Kicking off our first day of lectures in Miami, Dr Brad Glick reviewed his tips and tricks for treating challenging psoriasis, including when psoriasis ends up being something else entirely. In this case-based presentation, he reviewed therapies for unresponsive palmoplantar psoriasis, comorbidities that may impact treatment of plaque psoriasis and psoriatic arthritis, and a psoriasis look-a-like presenting as exfoliative dermatitis.
In the first case, a 74-yo female with palmoplantar psoriatic disease who failed many biologic therapies including secukinumab, ustekinumab, and risankizumab was started on deucravacitinib with remarkable improvement in palms, soles, and scalp psoriasiform lesions. This novel TYK-2 inhibitor can be considered as an “add-on” therapy due to its complimentary mechanism of action to many other biologics and is a reminder that more challenging cases may require compound treatment regimens.
In the second case, a former smoker with severe psoriasis, psoriatic arthritis, and a pertinent medical history of valvular heart disease, cerebral aneurysm, and obesity was walked through a variety of treatments with gradually improving responses. While more targeted therapies may have been partially contributing to this patient’s dramatic reduction in IGA, Dr Glick also proposed the importance of weight loss for obese patients with only moderate responses to treatment. Two articles that were cited examine the impact of bariatric surgery and weight loss in general on psoriatic disease. Another pearl in this case is to consider repeating positive QuantiFERON-TB Gold tests before removing patients from successful treatment regimens, as they may be false positives or laboratory errors.
He ended with a case of severe exfoliative dermatitis unresponsive to many different therapies that, after review of an initial biopsy report by a second pathologist, was more consistent with pityriasis rubra pilaris. Islands of sparing were evident in clinical photos, and the patient responded to risankizumab and acitretin. In patients with exfoliative dermatitis, always test for scabies and take a detailed exposure history.
In the first DermInsider - A Virtual Grand Rounds Series session of the year, join leading experts Dr. Bhutani and Dr. Serota for a dynamic deep dive into one of the most exciting frontiers in psoriatic disease management. Dr. Del Rosso moderates this 45-minute activity that explores the rapidly emerging role of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and their potential impact beyond metabolic disease. Don't miss out on this opportunity to catch up on breakthrough insights and emerging evidence on this hot topic!“We have some really interesting data on the horizon that’s going to hopefully help more providers feel confident about using [GLP-1] medications in conjunction with their psoriasis medications that they are used to using.” – Tina Bhutani, MD MASBest of FC25: GLP-1RAs in Psoriasis – Catching Up on The ScienceThis activity is supported by an educational grant from Lilly.
Got a few minutes? Join our expert faculty for their rapid-fire tips on getting started with GLP-1 receptor agonists for patients with psoriasis and obesity.“When we are treating patients with obesity and psoriasis in weight management, really focus on the health gains. It’s not about what people are losing, it’s about what they are gaining in this process.” – Angela Fitch, MDPlease visit the “Educational Resources” page to access the handouts developed by faculty on GLP's in psoriatic disease mentioned in this activity.This activity is supported by an educational grant from Lilly.
In this 20-minute Seminar in Depth from the 2025 Fall Clinical Dermatology Conference, the faculty explore what differentiates TYK2 inhibitors from traditional JAK inhibitors, as well as how to identify patients with psoriasis who may benefit from oral small molecule therapy.“When thinking about a medication, you need to take a number of things into consideration: location of disease, disease severity, and age. Age plays a big role when I think about what medication I’m going to choose for a patient – Are they of child-bearing age? Are they young and they live in group housing or a dorm?” – Benjamin Lockshin, MDFC25: Encapsulating Progress With New and Emerging TYK2 Inhibitors for Psoriasis: An Online ActivityThis activity is supported by an educational grant from Bristol Myers Squibb.