VIDEO: Discussing psoriasis care with patients

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When I discuss with my patients therapies for their psoriasis, I oftentimes first take an assessment of their psoriasis severity. This is very important because our approach to a patient who may have a small patch, for example, on their elbow, compared to someone who may be covered head to toe, 70% of their body surface area involved, the approach can be quite different. In general, for patients with more limited psoriasis, topical therapy still remains the main treatment course for these patients.

And we have a number of different topical therapies that are available for our patients. For those with a more moderate to severe disease, those have a greater body surface area involvement, for example, then we want to think about the use of, for example, biologic therapy, oral therapy, or phototherapy concurrently. I would say these days due to the convenience of the biologic therapy as well as the high efficacy, the high effectiveness, and good safety profile of biologics, it's being used increasingly as a first line agent among our patients with a more moderate to severe disease. However, we also have a few oral therapies that are available for patients who may not be able to tolerate a self-injection, for example.

Phototherapy is still a good option for some patients, however, for most phototherapy to be administered, oftentimes patients have to travel to the doctor's office two to three times a week to get phototherapy. So, this is oftentimes considered a bit inconvenient for most of our patients who may need to work or be at school. So, the choice of therapy for our patients really depend on the severity.

And when I talk about severity, I talked earlier about the extent of severity. So, the amount of patches or plaque that are covering the body, but it's also important to note that there are certain areas of our body, even though the amount of patch covering those areas may be small, can have a disproportionate effect on our patient's quality of life. So, for example, if you have psoriasis on the face, if you have psoriasis affecting your palms and soles, if you have psoriasis in the genital area, those are all areas that's considered high impact areas. So, even if you have what's considered a small area of involvement in those critical areas, we oftentimes will consider the more systemic therapies for those patients.