Karan Lal, DO: Preferred Treatments for Adult Plaque Psoriasis Patients

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A discussion regarding the use of plaque psoriasis treatments such as apremilast, ixekizumab, and methotrexate.

During an interview with HCPLive, the use of topical treatments versus apremilast for plaque psoriasis was covered by Karan Lal, DO, MS, FAAD, the director of pediatric dermatology and cosmetic surgery for Affiliated Dermatology Scottsdale. He also holds the social media chair position for the Society for Pediatric Dermatology.

“So apremilast is a medicine that's been around for a while,” Lal said. “And it has done okay. It's not typically something that in my opinion is one of my go to treatments for patients with psoriasis. And the reason is because psoriasis is either something that is stubborn and doesn't bother people and they're okay with treating with topicals, or it's to the point where it's severe enough and they want to do biologic treatments.”

Lal went on to explain his views on apremilast versus other medications, comparing patient opinions as well as effects of the drugs’ use. He added that he believes apremilast may work better for psoriatic arthritis, specifically.

“And now, a lot of guidelines have changed where we're not ordering as much bloodwork for the biologics and we're learning that these biologics are actually much safer than what you know, was previously thought or is what is labeled,” Lal said. “So my go-to’s are either, you know, I do topicals, I do methotrexate, and I do a lot of biologics. Ixekizumab is one of my favorites.”

The discussion also shifted to a conversation about the skin microbiome, which Lal believes is being increasingly examined in the world of dermatology research.

“We're learning more and more every day on how important our skin microbiome is,” Lal explained. “And we're learning that there are a lot of diseases that are implicated and involve the skin microbiome and that imbalance.”

Lal further discussed the skin’s microbiome and the different kinds of bacteria found on the skin. For more information, watch the full HCPLive interview above or a previous interview with Dr. Lal.