Psoriasis Pearls

Don’t Neglect Topicals

“We have to remember that topical therapy is still important for our psoriasis patients, because the vast majority of our patients actually have localized disease. With topical therapy, we have to remember that vehicle is important because it can actually affect penetration of the drug as well as the safety profile of the drug.”

—Linda Stein Gold, MD

Consider a Role for Neuromodulation

“We know that people with psoriasis are itchy. We know that basically nerves are involved in a lot of these neurogenic diseases...You can essentially denervate using neuromodulators and it lasts—and it lasts a long time.”

—Erin Gilbert, MD, PhD

 

Hit Hard with Topicals

“People with mild psoriasis still want to get better quick. You have to balance the effectiveness of a topical steroid versus the risk…For localized psoriasis, I still like to use topical steroids. Depending on the body part, I go with ointments if I can, because I think they have better penetration in general.”

—Jerry Bagel, MD

A Note on Skin of Color

“Psoriasis in skin of color can manifest in many forms,” says Seemal R. Desai, MD. “Don’t always think red and scaly! It can be brownish to purple and have less scaling.”

According to Dr. Desai: “Scalp disease often requires different types of medications in skin of color due to hair texture, style, cultural implications, and/or patient preference. For example, a patient with braids may prefer an ointment vehicle for treatment, whereas someone with more a traditional Caucasian hair structure would never consider an ointment to be applied in their hair.

“In skin of color, psoriasis is often times more extensive at time of diagnosis.”