ABSTRACT
In the United States, patients suffering from psoriasis face two dilemmas. First, they have a disease that negatively impacts quality of life on a scale that is comparable to other serious conditions. Second, there is a real potential for being undertreated by their dermatologists. One of the major reasons behind the reluctance of dermatologists to embrace traditional systemic therapies, such as cyclosporine or methotrexate, relates to the fear of major organ toxicity associated with these agents. With regard to the immunosuppressor category, the precise extent of patient-years becomes less critical. These are agents that have been documented to convincingly cause the immunemediated side effects in human whether such documentation occurs early or late in its history of human usage. The proposed classification system for the immune-mediated risks clearly parallels the pregnancy classification system in its proposed usage.
