Psoriasis and Other Papulosquamous Eruptions: Clinical Pearls

Bruce Strober, MD, PhD

  1. The severity of psoriasis is based on BSA, location, impact on quality of life and presence of psoriatic arthritis.
  2. Patients diagnosed with psoriasis should also be assessed for psoriatic arthritis and other comorbidities.
  3. Psoriasis treatment is not stepwise.
  4. Choice of therapy depends on individual patient characteristics.
  5. Combination therapy may be desirable in some patients.
  6. Topical therapies are appropriate initial step for patients with MILD psoriasis.
  7. Patients failing to response to treatment or worsening symptoms, RETHINK the psoriasis diagnosis.
  8. Erythrodermic or exfoliative dermatitis needs aggressive therapeutic intervention.
  9. 90% of psoriasis patients with nail involvement also have psoriatic arthritis and may require systemic therapy.
  10. Monotherapy is easier, but combination therapy is more effective for patients with moderate to severe psoriasis.