Wilkin J, Dahl M, Detmar M, et al. Standard classification of rosacea.J Am Acad Dermatol. 2002;46(4):585.

1.Canadian Clinical Practice Guidelines for Rosacea. Y Asai et al. Journal of Cutaneous Medicine and Surgery. 2016, Vol. 20(5) 432–445

Fowler J Jr, Jackson M, Moore A, et al. Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of two randomized, double-blind, and vehicle-controlled pivotal studies. J Drugs Dermatol. 2013;12(6):650-656.

1. Am J Clin Dermatol. 2000 May-Jun;1(3):191-9.Topical metronidazole. A review of its use in rosacea.McClellan KJ, Noble S.

https://www.ncbi.nlm.nih.gov/pubmed/11702300https://www.ncbi.nlm.nih.gov/pubmed/?term=McClellan KJ[Author]&cauthor=true&cauthor_uid=11702300https://www.ncbi.nlm.nih.gov/pubmed/?term=Noble S[Author]&cauthor=true&cauthor_uid=11702300

PRODUCT MONOGRAPH PrROSIVERTM Ivermectin Cream, 1% w/w Topical Rosacea Therapy. Galderma Canada Inc.

Ivermectin 1% cream (n=478) Metronidazole 0.75% cream (n=484)

IGA ‘clear’ or ‘almost clear’ 84.9%† 75.4%

Reduction in inflammatory lesion count from baseline

83.0%† 73.7%

Table 2. Efficacy endpoints for the phase 3 trial of ivermectin 1% cream vs. metronidazole 0.75% cream IGA = Investigator global assessment; †P

Br J Dermatol. 2015 Apr;172(4):1103-10. doi: 10.1111/bjd.13408. Epub 2015 Feb 11.Superiority of ivermectin 1% cream over metronidazole 0·75% cream in treating inflammatory lesions of rosacea: a randomized, investigator-blinded trial.Taieb A1, Ortonne JP, Ruzicka T, Roszkiewicz J, Berth-Jones J, Peirone MH, Jacovella J; Ivermectin Phase III study group.

https://www.ncbi.nlm.nih.gov/pubmed/25228137https://www.ncbi.nlm.nih.gov/pubmed/?term=Taieb A[Author]&cauthor=true&cauthor_uid=25228137https://www.ncbi.nlm.nih.gov/pubmed/?term=Ortonne JP[Author]&cauthor=true&cauthor_uid=25228137https://www.ncbi.nlm.nih.gov/pubmed/?term=Ruzicka T[Author]&cauthor=true&cauthor_uid=25228137https://www.ncbi.nlm.nih.gov/pubmed/?term=Roszkiewicz J[Author]&cauthor=true&cauthor_uid=25228137https://www.ncbi.nlm.nih.gov/pubmed/?term=Berth-Jones J[Author]&cauthor=true&cauthor_uid=25228137https://www.ncbi.nlm.nih.gov/pubmed/?term=Peirone MH[Author]&cauthor=true&cauthor_uid=25228137https://www.ncbi.nlm.nih.gov/pubmed/?term=Jacovella J[Author]&cauthor=true&cauthor_uid=25228137https://www.ncbi.nlm.nih.gov/pubmed/?term=Ivermectin Phase III study group[Corporate Author]

1.Reviewed in Canadian Clinical Practice Guidelines for Rosacea. Y Asai et al. Journal of Cutaneous Medicine and Surgery. 2016, Vol. 20(5) 432–445 2.PRODUCT MONOGRAPH PrAPPRILON® Doxycycline Modified-Release Capsule, 40 mg (as doxycycline monohydrate). Galderma Canada Inc.3. Schaller M et al. J Am Acad Dermatol. 2019 May 28. A randomized phase 3b/4 study to evaluate concomitant use of topical ivermectin 1% cream and doxycycline 40 mg modified-release capsules versus topical ivermectin 1% cream and placebo in the treatment of severe rosacea.,

https://www.ncbi.nlm.nih.gov/pubmed/?term=Schaller M[Author]&cauthor=true&cauthor_uid=31150711https://www.ncbi.nlm.nih.gov/pubmed/31150711

