**5. Conclusion**

284 Psoriasis

inconvenience of hospitalized infusion is deemed negligible by most patients. For many, this aspect of full care is even deemed to be positive. One possible problem, in psychological terms, is that the infusions take place in hospitals which treat other ambulatory patients, in particular patients undergoing cancer chemotherapy. This co-existence can be difficult to experience for some patients affected with psoriasis. It is easier to manage in large hospitals,

We did not have systematically evaluate a score of quality of life. Thus, no analyzis is possible. Only one patient has stopped the treatment because considered too heavy to manage. Four patients complain about the need of hospital infusion. All others were

As for other psoriasis treatments, erythematous scars occuring after initial improvement

The major problem is to psychologically and medically manage losses of clinical response. But for patients with a sustained complete response, the dermatological quality of life is

which can organize their wards accordingly.

may be of transitory bad perception by the patient (figure 5).

Fig. 5. W6, PASI75 response with erythematous sequelae

**4.5 Quality of life** 

perfect.

satisfecied by the treatment.

From this series of 50 patients treated by infliximab, we can confirm the efficacy of the product: PASI 100 (46%), PASI 90-99 (15%), PASI 75-89 (15%), PASI 50-74 (10%). In around half the cases, this efficacy is reduced over time (26%), or completely lost (34%); it is maintained in 40% of cases. In this study, we have a tendency for a more sustained response among complete initial responders in comparison with partial initial responders (47 vs 31%).

We always present infliximab to new patients as the most effective therapy in principle, warning them however about this risk of efficacy loss. The concurrent use of methotrexate could be considered, having proved its worth in indications other than plaque psoriasis (Kamili et al., 2011). Patient satisfaction is increased, despite the need for infusions in specialized and equipped centers. The occurrence of hypersensitivity reactions during infusion must be monitored and the risk of arthritic and lupus reactions must be known.
