key: cord-0840987-x82jpyfd
authors: Abdelmaksoud, Ayman; Goldust, Mohamad; Vestita, Michelangelo
title: Comment on “Antipsoriatic treatments during COVID‐19 outbreak”
date: 2020-05-01
journal: Dermatol Ther
DOI: 10.1111/dth.13491
sha: da4dca6e6514526359a0bc0e4147455c99ba749c
doc_id: 840987
cord_uid: x82jpyfd

nan

respiratory virus infection, with Rhinovirus and Coronavirus as the most frequently detected pathogens, without evidence for group A Streptococcus as been reported (Sbidian et al., 2019) . A recent study from UK on 338,620 patients with active psoriasis, who were candidate for systemic therapies, was conducted to determine whether patients with psoriasis have a higher risk of hospitalization due to any infection, including respiratory infections, or a higher risk of death due to infections. The authors noted that patients with psoriasis have a small but increased risk of serious infection compared with those without psoriasis. The authors concluded that patients with psoriasis should not be unduly concerned about the risk of serious infection associated with the disease, because the absolute risks are small (Yiu et al., 2020) . azathioprine: ≤0.5 mg/kg/day, cyclosporine: ≤1 mg/kg/day, and methotrexate: ≤10 mg/week in the era of pandemic COVID19 infection. Immunomodulators dose modification would safely control virus-activated "cytokine storm" (Rademaker et al., 2020) . The TNF-α inhibitors, adalimumab is currently under evaluation for use in treating severe COVID-19 pneumonia. The efficacy and safety of adalimumab in the treatment of moderate-to-severe psoriasis, even at a low doses of 40 mg every week has been reported (Leonardi, 2012) . Interestingly, there is no evidence of COVID-19 (or any RNA virus) related harm from systemic retinoids. Owing to its efficacy, tolerability and absence of immunosuppressive effect, long-term, low-dose acitretin may be a safe alternative in countries with difficulty accessing biological agents for psoriasis (Chularojanamontri et al.,2019) .

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