psoriasis: A Roadmap for Care
Published: Jun 02, 2024
Treatment guidelines for chronic plaque psoriasis provide a framework for optimal patient care. This article outlines key recommendations from major dermatology organizations to help patients understand their treatment options.
Assessing Psoriasis Severity
Guidelines recommend assessing psoriasis severity to guide treatment decisions. This typically involves measuring the body surface area affected, the intensity of plaques, and the impact on quality of life. Mild psoriasis generally affects less than 3% of the body, while moderate to severe psoriasis affects more than 3-10% or has a significant impact on quality of life.
Treatment Approach for Mild Psoriasis
For mild psoriasis, guidelines recommend starting with topical treatments. This may include corticosteroids, vitamin D analogues, or combination products. Targeted phototherapy may be considered for resistant areas. If topical treatments are ineffective, progression to systemic treatments may be warranted.
Managing Moderate to Severe Psoriasis
For moderate to severe psoriasis, guidelines suggest considering phototherapy or systemic treatments. Biologics are often recommended as first-line systemic therapy due to their efficacy and safety profile. Traditional systemic drugs like methotrexate or cyclosporine may be used in certain cases. Treatment choice depends on factors like psoriasis severity, comorbidities, and patient preferences.
Monitoring and Adjusting Treatment
Guidelines emphasize the importance of regular monitoring and treatment adjustment. This includes assessing treatment response, typically aiming for at least 75% improvement in psoriasis severity. If the response is inadequate, guidelines suggest considering dose adjustments, switching treatments, or combination therapy. Long-term safety monitoring is crucial, especially for systemic treatments.
Frequently Asked Questions
Guidelines recommend review every 3-6 months or as needed.
They're often preferred, but treatment is individualized.
Yes, they recommend screening and early treatment.
Some are mentioned, but evidence is limited for most.
Major updates typically occur every few years as new evidence emerges.
Personalized Care Within Guidelines
While guidelines provide a framework, psoriasis treatment should always be tailored to the individual patient's needs and preferences.
References
- Menter A, et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. J Am Acad Dermatol. 2019;80(4):1029-1072.
- Smith CH, et al. British Association of Dermatologists guidelines for biologic therapy for psoriasis 2020: a rapid update. Br J Dermatol. 2020;183(4):628-637.
- Nast A, et al. European S3-Guidelines on the systemic treatment of psoriasis vulgaris - Update 2015 - Short version - EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol. 2015;29(12):2277-94.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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