skin disorders
Psoriasis
Systemic treatments
Systemic treatments are medications that affect the whole body or certain systems of the body. They can be taken by mouth or injected. Systemic immunosuppressants are medications that intentionally weaken (suppress) the immune system to keep it from making psoriasis worse. Immunosuppressants can reduce the body's ability to fight infections. Examples include Cyclosporinecan be used to treat severe psoriasis. This medication may cause high blood pressure and damage the kidneys. Mycophenolatemofetilcommonly causes gastrointestinal problems and bone marrow suppression (decreased production of red blood cells, white blood cells, and platelets). It may also increase the risk of lymphoma and other cancers. Methotrexatedecreases inflammation in the body and interferes with the growth and multiplication of skin cells. Doctors usemethotrexateto treat people whose psoriasis is severe or does not respond to less harmful forms of therapy. Liver damage and impaired immunity are possible side effects. Biologic agentsare made from living organisms and inhibit certain chemicals involved in the immune system. They includeetanercept,adalimumab,infliximab,certolizumab pegol,ustekinumab,secukinumab,brodalumab,ixekizumab,tildrakizumab,risankizumab,guselkumab, andtofacitinib. All of these medications are given by injection excepttofacitinib, which is taken by mouth. These medications tend to be the most effective ones for severe psoriasis, but they can have more troublesome side effects. Biosimilar medications are medications that are highly similar to biologic agents and are sometimes substituted for biologic agents. Other medications may be given to treat moderate to severe forms of psoriasis and psoriatic arthritis: Systemic retinoids,such asacitretinandisotretinoin, may be effective for severe and hard to treat cases of plaque psoriasis, pustular psoriasis (for whichisotretinoinis often preferred), and palmoplantar psoriasis. These medications are given by mouth. They can cause severe birth defects and should not be taken by women who may become pregnant. Women should wait at least 3 years after their last dose ofacitretinand at least 1 month after their last dose ofisotretinoinbefore attempting pregnancy. These medications can raise levels of triglycerides and cause reversible problems with the liver, blood counts, bones, and hair. Apremilastis another option and it is taken by mouth. The most common side effects are nausea and diarrhea. 