Document Detail


Psoriasis in the elderly: from the Medical Board of the National Psoriasis Foundation.
MedLine Citation:
PMID:  21496950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The continuous increase in the US population older than 65 years and the chronic course of psoriasis make management of psoriasis in the elderly an important health care problem.
OBJECTIVE: We sought to develop a treatment algorithm for patients with psoriasis who are older than 65 years.
METHODS: A systematic literature search for studies on elderly patients with psoriasis was performed using MEDLINE.
RESULTS: We summarize the available published data on therapeutic modalities used in the elderly. We suggest a treatment algorithm including topical medications as first-line treatment for limited disease, with phototherapy, systemic retinoids, methotrexate, and biologics as the first-line systemic treatments for patients with more extensive disease. Cyclosporine should only rarely be used as a second-line systemic treatment for extensive disease in elderly patients with psoriasis.
LIMITATIONS: Limited data are available regarding treatment modalities specifically for elderly patients with psoriasis.
CONCLUSION: Appropriate treatment for elderly patients with limited psoriasis includes topical corticosteroids, topical vitamin D analogues, and topical tazarotene. For appropriately monitored elderly patients who have psoriasis with extensive disease, phototherapy, acitretin, methotrexate, alefacept, etanercept, adalimumab, infliximab, and ustekinumab are first-line therapies that can generally be safely used. There remains a need for further research on the management of psoriasis in elderly patients with psoriasis.
Authors:
Ivan S Grozdev; Abby S Van Voorhees; Alice B Gottlieb; Sylvia Hsu; Mark G Lebwohl; Bruce F Bebo; Neil J Korman;
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't     Date:  2011-04-15
Journal Detail:
Title:  Journal of the American Academy of Dermatology     Volume:  65     ISSN:  1097-6787     ISO Abbreviation:  J. Am. Acad. Dermatol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-15     Completed Date:  2011-10-19     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  7907132     Medline TA:  J Am Acad Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  537-45     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Dermatology and Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, OH 44106, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Dermatologic Agents / therapeutic use
Humans
Immunoglobulin G / therapeutic use
Immunosuppressive Agents / therapeutic use
Methotrexate / therapeutic use
Psoriasis / drug therapy,  therapy*
Receptors, Tumor Necrosis Factor / therapeutic use
Recombinant Fusion Proteins / therapeutic use
Ultraviolet Therapy
Chemical
Reg. No./Substance:
0/Dermatologic Agents; 0/Immunoglobulin G; 0/Immunosuppressive Agents; 0/Receptors, Tumor Necrosis Factor; 0/Recombinant Fusion Proteins; 185243-69-0/TNFR-Fc fusion protein; 59-05-2/Methotrexate; ELK3V90G6C/alefacept

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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