Psoriasis
Clinical types and triggers, severity scoring, the IL-23/IL-17 axis behind modern drugs, the topical to phototherapy to systemic to biologic ladder, current PBS biologic criteria (2 of 6 prior treatments, PASI over 15), comorbidity screening and choosing a drug around pregnancy, IBD, heart failure and TB.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Chronic immune-mediated disease of skin and joints affecting 2 to 3% of Australians. Two peaks of onset: late teens to 30s (often HLA-C*06:02, family history) and 50s to 60s.
- A systemic disease: psoriatic arthritis in up to 30%, plus obesity, metabolic syndrome, MASLD, cardiovascular disease and depression. Screen for all of them.
- Severity combines extent (BSA, PASI), quality of life (DLQI) and high-impact sites (scalp, face, nails, palms and soles, genitals).
Loading the rest of the note…
Finished reading?
Sources
- Neotigason (acitretin) Australian Product Information, sections 4.3 and 4.4 (no pregnancy or blood donation for 3 years after stopping)AU/NZmedsinfo.com.au (sponsor Product Information), January 2025
- Therapeutic Guidelines: Dermatology (psoriasis)AU/NZTherapeutic Guidelines Limited (eTG complete), Version 5, 2022 (no newer edition found, November 2026)
- Foley P et al. Australian consensus: treatment goals for moderate to severe psoriasis in the era of targeted therapies. Adult patients. Australas J Dermatol 2023;64:476-87AU/NZAustralasian College of Dermatologists, 2023 (replaces the 2013 Australian consensus)
- PBS Schedule: biological medicines for severe chronic plaque psoriasis (for example risankizumab, items 14111Q and 14142H) and deucravacitinib (item 13649J)AU/NZAustralian Government Department of Health, Disability and Ageing (PBS), Schedule checked November 2026
- Rademaker M et al. Psoriasis in those planning a family, pregnant or breast-feeding. The Australasian Psoriasis Collaboration. Australas J Dermatol 2018;59:86-100AU/NZAustralasian Psoriasis Collaboration, 2018
- Nast A et al. S3 guideline for the treatment of psoriasis vulgaris, adapted from EuroGuiDerm. Part 1: treatment recommendations and monitoring. J Dtsch Dermatol Ges 2026;24:122-37German Dermatological Society (adapted from EuroGuiDerm), 2026 update (adds bimekizumab and deucravacitinib)
- Strober B et al. Recategorization of psoriasis severity: Delphi consensus from the International Psoriasis Council. J Am Acad Dermatol 2020;82:117-22International Psoriasis Council, 2020
- Menter A et al. Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics. J Am Acad Dermatol 2019;80:1029-72American Academy of Dermatology and National Psoriasis Foundation, 2019 (series completed 2021; no full update found, November 2026)
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy