Psoriasis Update 2025: Dr. Stein Gold

Dr. Linda Stein-Gold:
Greetings from Maui Derm. My name is Dr. Linda Stein Gold, and I'm the director of Dermatology Clinical Research at Henry Ford Health System in Detroit, Michigan.

At this meeting, we had a really great psoriasis symposium. I talked about some patients who are often forgotten, and those are those patients who have intertriginous or genital disease. Often in our busy practices, we don't ask patients if they have it in private areas, and these are patients who really, really are undertreated and their disease has a tremendous impact on them.

I discussed traditionally we use topical non-steroidals, including topical calcineurin inhibitors and crisaborole, which did work in skin folds even though they don't work in plaque psoriasis. Now, more recently, we've had FDA approval of two non-steroidal options, topical roflumilast, which specifically studied intertriginous disease, and topical tapinarof, which also did a Phase 4 study in intertriginous disease. Both of these drugs are highly effective in getting the disease under control and also are very well-tolerated.

In terms of systemic therapy, I think these patients absolutely deserve systemic therapy, especially if they failed topicals. We know there are several systemics, including apremilast, that studied genital psoriasis and was found to be effective. We know ixekizumab also studied genital psoriasis and was highly effective. And more recently, guselkumab did a study called the Spectrum Study, which looked at patients with low body surface area and high impact areas, including genital disease.

So the bottom line is we have some tremendous treatments for those high-impact sensitive areas. Let's make sure we get our patients under great control.