The 2014 National Institute for Health and Care Excellence (NICE) guidelines for the assessment and management of psoriasis were updated in 2017. There is little of note in relation to the previous articles in this series, however since the development of more biologics and cheaper forms of biosimilars, the guidelines were amended to reflect these readily available treatments (NICE, 2017a). The seventh and final article in this series provides an overview of systemic non-biological and biologic therapies. It looks at how these treatments target and treat psoriasis, as well as side-effects, contraindications and monitoring recommendations of certain drugs.
This series has addressed the treatments for psoriasis as advised by
the National Institute for Health and Care Excellence (NICE, 2017). This condition affects between 1.3-2.2% of the population (Parisi et al, 2011). It is recognised that psoriasis can have a significant impact on mood, mental health, poor lifestyle choices (Cohen et al, 2016; Landriscina et al, 2016), reduced activities of daily living, and is linked with other comorbidities, such as diabetes (Armstrong, 2013) and cardiovascular disease (Rutter et al, 2016). NICE developed a treatment pathway, advising bland emollients, topical treatments, phototherapy, systemic medications and systemic non-biological and biologic therapy. In recent years, the latter options have increased dramatically. This article focuses on the more traditional systemic
treatments, as advised by NICE.
This series focuses on the patient treatment pathway in managing psoriasis as laid out by the National Institute for Health and Care Excellence guidelines (NICE, 2016). This disease affects up to 1.8 million people within the UK, necessitating up to 60% of these patients requiring a form of secondary care input (Jackson, 2012). Secondary care is often required to provide further topical treatment advice, but equally this also falls within the remit of all healthcare professionals, such as community nurses, who have face-to-face contact with patients with psoriasis. As these topical treatments may not manage the symptoms of psoriasis alone, referral to dermatology departments where more specialist treatments can be prescribed may be needed. The first option is to offer a course of phototherapy. There are several forms of treatment under this umbrella, with which community nurses should be familiar.
This fourth article in a seven-part series looks at scalp psoriasis. Managing this condition can be difficult as treatments are often messy, time-consuming or ineffective. The impact of scalp psoriasis can affect several aspects of daily living, notably choice of clothes, intense itching, which can be embarrassing for patient. intense itching, which can be embarrassing for patients. Finding suitable treatments can be life-changing to some. This piece focuses on treatment options, from bland and simple techniques through to the variety of treatments available on prescription. This should enable community nurses to facilitate patients in managing their scalp psoriasis when asked
This third article in a seven-part series looking at the identification and treatment of psoriasis, explores the active ingredients and action of the main topical treatments for psoriasis. Community nurses are perfectly placed to help patients take control of their skin condition, particularly in advising them on the benefits of topical treatments, which as they can be applied directly to the skin, allow the area to be targeted, lowering the level of absorption into the bloodstream and reducing side-effects (Psoriasis and Psoriatic Arthritis Alliance (PAPAA, 2017a).
Psoriasis is a common skin problem that can cause significant distress to primary care patients, as well as representing a significant burden to healthcare resources. Often seen by communinity nurses, psoariasis is a condition that requires careful management as well as extensive knowledge of the different presentation. This article, the second in a series looking at the identification and treatment of psoriasis, examines the use of emollients in psoriasis treatment, focusing on the aims, benefits and efficacy of these topical treatments.
Community nurses will often encounter patients with psoriasis in their day-today work, and may be involved in delivering care directly or monitoring the condition. However, psoriasis has various presentations and knowledge of these variations is beneficial for all clinicians working in the community, particularly when it comes to understanding the range of treatments available. This article, the first in a series on psoriasis, will discuss the types of psoriasis that can be encountered, while future articles will examine the different treatment options that are currently available, focusing on the National Institute for Health and Care Excellence’s (NICE, 2016) treatment pathway for managing patients with psoriasis (see Figure 1). The series will focus on each of the steps in the pathway and how they relate to nurses working in the community.
