Department of Physiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Department of Neurosciences, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Int J Clin Pract. 2021 Aug;75(8):e14290. doi: 10.1111/ijcp.14290. Epub 2021 May 17.
Psoriasis is one of the most common chronic cutaneous skin disorders, having genetic and immunological components. It is currently unknown what exactly triggers it, or how far reaching are the etiological factors, although great strides have been made in uncovering the pathophysiological cascade. Presently, there is a wide diversity of treatment methods for psoriasis, yet not all are applicable for each patient. Selection of both drug and dosage depends on both the knowledge and experience of the treating dermatologist and also on the specific characteristics of each patient. Therefore, the treating physicians should be made aware of the management possibilities, their advantages and their side effects.
We have performed a non-systematic literature review on the current treatment methods for psoriasis. We have included the studies, articles, and prescription information that provided the most relevant information regarding each therapeutic agent. Afterward, we divided the treatment methods according to delivery and illustrated the management protocols for adult, paediatric, and pregnant patients.
Current therapies are divided into topical drugs, phototherapy, systemic and biological agents. Topical therapies and phototherapy are generally the first and second line of management respectively, being typically effective in treating mild to moderate forms of psoriasis. On the other hand, the chronic moderate to severe forms usually benefit from systemic drugs, whereas biologic agents are reserved for severe or unremitting cases, especially those suffering from psoriatic arthritis. Also of importance is the understanding of the pathophysiological mechanisms in psoriasis and how the selected drugs interfere in the pathological cascade. Furthermore, physicians should be able to recommend the appropriate therapy not only for adults but also for paediatric and pregnant patients as well. In the following manuscript, we present an updated version of these management options, alongside their indications, posology and most common side effects, a guide that may be useful for every practitioner in this field.
银屑病是最常见的慢性皮肤疾病之一，具有遗传和免疫成分。目前尚不清楚是什么触发了它，或者病因因素的影响有多深远，尽管在揭示病理生理学级联方面已经取得了很大的进展。目前，银屑病有多种治疗方法，但并非所有方法都适用于每个患者。药物和剂量的选择不仅取决于治疗皮肤科医生的知识和经验，还取决于每个患者的具体特征。因此，治疗医生应该了解管理的可能性、优点及其副作用。
我们对目前银屑病的治疗方法进行了非系统性文献回顾。我们纳入了提供有关每种治疗药物最相关信息的研究、文章和处方信息。之后，我们根据药物的给药方式对治疗方法进行了分类，并为成人、儿童和孕妇患者展示了管理方案。
目前的治疗方法分为局部药物、光疗、系统和生物制剂。局部治疗和光疗通常分别是一线和二线治疗方法，对于治疗轻度至中度银屑病通常是有效的。另一方面，慢性中重度银屑病通常受益于系统药物，而生物制剂则保留给严重或持续不愈的病例，特别是那些患有银屑病关节炎的患者。了解银屑病的病理生理学机制以及所选药物如何干扰病理级联也很重要。此外，医生不仅应该能够为成人推荐适当的治疗方法，还应该能够为儿童和孕妇患者推荐适当的治疗方法。在下面的文章中，我们介绍了这些管理选择的更新版本，包括其适应证、剂量和最常见的副作用，这是该领域每位从业者都可能有用的指南。
