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Systemic Corticosteroids Less Likely to Cause Severe Flares in Patients With a History of Psoriasis

A recent study published in the Journal of the American Medical Association (JAMA), Dermatology reported that administration of systemic corticosteroids showed lesser rates of severe psoriasis flares in patients with a known history of psoriasis.

This was a retrospective cohort study which included adult patients from the Marshfield Clinic Health System. These patients were included based on an established diagnosis of psoriasis followed by administration of at least one corticosteroid from October 31, 2012 to July 1, 2018. Patients below the age of 18 years, patients diagnosed with psoriatic arthritis and patients who were only under topical, intrabursal or intraarticular corticosteroids were all excluded from the study.

Primary outcomes were measured within the first 3 months after stopping the first course of systemic corticosteroids. Secondary outcomes were measured based on rates of psoriasis flares in specific types of psoriasis including erythrodermic, pustular and worsening plaque stage psoriasis.

The results showed that a total of 1.42% psoriasis flare rate was observed among 1970 patients who received their first course of systemic corticosteroids. Further analysis determined only one severe flare with erythrodermic psoriasis and no flares with pustular psoriasis.

Thus, the findings of the study suggested that systemic corticosteroids are less likely to produce severe psoriasis flares in patients with a history of psoriasis.

Source: Gregoire A, DeRuyter B, Stratman E. Psoriasis Flares Following Systemic Glucocorticoid Exposure in Patients with a History of Psoriasis. JAMA Dermatol. (2021); 157(2):198.

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