Mastering Oral Psoriasis Therapies: What Every Resident Should Know

In episode 30 of Cutaneous Miscellaneous, host Nicholas Brownstone, MD, welcomes April Armstrong, MD, Professor and Chief of Dermatology at UCLA, for a detailed discussion on oral therapies for psoriasis and their continued relevance in today's treatment landscape. They begin with a board review of 2 classic therapies, methotrexate and cyclosporine, breaking down their mechanisms of action, dosing protocols, key adverse effects, and important monitoring guidelines. They then explore methotrexate’s continued use, particularly for uninsured patients, and cyclosporine’s role as a short-term “bridging” therapy for patients in crisis. They review acitretin, discussing its risks, chemopreventive benefits, and lab monitoring requirements; apremilast, highlighting its safety and lack of required lab monitoring; and deucravacitinib, a TYK-2 inhibitor noted for its unique mechanism, long-term efficacy, and suitability for challenging psoriasis types. Tune in to hear expert guidance on navigating these oral therapies, practical tips for residents, and updates on how each therapy fits into modern psoriasis care!