Psoriasis Update: Maui Derm 2019 Highlights

Maui Derm’s panel of leading authorities discussed a number of topics related to psoriasis, including the “metabolic” impact of psoriasis, new topical and systemic drugs in 2019, psoriatic arthritis, and the immunology and genetics of psoriasis.

Andrew Blauvelt, MD

Andrew Blauvelt, MD, MBA, focused his presentation on new translational psoriasis research. Dr. Blauvelt discussed important clinical questions in psoriasis, including:

Why does skin disease recur at the same anatomic sites when relapsing?
Can we cure patients with currently available biologic therapies?
Do biologic therapies decrease the risk of cardiovascular disease?

Arthur Kavanaugh, MD

Arthur Kavanaugh, MD presented attendees with a psoriatic arthritis (PsA) update. PsA treatment options discussed by Dr. Kavanaugh include adjunctive treatments, DMARDs, biologics, JAK inhibitors, PDE4 inhibitors, and experimental treatments.

LInda Stein-Gold, MD

Linda Stein-Gold, MD, educated attendees on how to optimize treatment approaches with topical therapies. Dr. Stein-Gold discussed the importance of vehicles and how they affect the potency, and as a result, the efficacy of topical treatments. She pointed to different vehicles used with betamethasone dipropionate 0.05% to illustrate the concept. Dr. Stein-Gold discussed other ways to enhance topical treatment penetration, including hydration and heat as well as topical vitamin D3. She also discussed the prevention of steroid-induced atrophy using combination therapies. Also discussed was a phase 3 clinical study to assess the safety and efficacy of halobetasol propionate and tazarotene lotion in plaque psoriasis. Dr. Stein-Gold also reviewed new topical molecules including PDE4 inhibitors, JAK inhibitors, and aryl hydrocarbon receptor agonists.

Bruce Strober, MD, PhD

Bruce E. Strober, MD, PhD presented interesting psoriasis data from 2018. He discussed apremilast, specifically changes in weight and A1c after 16 weeks of apremilast in patients with psoriasis and PsA. Dr. Strober also discussed cardiovascular risk in psoriasis, reviewing research on the effect of systemic and biologic drug treatment on carotid intima-media thickness in patients with moderate-to-severe psoriasis as well as vascular and systemic inflammation following treatment with ustekinumab in patients with psoriasis. Finally, Dr. Strober discussed pediatric psoriasis and reviewed research on the efficacy and safety of apremilast for pediatric patients with moderate-to-severe plaque psoriasis. Another treatment discussed included ixekizumab and ustekinumab for the treatment of nail lesions in patients with plaque psoriasis.