Can Psoriasis Treatment Affect Bones ?

 

There are no specific guidelines for the treatment of Osteoporosis in psoriasis. Bone assessment is recommended in patients of both sexes with moderate to severe psoriasis, with associated psoriatic arthritis, and in patients in chronic treatment with oral corticosteroids, in presence of other factors mentioned that have been shown to be predictive of risk of fracture in the general population, such as age > 65 years and presence of previous frac¬tures. In these patients, dermatologists should assess the risk of fracture through study of the clinical risk factors and using fracture risk scales (FRAX).

Bone densitometry and/or dorsal and lateral lumbar radiography enable the detec¬tion of prevalent morphometric fractures and increase the probability of requiring pharmacological treatment. Patients should be assessed by specialists, such as rheumatologists, endocrinologists, and, as always, the primary care physician. Disease control to minimize bone loss associated with systemic inflammation and ensuring that corticosteroids are given in the lowest possible dose for the shortest possible duration are essential measures. Patients in chronic treatment with corticosteroids should follow the published guidelines for the prevention and treatment of corticosteroid-induced Osteoporosis.

The main objective of Osteoporosis treatment is to reduce the risk of fracture. The therapeutic approach involves pharmacological measures basically aimed at increasing bone resistance and nonpharmacological measures, with the aim of maintaining as far as possible a good state of health, decreasing the risk of falls, and minimizing their consequences. In general, the decision when to administer pharmacological treatment is based on the assessment of absolute risk of fracture, and this is well defined by age. Treatment should be tailored to each patient, taking into account his or her particular circumstances. ( NEXT: How Bad Can Psoriasis Get ? How To Treat It Naturally at Home ? )