Involving the Patient in Their Psoriasis Treatment With a 42-Year-Old Woman With a Busy Lifestyle

EP: 1.Personalizing Psoriasis Treatment and Site-of-Care Decisions

EP: 2.Managing Psoriasis in a 72-Year-Old Woman through In-Office Biologic Administration

EP: 3.Incorporating Patient Lifestyle into Treatment Decisions in a 64-Year-Old Man with Late-Onset Psoriasis

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EP: 4.Involving the Patient in Their Psoriasis Treatment With a 42-Year-Old Woman With a Busy Lifestyle

EP: 5.Importance of Shared Decision-Making and Tailored Treatment in Psoriasis Care

The final case study presents a 42-year-old female marketing executive with long-standing plaque psoriasis since age 24, now progressing to affect her scalp and fingernails. This high-functioning professional faces significant stress, anxiety, and self-injection hesitancy, having previously used biologics including ustekinumab and secukinumab with inconsistent results due to missed doses and injection anxiety. Her demanding career leaves little personal time for consistent treatment management.

Scalp and nail psoriasis present unique treatment challenges that significantly impact professional patients. Scalp psoriasis affects over 50% of patients with plaque psoriasis and can be extremely difficult to treat with topicals, particularly for patients with certain hairstyles. Professional patients wearing dark clothing become self-conscious about visible flaking, and nail psoriasis affects emotional well-being and professional interactions. These areas are often recalcitrant to treatment, making biologic therapy essential for meaningful improvement.

Dr. Noor emphasizes the importance of addressing anxiety and depression in patients with psoriasis, noting the 3-fold increase in depression rates compared with the general population. For this patient, health care provider–administered tildrakizumab with 12-week dosing intervals provides an optimal solution, reducing injection anxiety while accommodating her busy schedule. Tildrakizumab demonstrates efficacy in treating difficult areas such as scalp and nails, offering quality-of-life improvements crucial for professional patients who need confidence in their appearance and social interactions.