Registration benefits include: Access to CME/CE programs and certification Free subscription to Biologic Bulletin newsletter Reminders of new CME/CE activities REGISTER NOW Ask the Expert : Search Results Search Results This section of PsoriasisTx.com contains our Ask the Expert archive, where users can review the challenging clinical questions that have addressed by our expert panel regarding all aspects of psoriasis treatment, including therapies for chronic plaque psoriasis. Here, health care professionals can peruse pertinent questions posted by their colleagues (and, in some cases, patients) on topics ranging from psoriatic arthritis treatment to treating patients with comorbidities such as cancer or hepatitis. All questions have answers (often with accompanying commentary) provided by our panel of medical experts and include evidence-based recommendations where applicable. These archives are an excellent research tool for clinicians involved in the treatment of psoriasis and its comorbidities. The information contained in this section is comprehensive and provides a valuable, real-world resource for dermatology professionals. As you scroll through this section, notice that the results are arranged in categories: Efficacy, Side Effects/Safety, Dosing & Administration, and Treatment Considerations. These groupings facilitate navigation to the topics you wish to research. 29 question(s) listed Mechanism of Action CME - Deficiency of p40 and its role in psoriasis and immune response Centocor has identified a cohort of patients who are deficient in p40. They have increased bacterial infections, no increased viral infections, and no cases of psoriasis. The gene(s) that code for p40...    Click Here To Read Answer Clinical Trials Concurrent administration of cyclosporine and etanercept? What is your experience giving cyclosporine together with etanercept?    Click Here To Read Answer Efficacy Biologic agents in a patient with lymphoma Are there any biologics for psoriasis that may be used if a patient has a history of lymphoma? Which biologics would be preferred?    Click Here To Read Answer Side Effects/Safety CME - Tuberculosis testing, vaccinations, and the American Academy of Dermatology and National Psoriasis Foundation recommendations What are the recommendations for patients who were tested for tuberculosis prior to onset of biologic therapy but did not receive all the immunizations listed in the current American Academy of Dermat...    Click Here To Read Answer CME - Methotrexate and pregnancy What are the recommendations regarding treatment with methotrexate and pregnancy in a female patient?    Click Here To Read Answer CME - Peripheral edema and adalimumab A patient developed marked peripheral edema after the first dose of adalimumab. Is this a recognised adverse reaction and what are the mechanisms involved?    Click Here To Read Answer CME - PPD testing in patients on anti-TNF agents What is the recommended protocol for tuberculosis testing in patients who will be placed on an anti–tumor necrosis factor (TNF) agent?    Click Here To Read Answer Biologic treatment, male patients, and pregnancy Are there any concerns about placing a male patient who is trying to father a child on a biologic such as efalizumab?    Click Here To Read Answer Weight gain in patients receiving anti–tumor necrosis factor agents? Most of our patients on anti–tumor necrosis factor (TNF) drugs for psoriasis have put on a lot of weight since treatment was commenced. Is TNF-alpha normally associated with a mechanism for weight con...    Click Here To Read Answer Biologics and reactivation of latent tuberculosis What are your thoughts on biologics and their role in reactivation of latent tuberculosis? Is etanercept, because of its mechanism of action, less likely to reactivate tuberculosis? How often should y...    Click Here To Read Answer Association between efalizumab and Guillain-Barré syndrome Is there an association between treatment with efalizumab and Guillain-Barré syndrome?    Click Here To Read Answer Transitioning from alefacept in a patient who developed lymphopenia I have patient who had been treated successfully with 2 courses of alefacept in the past 12 months. While on his third course he developed lymphopenia, and his CD4+ counts have remained below 250 cell...    Click Here To Read Answer Etanercept use in a male patient trying to start a family What is the advice to give a male patient regarding contraception if he is due to start etanercept as he and his wife are trying to have a baby?    