A study conducted to determine the rates and types of flares during or after systemic corticosteroid administration in adult patients with a known history of psoriasis revealed that the rate of psoriasis flares were low, according to an article published in JAMA Dermatology.
The retrospective analysis identified 1,970 adult patients with an established diagnosis of psoriasis and exposure to at least one systemic corticosteroid. The primary outcome was rate of psoriasis flares during or within three months of discontinuation of the patient’s first course of systemic corticosteroids. Secondary measures included rates of specific types of psoriasis flares, including pustular, erythrodermic, and worsening plaque stage psoriasis.
Overall, the study found very low rates of psoriasis flares in patients who were receiving systemic corticosteroids for any reason. Less than 1.5 per cent of patients developed psoriasis flares, and most flares involved worsening plaque psoriasis. The rates of severe psoriasis flares, including erythrodermic and pustular psoriasis, were extremely low.
These findings show that psoriasis flare rates for patients taking or finishing systemic corticosteroid courses is very low and predominantly associated with mild flaring. The authors, therefore, challenge the notion that steroids induce severe psoriasis flares at significant rates in a general psoriasis population.