Abstract：
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.
journal_name
J Am Acad Dermatoljournal_title
Journal of the American Academy of Dermatologyauthors
Grozdev IS,Van Voorhees AS,Gottlieb AB,Hsu S,Lebwohl MG,Bebo BF Jr,Korman NJ,National Psoriasis Foundation.doi
10.1016/j.jaad.2010.05.014subject
Has Abstractpub_date
2011-09-01 00:00:00pages
537-545issue
3eissn
0190-9622issn
1097-6787pii
S0190-9622(10)00570-0journal_volume
65pub_type
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