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Current Dermatology Reports

Erschienen in:

30.09.2021 | Hospital-Based Dermatology (L Guggina and C Nguyen, Section Editors)

Inpatient Management of Psoriasis: A Current Perspective and Update for Clinicians

verfasst von: Edward Hadeler, Megan Mosca, Julie Hong, Nicholas Brownstone, Wilson Liao, Tina Bhutani, Kanade Shinkai

Erschienen in: Current Dermatology Reports | Ausgabe 4/2021

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Abstract

Purpose of Review

The purpose of this narrative review article is to describe the current literature on the psoriasis inpatient population, discuss considerations for admission, and provide updated recommendations for inpatient psoriasis workup, management, and post-discharge follow-up.

Recent Findings

Studies report variable rates of psoriasis hospitalizations in the last decade even with the advent of highly efficacious outpatient therapies. Inequities in access to these therapies have resulted in disparities in the psoriasis inpatient population. Patients with severe variants of psoriasis, including generalized pustular and erythrodermic psoriasis, often have severe systemic complications and require immediate stabilization and supportive care. Traditional, rapid acting systemic therapies, including cyclosporine and infliximab, are efficacious, though the interleukin-17 inhibitors, secukinumab, ixekizumab, and brodalumab, may represent reasonable options. The interleukin-36 inhibitor, spesolimab, is a new and promising therapy under investigation for generalized pustular psoriasis.

Summary

Psoriasis patients presenting with severe variants of disease, including pustular and erythrodermic psoriasis, in combination with systemic findings such as infection or compromised hemodynamic status, require hospitalization. Supportive measures to address systemic signs and complications are needed. Topical treatments with rapid acting systemic therapies should be employed to improve skin symptoms. Racial, ethnic, and insurance disparities exist in the hospitalized psoriasis patient population, highlighting the need for providers to obtain thorough sociodemographic histories and establish strong therapeutic alliances with these patients, identifying stable treatment options to prevent future exacerbations and hospitalizations.

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Titel: Inpatient Management of Psoriasis: A Current Perspective and Update for Clinicians
verfasst von: Edward Hadeler
Megan Mosca
Julie Hong
Nicholas Brownstone
Wilson Liao
Tina Bhutani
Kanade Shinkai
Publikationsdatum: 30.09.2021
Verlag: Springer US
Erschienen in: Current Dermatology Reports / Ausgabe 4/2021
Elektronische ISSN: 2162-4933
DOI: https://doi.org/10.1007/s13671-021-00342-5

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Riesenzellarteriitis: 15% der Patienten sind von okkulter Form betroffen

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In einer retrospektiven Untersuchung haben Forschende aus Belgien und den Niederlanden die okkulte Form der Riesenzellarteriitis genauer unter die Lupe genommen. In puncto Therapie und Rezidivraten stellten sie keinen sehr großen Unterschied zu Erkrankten mit kranialen Symptomen fest.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Isotretinoin: Risiko für schwere Laboranomalien „marginal erhöht“

08.05.2024 Akne Nachrichten

Die Aknetherapie mit Isotretinoin kann einen Anstieg von Leberenzymen und Blutfetten verursachen. Das Risiko für schwere Störungen ist laut einer Forschungsgruppe der Universität Lübeck aber nur marginal erhöht und auf einen engen Zeitraum konzentriert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

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