Download accompanying slides (PPT)

Zinc Code: UK/RET/0102/16b
Date of Prep: November 2016
The pharmacist’s role:
The rational use of topical
steroids
Zinc Code: UK/RET/0120/16b
Date of Prep: November 2016
Christine Eksteen
– Global Scientific Director for Dermatology at
Stiefel, a GSK company
– Pharmacist by training, working in the
pharmaceutical industry for the last 15 years
and in Global Medical Affairs for dermatology
over the last 3 years
– In Stiefel, she has been leading the Global
Medical Affairs activities for acne, superficial
skin infections, psoriasis, atopic dermatitis and
androgenic alopecia
Zinc Code: UK/RET/0120/16b
Date of Prep: November 2016
Webinar overview
1. Introduction to atopic dermatitis (AD) and psoriasis
2. Role of topical corticosteroids (TCS) in the treatment
of AD and psoriasis
3. Appropriate use and potential side effects of TCS
4. Role of pharmacists in patient education
5. Live Q&A
Zinc Code: UK/RET/0120/16b
Date of Prep: November 2016
Introduction to
atopic dermatitis (AD)
and psoriasis
Zinc Code: UK/RET/0120/16b
Date of Prep: November 2016
About atopic dermatitis (AD)
Common symptoms1
Causes1
No known single
cause
Dry skin
Impacts2
Itching
Redness
Reduced quality
of life
Genetic link
Prevalence3
Environmental
factors
Emotional distress
Affects at
Affects
least 15%
of children
2–10%
of adults
Disturbed sleep
AD can be mild, moderate or severe1
1. NICE. Eczema – atopic. Clinical Knowledge Summaries 2015; http://cks.nice.org.uk/eczema-atopic. Accessed September 2016;
2. Basra MK, et al. Expert Rev Pharmacoecon Outcomes Res 2009; 9(3):271–283; 3. Kabashima K. J Dermatol Sci 2013; 70:3–11.
Zinc Code: UK/RET/0120/16b
Date of Prep: November 2016
Assessing severity of AD
Clear
Mild
Moderate*
Severe**
Dry skin
None
Some
Some
Widespread
Itching
None
Infrequent
Frequent
Incessant
Redness
None
Possibly small
areas
Some areas
Redness
For moderate-to-severe cases, advise the patient to consult their doctor
For mild cases, patients may be able to be treated with over-the-counter treatment options
*May include excoriation and localised skin thickening
**May include picked skin, extensive thickening, bleeding, oozing, cracking, or colour alterations
NICE. Eczema – atopic. Clinical Knowledge Summaries 2015; http://cks.nice.org.uk/eczema-atopic. Accessed September 2016.
Zinc Code: UK/RET/0120/16b
Date of Prep: November 2016
About psoriasis
Causes
Common symptoms2
Impacts2,3
Itching
Reduced quality
of life
Scaly skin
lesions
Patches, papules
or plaques
Inappropriate
immune response1
Flare triggers
include:
Prevalence
Stress, trauma2
Affects approximately 2%
of the world’s population:4
nearly 150 million
people worldwide5
Environmental
Psychological
effects
There are several forms of
psoriasis, including plaque,
pustular, nail, guttate, and
erythrodermic2
Physical effects
factors2
Psoriasis should normally be managed by a primary or secondary care physician, following appropriate referral 2
1. Lowes MA, et al. Nature 2007; 445(7130):866–873; 2. NICE. Psoriasis. Clinical Knowledge Summaries 2014; http://cks.nice.org.uk/psoriasis. Accessed September 2016; 3. Basra
MK, et al. Expert Rev Pharmacoecon Outcomes Res 2009; 9(3):271–283; 4. Bhosle MJ, et al. Health Qual Life Out 2006; 4:35; 5. World population estimate: 7,450,000,000
(http://www.worldometers.info/world-population/, accessed 23 September 2016).
Zinc Code: UK/RET/0120/16b
Date of Prep: November 2016
Assessing severity of plaque psoriasis
Plaque psoriasis accounts for 80–90% of all psoriasis cases and the Physician’s Global Assessment (PGA)
is used for assessing severity of disease on a 7-point scale1
0
1
Clear
2
Nearly
clear
3
Mild
4
Moderate
5
Severe
6
Very
severe
The Psoriasis Area and Severity Index (PASI) is another commonly used tool to quantify disease severity.
Scores range from 0–72 with higher scores indicating more severe disease2
Those patients with severe or very severe PGA scores should be referred to a specialist dermatologist1
1. NICE. Psoriasis. Clinical Knowledge Summaries 2014; http://cks.nice.org.uk/psoriasis. Accessed September 2016; 2. Fredriksson T, Pettersson U. Dermatologica 1978; 157:238–44.
Zinc Code: UK/RET/0120/16b
Date of Prep: November 2016
Psoriasis and AD are common disorders that impact patients’ quality
of life
AD is a common condition featuring dry, itchy and red skin1
Only mild AD can be treated over the counter – patients with more severe forms of the condition should be
referred to their primary care physician1
Psoriasis is a debilitating disease with psychological and physical consequences;2,3 plaque psoriasis is by far
the most common form2
Patients with psoriasis should be managed collaboratively by both their primary care physician and
dermatologist with regard to assessing the impact of psoriasis and disease severity2
Doctor by ProSymbols, Noun Project
1. NICE. Eczema – atopic. Clinical Knowledge Summaries 2015; http://cks.nice.org.uk/eczema-atopic. Accessed September 2016; 2 NICE. Psoriasis. Clinical Knowledge Summaries 2014;
http://cks.nice.org.uk/psoriasis. Accessed September 2016; 3. Basra MK, et al. Expert Rev Pharmacoecon Outcomes Res 2009; 9(3):271-283.