Psoriasis Headquarters
Welcome to Psoriasis Headquarters, the center for free CME and CE courses and the most up-to-date information on psoriatic arthritis and psoriasis treatments. Here you will find the latest research data, expert opinions, and medical training to earn CME and CE credits as you increase your knowledge of these conditions.
Ask The Expert
Ask the Expert, Jeffrey Weinberg, MD, challenging questions regarding psoriatic conditions!
Jeffrey M Weinberg, MD, FAAD
Assistant Clinical Professor
Columbia University College of Physicians and Surgeons
New York, NY
Latest Questions (Click question for answer)
- It seems common that psoriasis flares up when other health conditions do. should we look for a trigger, or just treat the flare?
Answer: Psoriasis has several well-known triggers, including some medications, infections, skin injury, and stress. The major reason to look for a trigger is that, if this factor can be removed, the psoriasis may abate. Several years ago, a young woman presented with nail complaints consistent with psoriasis. Upon taking her history, she was taking lithium for bipolar disorder. The changing of this medication improved her nail dystrophy. Therefore, a detailed history, including potential triggers, may be useful and should be performed. If there is no obvious trigger, appropriate therapy can be instituted.
- Any tricks for treating widespread guttate psoriasis in children/young adults?
Answer: Guttate psoriasis can often present a therapeutic challenge, given its diffuse and patchy nature. Obviously topical therapy and phototherapy are options, but there are limitations to both of these. It is hard to apply topicals to diffuse guttate lesions, and phototherapy, while effective, can often be inconvenient. In the setting of streptococcal pharyngitis, a positive throat culture, or a positive AASO titer, an empiric course of antibiotics may be an option to remove the potential stimulus for the guttate flare. In extreme cases, a short course of systemic therapy, with appropriate monitoring, may be an option.
- When do you typically decide to start a patient with psoriasis on a systemic agent?
Answer: Although practitioner experience as well as clinician and patient preferences guide the answer to this question, some general guidelines can be recommended: Patients with psoriasis and psoriatic arthritis should be started on an anti-TNF agent with or without methotrexate. Patients with limited psoriasis may respond to topical therapy or targeted phototherapy while individuals with extensive disease are candidates for systemic intervention, which may include UVB/PUVA, traditional systemic (eg, cyclosporine), or biologic agents. In addition, patients with limited disease who do not respond to topical or targeted phototherapy should be considered for treatment with a traditional systemic or biologic.
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0.50 AMA PRA Category 1 Credit(s)™
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Editorial Advisory Board
Ellen H Frankel, MD
Chief Dermatology, St Joseph’s Hospital
President of the PHO, Kent County Memorial Hospital
Private Practice, Cranston, RI
Clinical Partners, LLC
Johnston, Rhode Island
Kristine J Kucera, PA-C, MPAS, DHS
Texas Dermatology Associates
Adjunct Clinical Instructor
University of Texas Southwestern Medical Center
Dallas, Texas
David M Pariser, MD, FACP, FAAD
Professor, Department of Dermatology
Eastern Virginia Medical School
Norfolk, Virginia
Melodie Young, RN, MSN, ANP-C, GNP-C
Adjunct Clinical Instructor
The University of Texas at Arlington
Modern Dermatology
Baylor Health Care System
Dallas, Texas
Click here for Credentials, Biographies, and Disclosures
Faculty & FDA Disclosure Statement
In accordance with Policy, presenters have indicated if they have a conflict of interest, and if so, it has been resolved.
The contents of some CME/CE activities may contain discussions of non-approved or off-label uses of some of the agents mentioned. Please consult the prescribing information for full disclosure of approved uses.
Practice with the Experts Volume 4 Issue 4
