Guideline On Psoriasis
Psoriasis is a chronic, multisystem inflammatory disease that primarily affects the skin and joints. Psoriasis has an extensive emotional and psychosocial impact on patients, affecting social functioning and interpersonal relationships in addition to the physical dimensions of the disease. Psoriasis, a systemic inflammatory disease, is associated with several comorbidities, including cardiovascular disease and cancer. A skin biopsy is rarely required because the diagnosis is primarily clinical. Treatment can be started based on the severity of the disease. Topical therapies such as corticosteroids, vitamin D3 analogs, and combination products are first-line treatments for mild to moderate disease. These topical treatments are effective and can be started and prescribed safely by primary care physicians. Patients with more severe and refractory symptoms may need to be evaluated by a dermatologist for systemic therapy. Many psoriasis patients seek initial evaluation and treatment from their primary care physicians. Recognizing psoriasis and its associated medical and psychiatric comorbidities would allow for timely diagnosis and appropriate management with effective and safe topical therapies and other medical and psychological interventions as needed. More severe and refractory cases may necessitate a dermatologist’s evaluation and possible systemic therapy.
Psoriasis is a chronic disease affecting an estimated 1.7% of Canadians. Psoriasis is a multisystem inflammatory disease that primarily affects the skin and joints. It affects both sexes equally and has a bimodal age of onset (16 to 22 and 57 to 60 years). Pathogenesis is multifactorial, with dysregulated inflammation and genetic links. Beyond the physical dimensions of the disease, psoriasis has a significant emotional and psychosocial impact on patients, resulting in stigma, low self-esteem, and increased stress, all of which affect social functioning and interpersonal relationships. Despite significantly impacting quality of life, psoriasis is underdiagnosed and undertreated. This necessitates a better understanding of the disease and the available treatment options to provide optimal psoriasis management. Family physicians are well-positioned to diagnose and initiate psoriasis treatment because many patients seek initial evaluation and treatment at the primary care level. This review provides an update and the most recent evidence for a practical and comprehensive overview of psoriasis diagnosis and treatment.