Click Here To Read Answer Using etanercept to treat patients with history of hepatitis B How do you feel about using etanercept to treat patients who have a history of hepatitis B but are in remission? Do you feel it is absolutely contraindicated, or do you believe that patients may recei...    Click Here To Read Answer Severe pruritic psoriasis My patient is a 53-year-old male with severe pruritic psoriasis. He did reasonably well with alefacept at one point, but his psoriasis began to flare badly and I placed him on efalizumab. He recently ...    Click Here To Read Answer Dosing & Administration Treatment options after unsatisfactory results with efalizumab and etanercept A patient who has had minimal responses to efalizumab and etanercept now notes a good response to infliximab, but only if he receives the 5 mg/kg dose every 4 weeks. Is this OK? Are there any other op...    Click Here To Read Answer Increased dosing frequency with infliximab I have a patient with recalcitrant psoriasis who has tried all the available biologics. He is currently on infliximab and has been for 3–4 months. Because of flaring, he is also on 2 mg/kg/day of cycl...    Click Here To Read Answer Treatment Considerations CME - Calculating Nail Psoriasis Severity Index (NAPSI) How can I calculate Nail Psoriasis Severity Index (NAPSI)?    Click Here To Read Answer CME - Biologic treatment of adolescents Are there any biologic agents that can be used in an adolescent (12-year-old) patient with severe psoriasis that is not responding to topical treatments or phototherapy?    Click Here To Read Answer CME - Biologics and tuberculosis A patient who has been on infliximab for 14 months had a positive PPD. I discontinued the infliximab. Is there a biologic agent that I can safely use in this patient?    Click Here To Read Answer Etanercept and breast cancer I have a patient who had been on etanercept 50 mg for the past 4 years with good control of her psoriasis. She was recently diagnosed with ductal carcinoma in situ (DCIS) breast cancer and no lymph no...    Click Here To Read Answer Efalizumab treatment in a patient receiving peginterferon and ribavirin for hepatitis C Do you think it's safe to treat somebody for psoriasis with efalizumab at the same time as they are being treated for hepatitis C with peginterferon and ribavirin for 48 weeks? I cared for a patient w...    Click Here To Read Answer Treatment options for a patient with plaque psoriasis and a history of hepatitis C and throat cancer Do you have any treatment suggestions for a 67-year-old male who has severe plaque psoriasis, a history of hepatitis C, and laryngectomy for throat cancer 5 years ago, and who previously did not respo...    Click Here To Read Answer Biologic treatment in patients with successfully treated skin cancer I recently had a squamous cell carcinoma that was caused by too many PUVA treatments removed. Is there a biologic that would be safe for my very severe psoriasis, even though I have had skin cancer? I...    Click Here To Read Answer Pregnancy and the use of biologics A 32-year-old female patient who has had chronic moderate psoriasis since age 22 had success with etanercept for the past 18 months. She is now trying to get pregnant, but she is concerned about remai...    Click Here To Read Answer Treatment options for severe nail psoriasis I have psoriatic arthritis and mild psoriasis that has affected my toenails and fingernails quite severely. My dermatologist has recommended etanercept. Do you have any other treatment suggestions tha...    Click Here To Read Answer Etanercept in a patient with melanoma I have a psoriasis patient who was recently diagnosed with (and treated for) melanoma: 0.68 mm, Clark level III. Is etanercept contraindicated in this situation?    Click Here To Read Answer Biologics in patient with lung carcinoma A 60 year-old woman recently had bronchoalveolar lung carcinoma removed with good prognosis. She cannot tolerate acitretin or ultraviolet B (UVB) therapy. She had previously been on methotrexate. Coul...    Click Here To Read Answer Patient with psoriasis and psoriatic arthritis and family history of multiple sclerosis I have a 40-year-old patient with moderate (40% body surface area) psoriasis and psoriatic arthritis who is a Fitzpatrick type I skin type. He has been on methotrexate for over a year. The patient rep...    Click Here To Read Answer   Ask the Expert Home