Psoriasis of special localizations and the effectiveness of the IL-23 inhibitor guselkumab in clinical practice

Vladimirova I.S., Kruglova L.S.

1) Skin and Venereal Diseases Dispensary No. 10 – Clinic of Dermatology and Venereology, Saint Petersburg, Russia; 2) Military Medical Academy named after S.M. Kirov, Saint Petersburg, Russia; 3) Central State Medical Academy of the Presidential Administration of the Russian Federation, Moscow, Russia

Biological therapy has radically changed approaches to the management of moderate to severe psoriasis vulgaris, achieving complete or almost complete skin clearance and demonstrating a high safety profile. However, the treatment of psoriasis in specific locations presents certain difficulties in choosing the optimal therapeutic strategy. Psoriasis in specific locations, namely in the scalp, face, anogenital area, palms/soles, with nail plate involvement, is not diagnosed in a timely manner and is often underestimated. Despite the limited lesion, it has a significant impact on physical functioning, work capacity and health-related quality of life. Affecting limited areas, psoriasis in specific locations can be isolated, which, according to the severity index (PASI) and lesion area (BSA), corresponds to a mild degree of severity, however, in the EuroGuiDerm recommendations, psoriasis in specific locations is classified as a moderate degree of the disease, which expands the possibilities of prescribing systemic biological drugs. The IL-23 inhibitor guselkumab is currently the only biological drug for the treatment of psoriasis in difficult locations (scalp, palms/soles, nails) according to the level A (strong recommendation) recommendation in the AAD-NPF guideline and the GRAPPA recommendation. However, there is insufficient literature data on the use of the IL-23 inhibitor guselkumab in special areas in real clinical practice. In this article, we discuss the clinical characteristics of psoriasis in special locations, the impact on quality of life, and demonstrate the efficacy and safety of biological therapy with the IL-23 inhibitor guselkumab using clinical cases as an example.

Keywords

About the Authors

Corresponding author: Irina S. Vladimirova, Cand. Sci. (Med.), Dermatovenerologist, Skin and Venereal Diseases Dispensary No. 10 – Clinic of Dermatology and Venereology; Senior lecturer of the Department of Skin and Venereal Diseases, Military Medical Academy named after S.M. Kirov, Saint Petersburg, Russia; ivladimirva@rambler.ru

Similar Articles