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Psoriasis treatment in adults:
a shared decision with a well-informed patient

The various treatments for psoriasis do not guarantee recovery, and some expose the patient to potentially serious adverse effects. The choice of treatment should be discussed with the patient.

Plaque psoriasis is the most frequent form of psoriasis in adults. Its development is unpredictable, its complications rare, but it can have a devastating psychological effect. None of the treatments currently available can cure the condition completely. In light-to-moderate forms of psoriasis, emollients can reduce skin dryness. Topical corticosteroids can help calm outbreaks of psoriasis, but they carry the risk of serious adverse effects. If topical treatment fails, depending on the gravity of the lesions, phototherapy (preferably narrow-spectrum UVB) is sometimes offered. Systemic treatments using immunosuppressants are offered as a last resort, due to their serious adverse effects. Patients should be informed of the risks associated with the various treatments and the uncertainties concerning the duration of the possible remission, so that a joint decision on treatment can be made. ©Prescrire November 2005

Source: "Psoriasis des adultes: des rémissions mais pas de traitement curatif" Rev Prescrire 2005 ; 25 (266) : 751-762.

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