Psoriasis: to treat or to manage?
Article first published online: 2 AUG 2014
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 23, Issue 10, pages 705–709, October 2014
How to Cite
Mrowietz, U., Steinz, K. and Gerdes, S. (2014), Psoriasis: to treat or to manage?. Experimental Dermatology, 23: 705–709. doi: 10.1111/exd.12437
- Issue published online: 27 SEP 2014
- Article first published online: 2 AUG 2014
- Accepted manuscript online: 11 MAY 2014 04:30AM EST
- Manuscript Accepted: 7 MAY 2014
The recognition of psoriasis as a systemic disorder with characteristic skin symptoms and associated diseases has changed treatment concepts substantially. The complexity of psoriasis disease not only requires appropriate therapy but also weight-loss and smoking cessation programmes as well as trigger factor elimination. The term ‘management’ may better reflect the aim for a holistic approach of disease control. Comorbidity and the presence of psoriatic arthritis are important denominators for drug selection. However, there is a lack of prospective data substantiating a benefit of associated diseases by antipsoriatic therapy. Securing success using treatment goals helps to establish an efficacious therapy and to control inflammation. A regular scoring of disease severity, patients’ quality of life and assessment of other clinically relevant conditions are mandatory to closely follow the disease course. There is debate whether an early treatment may modulate the future course of psoriasis. Concepts of minimal disease activity have not been implemented in psoriasis yet. There is a lack of evidence how long any treatment should be given and when and how to terminate. Finally, outcome tools should specifically be tailored for psoriasis to evaluate disease-related items as well as the benefit of management from the patient's perspective.