CURRENT MEDICAL DIAGNOSIS AND
TREATMENT 2026 EXAM STUDY GUIDE
◉ Scaling Disorders:
Psoriasis:
Treatment: Answer: Scaling Disorders:
Psoriasis:
-Systemic CS should NEVER be used to treat flares (may lead to
severe rebound)
-Certain medication flare: BB, antimalarials, statins and lithium.
-Moderate to severe psoriasis should be managed by or in
conjunction with a dermatologist
◉ Scaling Disorders:
Psoriasis:
Treatment:
,Limited Disease: Answer: Scaling Disorders:
Psoriasis:
Treatment:
Limited Disease:
-(Less than 10%BSA)
-High- to ultra-high potency CS 2-3 weeks of BID then switch to only
weekends or mid-potency CS
-Vitamin D analog: BID which is continued long term and usually
needs to be given at different times of the CS due to compatibility
issues.
-Thick plaque on scalp: start with tar shampoo, additional
treatments: salicylic acid gel, P & S solution or fluocinolone
acetonide under shower cap at night
-Tacrolimus or equivalent may be effective in intertriginous or
sensitive area.
◉ Scaling Disorders:
Psoriasis:
,Treatment:
Moderate Disease: Answer: Scaling Disorders:
Psoriasis:
Treatment:
Moderate Disease:
-(10-30% BSA)
-Frequently treated with UV phototherapy
-Systemic Agents used in Generalized Disease (Methotrexate,
Acitretin,Cyclosporine)
◉ Scaling Disorders:
Psoriasis:
Treatment:
Generalized Disease: Answer: Scaling Disorders:
, Psoriasis:
Treatment:
Generalized Disease:
-(>30% BSA)
-Difficult to treat with topical agents
-Treatment of choice is OP narrowband UVB (NB-UVB) 3x/week
-Clearing occurs in about 7 weeks
-Maintenance may be required
-UVA may be effective if no response to UVB however associated
with skin CA
-Methotrexate: up to 25 mg once weekly, may be associated with
cirrhosis (after received 3.5-4 g cumulative dose - about 3-4 months
should be referred to hepatologist to evaluation, administration of
folic acid, 1-2 mg QD, can eliminate nausea caused by
Acitretin: synthetic retinoid, most effective for pustular psoriasis,
check liver enzymes and serum lipids, must wait at least 3 years
before considering pregnancy, greatest used when combined with
phototherapy
TREATMENT 2026 EXAM STUDY GUIDE
◉ Scaling Disorders:
Psoriasis:
Treatment: Answer: Scaling Disorders:
Psoriasis:
-Systemic CS should NEVER be used to treat flares (may lead to
severe rebound)
-Certain medication flare: BB, antimalarials, statins and lithium.
-Moderate to severe psoriasis should be managed by or in
conjunction with a dermatologist
◉ Scaling Disorders:
Psoriasis:
Treatment:
,Limited Disease: Answer: Scaling Disorders:
Psoriasis:
Treatment:
Limited Disease:
-(Less than 10%BSA)
-High- to ultra-high potency CS 2-3 weeks of BID then switch to only
weekends or mid-potency CS
-Vitamin D analog: BID which is continued long term and usually
needs to be given at different times of the CS due to compatibility
issues.
-Thick plaque on scalp: start with tar shampoo, additional
treatments: salicylic acid gel, P & S solution or fluocinolone
acetonide under shower cap at night
-Tacrolimus or equivalent may be effective in intertriginous or
sensitive area.
◉ Scaling Disorders:
Psoriasis:
,Treatment:
Moderate Disease: Answer: Scaling Disorders:
Psoriasis:
Treatment:
Moderate Disease:
-(10-30% BSA)
-Frequently treated with UV phototherapy
-Systemic Agents used in Generalized Disease (Methotrexate,
Acitretin,Cyclosporine)
◉ Scaling Disorders:
Psoriasis:
Treatment:
Generalized Disease: Answer: Scaling Disorders:
, Psoriasis:
Treatment:
Generalized Disease:
-(>30% BSA)
-Difficult to treat with topical agents
-Treatment of choice is OP narrowband UVB (NB-UVB) 3x/week
-Clearing occurs in about 7 weeks
-Maintenance may be required
-UVA may be effective if no response to UVB however associated
with skin CA
-Methotrexate: up to 25 mg once weekly, may be associated with
cirrhosis (after received 3.5-4 g cumulative dose - about 3-4 months
should be referred to hepatologist to evaluation, administration of
folic acid, 1-2 mg QD, can eliminate nausea caused by
Acitretin: synthetic retinoid, most effective for pustular psoriasis,
check liver enzymes and serum lipids, must wait at least 3 years
before considering pregnancy, greatest used when combined with
phototherapy
