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Psoriasis Academy

Clinical Cases

Read time: 45 mins
Understanding the individual needs of patients with psoriasis is key to achieving treatment optimisation (Van der Kerkhof, 2017). The following patient case reports illustrate the multi-faceted nature of this condition, providing detailed insight into the rationale behind the treatment decisions made in each case.

Professor Ulrich Mrowietz and Dr Kirsten Morrison from Psoriasis-Centre, Department for Dermatology, (Kiel, Germany) share a series of patient scenarios from their daily outpatient practice. Significant comorbidity, co-treatment with possible drug-drug interactions, previous treatment failure and other aspects of treating psoriasis patients are discussed, with the major focus on systemic therapy with oral dimethyl fumarate and its role as first- or second-line systemic therapy. We explore how best to manage gastrointestinal discomfort associated with oral dimethyl fumarate and its place in the treatment pathway. We hope that the cases described may be helpful for future management of patients with psoriasis for whom dimethyl fumarate therapy is an option.

References

Van der Kerhof PCM. Stratified or personalised medicine in the treatment of psoriasis. J Dermatol Treat. 2017;28(8):683.

Current case reports on chronic plaque psoriasis – Case Report Skilarence®: Wiley; 2018.

Follow this patient journey with severe psoriasis and see the outcome after 6months including how dimethyl fumarate can be a very successful first line treatment for moderate-to-severe plaque psoriasis.

Abstract

This case report describes a patient with severe plaque psoriasis of 15 years’ duration who first presented in December 2017. The skin lesions had worsened in the 12 months prior to presentation but improved after treatment with dimethyl fumarate (Skilarence®).

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Follow this patient journey with comorbidities such as chronic obstructive pulmonary disease, osteoarthritis, hypothyroidism, and see the outcome after 6months including how it may reduce cardio- vascular risk.

Abstract

This patient presented with moderate to severe psoriasis vulgaris at our centre in October 2017. He had multiple comorbidity (including chronic obstructive pulmonary disease [COPD], osteoporosis and hypothyroidism) and he had previously been diagnosed with prostate cancer.

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Follow this patient journey over 3 months and see how patients receiving fumaric acid ester compounds who need to switch to dimethyl fumarate can do so without any change of dosage or induction period.

In December 2013, a 29-year old man presented with moderate to severe psoriasis.

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Follow this patient journey over 3 months and see how a slower upwards dose titration may increase tolerability, especially in the early weeks of treatment.

A 23-year old man presented to our centre with moderate to severe psoriasis in February 2018.

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