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Updated: Mar 23, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
39.6K
Tailor systemic therapy to the patient with severe psoriasis
The Practitioner
|April 2, 2016
Summary
Psoriasis severity lacks a standard definition, requiring assessment of skin extent, joint involvement, treatment response, and quality of life impact. Severe cases like erythrodermic or pustular psoriasis necessitate urgent specialist care and systemic evaluation.
Area of Science:
- Dermatology
- Rheumatology
- Public Health
Background:
- Psoriasis severity lacks a standardized definition, complicating patient assessment and care.
- Factors influencing severity include skin disease extent, joint involvement, treatment efficacy, and quality of life.
- Severe psoriasis forms, such as erythrodermic and pustular psoriasis, can lead to systemic illness.
Purpose of the Study:
- To outline key areas for evaluating psoriasis severity and patient well-being.
- To provide guidance on screening for psoriatic arthritis and cardiovascular risk.
- To establish criteria for referral to specialist care.
Main Methods:
- The static Physician's Global Assessment (sPGA) is recommended for assessing severity.
- The Dermatology Life Quality Index (DLQI) is used to evaluate disease impact on well-being.
- The Psoriasis Epidemiology Screening Tool (PEST) aids in psoriatic arthritis screening.
Main Results:
- NICE guidelines recommend evaluating severity (sPGA), quality of life (DLQI), psoriatic arthritis, and comorbidities.
- Annual screening for psoriatic arthritis is advised, with PEST as a validated tool.
- Cardiovascular risk assessment is recommended for severe psoriasis patients.
Conclusions:
- Comprehensive assessment of psoriasis involves multiple factors beyond skin presentation.
- Timely referral to specialists is crucial for patients with poor treatment response, significant quality of life impact, or severe disease forms.
- Integrated care addressing dermatological, rheumatological, and cardiovascular aspects is essential for managing psoriasis.
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