Psoriasis Management: A Multidisciplinary Approach (For Professionals)

• Psoriasis is a skin condition which involves 2% of the population. Its causes include environmental and genetic factors.
• It can be localized or extensive and treatment ranges from topical to systemic agents.

• Beyond the dermatologist, who is often the only physicians psoriasis patients will see, there is often associated conditions which need to be taken into account.
• Psoriasis is associated with the metabolic syndrome and this includes:

1. Obesity
2. Hypercholesterolemia (Dyslipidemia)
3. Diabetes Mellitus
4. Hypertension
5. Other associations include cardiovascular disease, Crohn’s Disease

• It is therefore important that all psoriasis sufferer be considered in a holistic manner and be referred to a general practitioner. Indeed all dermatologists will not be confortable in dealing with these associated comorbidities. It is important to have a close long term management as  for example lifestyle choices such as smoking and drinking can trigger these associated diseases, and at any time one can decide to stop these habits.
• Psoriasis can be associated with psoriatic arthritis which warrants the cooperation with a rheumatologist. Immunosupressant therapies (such as with methotrexate) and biologics treatment can be particularly beneficial in those cases (not only against arthritis and psoriasis, but also against the associated comorbidities.
• In addition, psoriasis is often associated with psychological distress and this can lead to psychiatric labels including anxiety and depression. There is therefore an advantage to be able to work closely with psychiatrists when necessary.

• The above shows that there could be an added advantage of health networks incorporating different medical specialties under the same roof.

Bibliography: What lies beneath, Angelucci DD. Supplement to Dermatology World, August 2012