Psoriasis, a chronic, inflammatory skin condition, affects approximately 1% to 4% of the world’s population and is associated with significant morbidity. Over the last several decades, the incidence of psoriasis appears to have increased dramatically, and a survey from the National Psoriasis Foundation found that 22% of patients with psoriasis were being seen by primary care physicians (PCPs) instead of dermatologists. Psoriasis can greatly impact a patient’s quality of life, but many patients with psoriasis do not receive any treatment or are undertreated, and 18% of patients have difficulty discussing psoriasis with their physicians. This web activity will focus on optimal management of psoriasis by the PCP, including treating psoriasis as a systemic disease, considering risk–benefit profiles when choosing treatment regimens, recognizing when to refer a patient to a specialist, and how to implement strategies for improving patient communication and adherence.
This talk will discuss commonly encountered oral erosions and ulcers. Diagnoses will include herpes simplex, erythema multiforme, oral erosive lichen planus, and pemphigus vulgaris. A handful of sexually transmitted diseases will also be covered, emphasizing clinical recognition of and first line treatments of syphilis, human papilloma virus, scabies, and molluscum. Finally, therapeutic updates in melanoma, psoriasis, and chronic idiopathic urticaria will be reviewed. Finally, antibody-based therapies for chronic idiopathic urticarial will be discussed.
In this Clinical Coffee Break, Dr. Jacob Levitt reviews the different presentations of plaque psoriasis and compares the various therapy classes, including topical corticosteroids, conventional systemic therapies, and biologics. He also discusses how to select treatments based on symptom severity, and which treatments to avoid in special populations, such as pregnant women and those with renal insufficiency.
Although it is now clear that psoriasis is a systemic disease with associated comorbidities, many primary care physicians continue to treat it with local agents. This case study will review when patients with psoriasis should be treated with topical therapy, when to refer patients to specialists for treatment with systemic agents, what prerequisite work-up is needed prior to the initiation of biologics/immunosuppression, and how to monitor patients with psoriasis on biologic therapy for potential safety and efficacy issues.
The primary goal of this multi-faceted educational program is to improve the PCP’s ability to recognize the signs and symptoms of psoriatic disease, when to refer to specialty, and how to collaboratively advance patients along the correct treatment pathway in order to improve patient health outcomes.
Although it is now clear that psoriasis is a systemic disease with associated comorbidities, many primary care physicians continue to treat moderate-to-severe psoriasis with local agents. In this activity, Anthony P. Fernandez, MD, PhD, answers questions submitted by participants during the Virtual Expert Roundtable titled "Optimizing Diagnosis and Management of Psoriatic Disease in Primary Care."
Dr. Kroshinsky reviews insect bites that mimic cellulitis in their presentation and the diagnostic and treatment approaches helpful for these conditions.