Treatments Biologics Anti-IL-17 Ixekizumab Targets IL-17A Trials – UNCOVER-1, UNCOVER-2, UNCOVER-3 (Ixekizumab treatment for psoriasis , Br J Dermatol 2018; 178:674, DOI:10.1111/bjd.16050) Better than placebo or etanercept Good for fingernail psoriasis Rapid onset – starts to show some benefit in 1 week Approximate PASI improvement after 3 months: About 80% of patients will get at least ..
Check Drug History Stop NSAIDs – including Difflam mouthwash (Benzydamine) Stop any other offending drugs 2 x 4mm punch biopsy – one for H+E (lesional in formalin) and one for IMF (perilesional in Michel’s transport media) Eyes – Urgent Ophthalmology review – need to prevent pseudomembrane formation Mouth ENT/Oral Medicine review. Betnesol 500mcg dissolved in ..
Check TFT’s, Free T3/T4, Thyroid autoantibodies Treatment – Fexofenadine 180mg once daily – If not working then increase to 180mg twice daily – If not working then add in cetirizine 10mg once daily – If not working then add in montelukast 10mg once daily – If not working then add in ranitidine 150mg-300mg once ..
General Occlusion of hair follicle infundibulum and then inflammation IL-36 (pro-inflammatory and part of the IL-1 family) may be relevant (IL-36 in hidradenitis suppurativa, Br J Dermatol 208; 178; 761-767) Risk of HS is doubled in smokers compared to non-smokers (Tobacco smoking and hidradenitis suppurativa, Br J Dermatol 208; 178:709-714) History – Age started – ..