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Dermbits

MD, MPH

There has been increased emphasis placed on treatment of plaque psoriasis in intertriginous and/or genital areas. How do you approach management of disease in these areas?

Psoriasis

You. So when we treat psoriasis in sensitive locations, anatomic locations like the axilli or the groin genital area, and other sensitive areas on the body, we have to think carefully about the safety of the topical agent, for example, the limitations of topical corticosteroids in those same areas. We are going to have higher risks of atrophy and other corticosteroid side effects, and so we're going to be very limited to how long we can use corticosteroids in those areas and how potent the corticosteroids are that we use. We also have to think about tolerability in these areas. And some of our psoriasis topicals like topical retinoids, even topical calcifying, can have some degree of irritation potential. And so thinking carefully about having an agent that has low risk for long term use and lacks irritation potential is really the ideal for facial and intratrignous sites. We have to recognize that these areas contribute a great deal to the adverse impact of psoriasis quality of life, and so it's important not to undertreat those areas as well.