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• W2936006980 endingPage "150" @default.
• W2936006980 startingPage "141" @default.
• W2936006980 abstract "The burden of psoriasis is particularly high for women, who report lower levels of happiness (women: 18.5%; men: 11.3% lower vs. general population) and are more likely to experience stress (women: > 60%; men: 42%), loneliness (women: 25-28%; men: 19-24%), stigmatization (Feelings of Stigmatization Questionnaire score; women: 93.2; men: 78.0), and reduced sexual activity (women: 33%; men: 19%) compared with men. The onset of psoriasis is bimodal, with one incidence peak (15-30 years) that coincides with the prime reproductive age for women, which poses specific challenges for their treatment. However, well-established guidelines for the treatment of women of childbearing age are lacking. Many women experience stabilization (21%) or improvement (55%) of their skin during pregnancy, but up to a quarter can experience disease worsening, and postpartum flares are common (> 50%). Therefore, balancing the risk of treatment with the risk of uncontrolled disease is important. Because half of pregnancies are unplanned, the implications of therapeutic options must be considered for all women with psoriasis who are sexually active, irrespective of intentions to start a family. Timely initiation of these discussions by health care professionals is paramount to prevent unintentional toxicity to the developing fetus. For example, acitretin, methotrexate, and oral psoralen/ultraviolet A are all contraindicated in pregnancy. Reassuringly, safety data for other psoriasis treatments during pregnancy are increasingly available, particularly for anti-tumor necrosis factor therapies. Despite encouraging data from pregnancy exposure registries and clinical studies now being included in anti-tumor necrosis factor drug labels, comfort with prescribing these therapies to pregnant women remains low (U.S. dermatologists: 21%; EU-5 dermatologists: 10%). In this article, we review issues specific to treating women of childbearing age with psoriasis and highlight the need for treatment guidelines to ensure consistent care and optimal outcomes for these patients." @default.
• W2936006980 created "2019-04-25" @default.
• W2936006980 creator A5001401093 @default.
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• W2936006980 date "2019-07-01" @default.
• W2936006980 modified "2023-10-10" @default.
• W2936006980 title "Clinical considerations for the management of psoriasis in women" @default.
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• W2936006980 doi "https://doi.org/10.1016/j.ijwd.2019.04.021" @default.
• W2936006980 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/6637092" @default.
• W2936006980 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/31360745" @default.
• W2936006980 hasPublicationYear "2019" @default.
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