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2 0 / 2 7 D E C E M B E R 2 0 1 2 | V O L 4 9 2 | N A T U R E | S 5 1

2003AMEVIVE

(ALEFACEPT)PASI 75 at 14

weeks: 21%

2004ENBEL (ETANECEPT)

PASI 75 at 24 weeks:59%

2006

EMICADE (INFLIXIMAB)PASI 75 at 26weeks: 50%

2008

HUMIA (ADALIMUMAB)PASI 75 at 16 weeks:71%

2009STELAA (USTEKINUMAB)PASI 75 at 28 weeks:7178%

970 980 990 2000 200

996

ACITETINEffective forgeneralized pustular

and erythrodermicpsoriasis, particularly in

combination with UVBor PUVA therapy.

970sUVB LIGHTCan clear mildcases of the disease.

PSOALEN AND UVALIGHT (PUVA)Possibly slightlymore effective,although lessconvenient, thanUVB therapy. Asecond-linetreatment.

993VITAMIN D3 ANALOGUES

Well tolerated and effectivefor long-term use with

minimal side effects.

increased risk of aheart attack for a 30-year-

old with severepsoriasis

Chronic plaque psoriasis

Red, scaly plaques indiscrete patches. Theextent of body surfacearea covered varies widelyfrom patient to patient.

Chronic plaque psoriasis

Red, scaly plaques indiscrete patches. Theextent of body surfacearea covered varies widelyfrom patient to patient.

Guttate psoriasis

Multiple small,red spots, usuallyon the trunk andlimbs.

Guttate psoriasis

Multiple small,red spots, usuallyon the trunk andlimbs.

Inverse/flexuralpsoriasis

Very red scale-freelesions that form inskin folds.

Inverse/flexuralpsoriasis

Very red scale-freelesions that form inskin folds.

Pustular psoriasis

White blisters surroundedby red skin, which may belocalized to a particulararea, but which can alsocover the whole body.

Pustular psoriasis

White blisters surroundedby red skin, which may belocalized to a particulararea, but which can alsocover the whole body.

Erythrodermic psoriasis

Severe red inflammation andskin shedding covering mostof the body. This is a rare butdangerous form of the diseasethat can cause patients to loseexcessive amounts of heatthrough the skin.

Erythrodermic psoriasis

Severe red inflammation andskin shedding covering mostof the body. This is a rare butdangerous form of the diseasethat can cause patients to loseexcessive amounts of heatthrough the skin.

PSORIASIS IS HIGHLY HETEROGENEOUSPsoriasis comes in several distinct forms. Patients usually display a single form at any one time, although forms can coexist, and one form can be followed by another.Around 80% of psoriasis cases are classified as mild.

< 0%

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