Joshua A. Zeichner, MD
Mount Sinai Medical Center, New York, New York

Disclosure: Dr. Zeichner is a consultant for Promius Pharma.

Abstract
Psoriasis in some body parts can be challenging to treat. Psoriasis in the scalp, palms and soles, and intertriginous areas differ from disease on other body parts, and treatment regimens must be tailored to these areas. The presence of hair, along with the frequent, thick scale of psoriasis makes the scalp a challenge to treat. Skin in the body’s intertriginous areas is often thin, limiting treatment options for inverse psoriasis. Finally, palmoplantar psoriasis is often resistant to topical therapies because of the thickness of the skin. Moreover, cosmetic acceptibilty of a topical medicine is important when treating these areas. Coal tar has been used to treat psoriasis for hundreds of years. In a novel foam vehicle, coal tar 2% is versatile and may be used to treat psoriasis even in challenging areas of the body, such as the scalp, intertriginous areas, and palms and soles.  (J Clin Aesthet Dermatol. 2010;3(9):37–40.) Read the rest of this article »

Jason J. Emer, MD; Amylynne Frankel, MD; Joshua A. Zeichner, MD
Mount Sinai School of Medicine, Department of Dermatology, New York, New York

Disclosure: Drs. Emer and Frankel report no relevant conflicts of interest. Dr. Zeichner is an investigator for Centocor.

Abstract
Psoriasis is a chronic, systemic, inflammatory skin condition that manifests predominantly as well-demarcated, erythematous, scaly plaques on the elbows, knees, and scalp. While mild cases (minimal body surface) often respond to various topical treatments and light therapy, patients with extensive disease (larger body surface and possibly joint involvement) may require systemic medications for remission. The development of biological agents provides dermatologists valuable ways to help treat psoriatic disease quite efficiently, but literature regarding the monitoring of patients on biological treatments is sparse. Clinical practice varies widely since there is modest strong evidence to recommend or refute most tests currently recommended by the United States Food and Drug Administration. The purpose of this article is to present a practical approach to monitoring patients on biological therapy based on the most up-to-date literature.  (J Clin Aesthetic Dermatol. 2010;3(8):20–26.) Read the rest of this article »

James Q. Del Rosso, DO, FAOCD; Grace K. Kim, DO

Dr. Del Rosso is Dermatology Residency Director, Valley Hospital Medical Center, Las Vegas, Nevada. Dr. Kim is Dermatology Research Fellow, Mohave Skin & Cancer Clinics, Las Vegas, Nevada. Disclosure: Dr. Del Rosso is a consultant, speaker, and or researcher for Allergan, Coria, Galderma, Graceway, Intendis, Leo Pharma, Medicis, Onset Therapeutics, Ortho Dermatology, PharmaDerm, Quinnova, Ranbaxy, SkinMedica, Stiefel, Triax, Unilever, and Warner Chilcott. Dr. Kim reports no relevant conflicts of interest. Read the rest of this article »

Grace K. Kim, DO, Dermatology Research Fellow, Mohave Skin & Cancer Clinics, Las Vegas, Nevada; James Q. Del Rosso, DO, Dermatology Residency Director, Valley Hospital Medical Center, Las Vegas, Nevada, and Director of Dermatology Research, Mohave Skin & Cancer Clinics, Las Vegas, Nevada

Abstract
Psoriasis is a commonly encountered dermatosis with a variety of internal and external paradoxical factors contributing to the clinical course of the disease. There are several drugs described in the literature that have been associated with the initiation, exacerbation, and aggravation of psoriasis. Understanding the pathophysiology can provide clues to treatment and management of drug-induced and drug-aggravated psoriasis, which may be indistinguishable from idiopathic psoriasis. The clinical manifestations of drug-associated psoriasis can range from plaque-type psoriasis to severe erythroderma, thus warranting astute and sustained clinical observation.
(J Clin Aesthetic Dermatol. 2010;3(1):32–38.) Read the rest of this article »

Mark Bechtel, MD; Catherine Sanders, MS; Ann Bechtel, RN, BSN
The Ohio State University College of Medicine, Columbus, Ohio

Disclosure: Dr. Bechtel is a speaker for Amgen, Centocor, Genentech, and Abbott. Ms. Sanders and Ms. Bechtel report no relevant conflicts of interest.

Abstract
Biologic agents have been a significant advancement in the management of psoriasis. Along with significant clinical improvement, there have been concerns for emerging side effects with the use of biologics. Reports have emerged showing the association between efalizumab and the development of progressive multifocal leukoencephalopathy and other demyelinating disorders. Tumor necrosis factor-alpha inhibitors have been associated with various demyelinating disorders. As such, it is imperative for dermatologists to be well informed regarding how to notify patients about the risks of biologic treatment. Dermatologists must be able to identify the signs and symptoms of neurological complications and recognize when to refer patients to neurologists for diagnostic workup, disease confirmation, and any necessary treatment. This review is a compilation of evidence showing the association between biologic therapy and neurological complications, as well as an overview of the clinical presentation and diagnosis of such diseases.
(J Clin Aesthetic Dermatol. 2009;2(11):27–32.) Read the rest of this article »

by Joshua A. Zeichner, MD

Author: Dr. Zeichner is a Chief Resident, Department of Dermatology, Mount Sinai Medical Center, New York, New York. Section Editors: Jerry Tan, MD, FRCPC, is Adjunct Professor, University of Western Ontario, London, Ontario; President, Windsor Clinical Research Inc., Windsor, Ontario; and Consultant, Windsor Regional Hospital, Windsor, Ontario, Canada. He is also in private practice. Dr. Bhambri is a Dermatology Resident, UCLA Division of Dermatology, Los Angeles, California.

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