Live Blog: The Basics of Psoriasis and Managing Mild, Moderate, and Severe Psoriasis – Abby Jacobson, MS, PA-C
In this live blog from the 12th Annual SDPA conference in Indianapolis, Abby Jacobson, MS, PA-C lectured on The Basics of Psoriasis and Managing Mild, Moderate, and Severe Psoriasis. Here are some of the highlights.
Physician assistant and former SDPA president Abby Jacobson lectured on treating patients with mild, moderate, and severe psoriasis. When rating a patient’s psoriasis, Jacobson allows her patients to give their input. “Severity of disease is in the eye of the beholder,” she said.
Jacobson shared great open-ended questions to get patients to open up:
- Does your skin itch, skin, burn, or hurt?
- How much does it bother you?
- What do you do or not do because of your Psoriasis?
- Does your skin make you feel depressed?
- For your insurance company I’m supposed to rate your psoriasis as mild, moderate, or severe. How would you choose to rate it?
- Besides a cure, which I do not have, what do you wish I had to give you as a treatment today? (This question can show you if the patient wants or doesn’t want topical, for instance.)
She reminds practitioners to listen to the presented symptoms and to remember the psychological, social, and occupational impact the disease has on the patient. If the patients do not offer this information, you can ask questions like: What do you do or not do because of your Psoriasis? Does your skin make you feel depressed?
Jacobson gave many helpful tips:
- Remember to look at drug history; Find and discontinue any drugs that make psoriasis worse (beta blockers, lithium)
- Remember that alcohol makes psoriasis worse and in some parts of the country, patients may not count beer as alcohol (Beer makes psoriasis flare!)
- If you’re unsure as to a patient’s compliance, have them bring in their prescription to every visit. You can “make sure the pharmacy gave them the right kind” while being able to check if they’ve used any
- Don’t be afraid to mark the tubes with a Sharpie. Label STEROID on the steroid.
- When treating palm/plantar psoriasis: try Halbetosol ointment wrapped with cellophane for the first few days so that moisture stays in and works the ointment into the skin
Jacobson’s interactive discussion allowed audience members to consider what treatment they would want in certain psoriasis cases, a question many can bring back to their practices to inform their treatment decisions.