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Clinical Dialogue: Managing Psoriasis and Psoriatic Arthritis in Primary Care: Maximizing Prospects for Improved Outcomes
This activity outlines the diagnosis, management, and treatment that maximize prospects for improved outcomes in patients with psoriasis or psoriatic arthritis. Also available, eCase Challenge and Monograph Managing Psoriasis and Psoriatic Arthritis in Primary Care: Maximizing Prospects for Improved Outcomes.

Managing Psoriasis and Psoriatic Arthritis in Primary Care: Maximizing Prospects for Improved Outcomes

Lawrence Herman, MPA, PA-C, DFAAPA; Jennifer Conner, MPAS, PA-C; Benjamin J. Smith, PA-C, DFAAPA

Psoriasis and PsA are chronic diseases that have a significantly negative impact on numerous aspects of patients’ lives. The toll on functional abilities can be pronounced, while patients are also at risk of a range of medical and psychological comorbidities. These considerations underscore the need for early diagnosis, treatment and monitoring. Unfortunately, both psoriasis and PsA remain underrecognized and undertreated. Psoriasis can be diagnosed on the basis of clinical findings, but must be carefully differentiated from other skin conditions so appropriate therapy can be initiated. In the case of PsA, PAs should be aware that this disease may develop even in patients with no previous skin symptoms. Timely diagnosis and treatment of PsA is imperative to prevent irreversible joint destruction. This range of issues underscores the need for PAs to be adept in the identification and management of psoriasis and PsA. 

Biologic agents have redefined the therapeutic landscape for moderate-to-severe psoriasis and PsA. These treatments offer greater efficacy and safety than traditional systemic therapies, improving prospects for favorable outcomes. It is therefore incumbent on PAs to be knowledgeable about the various biologic agents currently available, including specific considerations involved in their use. In particular, PAs need to be aware of the increased risk of TB with biologic therapies, mandating the assessment of patients for latent TB before starting treatment. Because biologics are immunosuppressive, PAs also must be alert to requirements for ensuring that all patients receive appropriate vaccinations before starting treatment.

Another key issue is the potential for cardiovascular risk factors and comorbidities in patients with psoriasis or PsA. PAs should be aware of these concerns and work with patients to manage modifiable risk factors. In particular, PAs should be mindful of the potential for dyslipidemia, hypertension, type 2 diabetes mellitus, obesity, and metabolic syndrome. A fundamental principle is that psoriasis and PsA should not be viewed as isolated dermatologic or rheumatologic conditions, but rather as multisystem chronic diseases.

Educational Objectives

At the conclusion of this activity, the PA should be better able to:
  • Discuss key considerations in the diagnosis of psoriasis and evaluation of severity.
  • Outline considerations in diagnosing psoriatic arthritis.
  • Describe the various biologic agents approved for the treatment of psoriasis and psoriatic arthritis, including efficacy and safety profiles.
  • Explain the multiple comorbidities that exist with psoriasis and psoriatic arthritis, considerations for monitoring of patients, and requirements for vaccinations.

Accreditation Statement

This activity has been reviewed and is approved for a maximum of 0.50 AAPA Category 1 CME credit by the AAPA Review Panel. Participants should only claim credit commensurate with their participation in the CME activity. This program was planned in accordance with AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs. Approval is valid until November 30, 2018.

Responsibility Statement

AAPA takes responsibility for the content, quality, and scientific integrity of this CME activity.

Disclosure Policy Statement

It is the policy of AAPA to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member has with the commercial interest of any commercial product discussed in an educational presentation. The participating faculty reported the following:


Lawrence Herman, MPA, PA-C, DFAAPA
Professor and Dean Emeritus (Retired)
College of Health Sciences
PA Studies
Gardner-Webb University
Boiling Springs, NC
Disclosures: Consultant - Novo Nordisk; Speaker’s Bureau - Novo Nordisk

Jennifer Conner, MPAS, PA-C
Staff PA
Sonterra Dermatology
San Antonio, TX
Disclosure: Speaker’s Bureau - Promius Pharma, Prugen

Benjamin J. Smith, PA-C, DFAAPA
Director of Didactic Education
Director of Student Evaluations
Florida State University College of Medicine
School of PA Practice
Tallahassee, FL

Rheumatology, McIntosh Clinic, P.C.
Thomasville, GA
Disclosures: Voting Panel Member - American College of Rheumatology/National Psoriasis Foundation; Psoriatic Arthritis Treatment Guideline Development Group

Activity Planners

Michael Speidel and Joanne Jeffers, Medical Logix, LLC and Nancy Baxter, have no relationship with any commercial interests whose products or services may be mentioned during this presentation.

AAPA Staff Activity Planners

Daniel Pace and Cheryl Holmes have no relationship with any commercial interests whose products or services may be mentioned during this presentation.

Off-Label/Unapproved Product(s) Discussion

There are no references to off-label/unapproved uses of products in this program.


The opinions and comments expressed by faculty and other experts, whose input is included in this program, are their own. This enduring material is produced for educational purposes only. Please review complete prescribing information of specific drugs mentioned in this program including indications, contraindications, warnings, and adverse effects and dosage before administering to patients.

Acknowledgement of Commercial Support

Supported by an independent educational grant from Novartis and Valeant Pharmaceuticals North America, LLC.

AAPA offers no returns or refunds for online CME activities purchased through the AAPA store. All sales are final.

Type:     Internet Activity (Enduring Material)
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