Perioperative management of medications for psoriasis and psoriatic arthritis: A review for the dermasurgeon

Claudia Hernandez*, Jason Emer, June K Robinson

*Corresponding author for this work

Research output: Contribution to journalReview article

9 Scopus citations

Abstract

BACKGROUND: Psoriasis affects an estimated 3% of the world's population. Many are on chronic immunosuppressive therapy for the cutaneous and joint manifestations of this disorder. The management of these medications in the perioperative period is controversial. Psoriasis and psoriatic arthritis medications can affect wound healing, hemostasis, and infection risk during cutaneous surgery. OBJECTIVES: The objective of this article is to provide a critical review of various medications used for care of the psoriatic patient and their potential effect on cutaneous surgical procedures. CONCLUSIONS: This review summarizes current understanding of wound healing, hemostatic effects, and infectious risks regarding many psoriasis medications including nonsteroidal anti-inflammatory drugs, cyclooxygenase inhibitors, corticosteroids, various immunosuppressants, and biologic response modifiers. Recommendations vary depending on the agent in question, type of procedure, and comorbid conditions in the patient. Caution is advised when using many of the medications reviewed due to lack of human data of their effects in the perioperative period.

Original languageEnglish (US)
Pages (from-to)446-459
Number of pages14
JournalDermatologic Surgery
Volume34
Issue number4
DOIs
StatePublished - Apr 1 2008

ASJC Scopus subject areas

  • Dermatology
  • Surgery

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