• Hazel H Oon, Chris Tan, Derrick Chen Wee Aw, Wei-Sheng Chong, Hong Yi Koh, Ying-Ying Leung, Kar Seng Lim, Jiun Yit Pan, Eugene Sern-Ting Tan, Ki Wei Tan, Siew Nee Tham, Colin Theng, and Su-Ni Wong.
• National Skin Centre, Singapore.
• Ann Acad Med Singap. 2024 Sep 27; 53 (9): 562577562-577.

IntroductionPsoriasis is a multisystem, chronic, inflammatory dermatological disease. In routine clinical practice, the management of psoriasis varies significantly. The current study aimed to develop a set of practice guidelines relevant to dermatology practice in Singapore.MethodThe Psoriasis Therapeutic Guidelines Workgroup, comprising members of the Dermato-logical Society of Singapore with a subspecialisation in psoriasis, was convened to develop the guidelines. Clinical questions on selected topics were generated and refined by the workgroup. A literature search using PubMed was performed on their assigned topics from June 2013 to December 2023. The articles were included and graded based on the level of evidence.ResultsThe guidelines address topics ranging from clinical assessment to practical considerations in the management of mild, moderate and severe psoriasis, including delivery of care, referrals to specialists and adherence to treatment. The recommended therapies include phototherapy, methotrexate, acitretin, cyclosporine; apremilast; topical corticoste-roids, calcipotriol, topical calcineurin inhibitors; and biologics (i.e. adalimumab, infliximab, secukinumab, ixekizumab, ustekinumab, etanercept) either in combina-tion or as monotherapy. Common therapeutic concerns relating to biologic use were addressed. Recommendations on generalised pustular psoriasis, palmoplantar pustular psoriasis and psoriatic arthritis were also made. Patients on systemic therapy would receive appropriate vaccine counselling. Therapeutic implica-tions in special populations, such as pregnant/ lactating women, children, the elderly, those undergo-ing surgery and those suffering from specific infections and cancer were addressed.ConclusionThese guidelines were developed for dermatologists, family physicians, rheumatologists and other specialists to support their selection of appropriate management options.

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