**First-line therapies:** – **Topical corticosteroids:** High-potency for limited disease (e.g., clobetasol 0.05%). Rationale: Rapid suppression of inflammation and proliferation. – **Vitamin D analogs (e.g., calcipotriene):** Moderate efficacy, often combined with corticosteroids. Rationale: Inhibits keratinocyte proliferation and promotes differentiation. – **Topical retinoids (e.g., tazarotene):** Useful for stable plaque psoriasis. Rationale: Normalizes keratinocyte differentiation. – **Second-line therapies:** – **Phototherapy (UVB, PUVA):** For moderate-to-severe disease. Rationale: Suppresses immune response and reduces hyperproliferation. – **Systemic agents (e.g., methotrexate, cyclosporine):** For severe or refractory cases. Rationale: Immunosuppression and anti-inflammatory effects. – **Biologics (e.g., adalimumab, ustekinumab):** For severe disease unresponsive to other therapies. Rationale: Targets specific immune pathways (TNF-α, IL-12/23). – **Lifestyle modifications:** – Avoid triggers (e.g., stress, infections, smoking). – Moisturize skin to reduce dryness and cracking. **Guidelines:** – AAD (American Academy of Dermatology) recommends stepwise approach based on disease severity. – EMA (European Medicines Agency) approves biologics for moderate-to-severe psoriasis.
Context: [Tintinallis_Emergency_Medicine] areas. Initial management of exogenous photosensitivity is similar to the sunburn reaction, including the avoidance of the sun until the eruption has cleared. Discontinue the causative agent, if possible. ■ PSORIASIS Psoriasis is a chronic skin disorder characterized by symmetric discrete ... [Full text of _Harrison's Internal Medicine 2022, 21th Edition Vol 1 & Vol 2_#page=6327] ™ PSORIASIS Psoriasis is one of the most common dermatologic diseases, affecting up to 2% of the world’s population. It is an immune-mediated disease clin- ically characterized by erythematous, sharply demarcated papules and rounded plaques covered by silvery micaceous scale. The skin lesions of... [Nelson-essentials-of-pediatrics] corticosteroids. Psoriasis Psoriasis is a common papulosquamous condition characterized by well-demarcated, erythematous, scaling papules and plaques. Psoriasis occurs at all ages, including infancy, with onset of 30% of cases during childhood. The disease is characterized by a chronic and relap...
Source Document: Full text of _Harrison's Internal Medicine 2022, 21th Edition Vol 1 & Vol 2_#page=6327
Nelson-essentials-of-pediatrics
Tintinallis_Emergency_Medicine