Document Detail

Psoriasis in the elderly: from the Medical Board of the National Psoriasis Foundation.
MedLine Citation:
PMID:  21496950     Owner:  NLM     Status:  MEDLINE    
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.
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.
Department of Dermatology and Murdough Family Center for Psoriasis, University Hospitals Case Medical Center, Cleveland, OH 44106, USA.
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MeSH Terms
Dermatologic Agents / therapeutic use
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
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

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