Infection Control Strategies

**87**

**Chapter 6**

**Abstract**

severe psoriasis.

systemic therapies, biologic agents

**1. Introduction and short history**

Medical Management of Chronic

*Teodora-Larisa Timis, Daniela-Rodica Mitrea* 

*and Ioan-Alexandru Florian*

Plaque Psoriasis in the Modern Age

Despite its frequency, psoriasis is still a difficult pathology to manage, in no small part due to the wide number of therapeutic choices available. These range from topical medicine to systemic drugs to more targeted agents such as biological therapies. All medical personnel involved in the treatment of psoriasis patients should be aware of these methods and apply them accordingly. Even though all patients may benefit from specific treatment options, these differ in regard to posology, monitoring, interactions and contraindications. Moreover, due to the adverse effects and drug interactions of some of these agents, not all patients are suitable candidates for each of therapies discussed. Therefore, nurses, trainees, general practitioners and dermatologists must carefully select the most appropriate therapy based on the characteristics of each patient, severity of the pathology, comorbidities and coexistent medications. This review aims to offer an updated, pragmatic insight into the modern management of patients with moderate-to-

**Keywords:** psoriasis, T cells, immunomodulators, keratinocytes, phototherapy,

Psoriasis is defined as chronic inflammatory systemic ailment, affecting the teguments foremost, and characterized by important genetic and immune constituents. The most common form is represented by psoriasis vulgaris, affecting every race and all ages, most often between the ages of 50 and 69 years, concerning at least 100 million individuals worldwide [1, 2]. It is a potentially devastating disorder with a progressive natural course, associated with multiple comorbidities and typified by underlying immunologic and inflammatory elements [3]. Despite it being a convoluted pathology with an incompletely elucidated pathogenesis, it has been shown that the environment, immune system and genetic predisposition all play a decisive role in triggering the psoriasis cascade [4]. As of today, treating psoriasis remains a demanding endeavour, merely attending the symptoms and ignoring the principal cause. Medical management is satiated by a wide variety of choices with fluctuating efficiency, for example, topical therapies, phototherapy, systemic drugs and biological agents [5]. It is fathomable that choosing the most appropriate treatment scheme for each individual can oftentimes be perplexing or even disheartening. Nevertheless, the treatment involved should imply a multidisciplinary course
