Sara Al-Misallam (Senior Registrar)
| Psoriasis clinic has started
in November 1999. Patients who are
candidates for this clinic include:
1) Severe psoriasis whether, generalized plaque psoriasis, erythrodermic or pustular psoriasis, who need rapid clearance of their disease.
2) Moderately severe psoriasis not responding to Phototherapy (PUVA or UVB).
3) Palmoplantar psoriasis not responding to conventional therapy.
The treatment protocol is tailored to each patient but in general, ee have the following systemic treatment options (apart from phototherapy):
1) Sequential therapy, using Neoral (cyclosporine) 5 mg/Kg/day for 1 month followed by addition of Neotigasone 25-50 mg/day. Thereafter, Neoral is gradually withdrawn over the next 6-7 months while Neotigasone is maintained, either alone or in combination with PUVA or topical therapy.
2) Methotrexate : is given either by oral or intramuscular route as weekly doses.
3) Newer therapies are also used whenever indicated including Mycophenolate mofetil and new the biologicals that include: Infliximab (Remicade), Adalimumab (Humira), Etanercept (Enbrel), Ustekinumab (Stelara), Ixekizumab (Taltz), Secukinumab (Cosentyx), Guselkumab (Tremfya), Risankizumab-rzaa (Skyrizi) and others.
Any patient who is a suitable candidate for biologic therapy is evaluated by a special committee of senior dermatologists in the center to approve the start, or change of a biologic therapy and ensure that all the required investigations have been requested for the patient prior to starting this type of treatment.
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