Canadian Clinical Practice Guidelines for Rosacea. Y Asai et al. Journal of Cutaneous Medicine and Surgery. 2016, Vol. 20(5) 432–445

Canadian Clinical Practice Guidelines for Rosacea. Y Asai et al. Journal of Cutaneous Medicine and Surgery. 2016, Vol. 20(5) 432–445

Ozarkderm.com

From Dermatology, 4th Ed. Jean Bolognia et al

1. Gieler U1, Gieler T2, Kupfer JP3. J Eur Acad Dermatol Venereol. 2015 Jun;29 Suppl 4:12-4..Acne and quality of life - impact and management.2. Jones-Caballero M, Chren MM, Soler B, Pedrosa E, Penas PF. Quality of ~ life in mild to moderate acne: relationship to clinical severity and factors influencing change with treatment. J Eur Acad Dermatol Venereol2007; 21: 219–226.

https://www.ncbi.nlm.nih.gov/pubmed/26059729https://www.ncbi.nlm.nih.gov/pubmed/?term=Gieler U[Author]&cauthor=true&cauthor_uid=26059729https://www.ncbi.nlm.nih.gov/pubmed/?term=Gieler T[Author]&cauthor=true&cauthor_uid=26059729https://www.ncbi.nlm.nih.gov/pubmed/?term=Kupfer JP[Author]&cauthor=true&cauthor_uid=26059729https://www.ncbi.nlm.nih.gov/pubmed/26059729

PLUS

Modified from: Management of acne: Canadian clinical practice guideline Yuka Asai MD MSc, Akerke Baibergenova MD PhD, Maha Dutil MD MEd, Shannon Humphrey BSc MD, Peter Hull MMed PhD, Charles Lynde BSc MD, Yves Poulin MD, Neil H. Shear BASc(Hons) MD, Jerry Tan BSc MD, John TooleBSc MD, Catherine Zip MD

Management of acne: Canadian clinical practice guideline Yuka Asai MD MSc, Akerke Baibergenova MD PhD, Maha Dutil MD MEd, Shannon Humphrey BSc MD, Peter Hull MMed PhD, Charles Lynde BSc MD, Yves Poulin MD, Neil H. Shear BASc(Hons) MD, Jerry Tan BSc MD, John TooleBSc MD, Catherine Zip MD

Management of acne: Canadian clinical practice guideline Yuka Asai MD MSc, Akerke Baibergenova MD PhD, Maha Dutil MD MEd, Shannon Humphrey BSc MD, Peter Hull MMedPhD, Charles Lynde BSc MD, Yves Poulin MD, Neil H. Shear BASc(Hons) MD, Jerry Tan BSc MD, John Toole BSc MD, Catherine Zip MD

Management of acne: Canadian clinical practice guideline Yuka Asai MD MSc, Akerke Baibergenova MD PhD, Maha Dutil MD MEd, Shannon Humphrey BSc MD, Peter Hull MMed PhD, Charles Lynde BSc MD, Yves Poulin MD, Neil H. Shear BASc(Hons) MD, Jerry Tan BSc MD, John Toole BSc MD, Catherine Zip MD

iStock.com

MedicineNet.com

Paul C et al. Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in patient with moderate-to severe plaque psoriasis over 52 weeks: a phase III RCT (ESTEEM 2). Br J Dermat 2015

Olivia Wind and Jeffrey Weinberg.Systemic Therapy for Nail Psoriasis. The Dermatologist. https://www.the-dermatologist.com/article/systemic-therapy-nail-psoriasis. Accessed June 12, 2019.

https://www.the-dermatologist.com/taxonomy/term/2989https://www.the-dermatologist.com/article/systemic-therapy-nail-psoriasis

Palmoplantar pustulosis. DA Wetter CMAJ Aug 6, 2013 185 (11) 982.

1. Cohen JM, Husni ME, Qureshi AA, et al. Psoriatic arthritis: it’s as easy as “PSA”. J Am Acad Dermatol. 2015;72:905–906.Torre Alonso JC, Rodriguez Perez A, Arribas Castrillo JM,2. Ballina Garcia J, Riestra Noriega JL, Lopez Larrea C. Psoriatic arthritis (PA): a clinical, immunological and radiological studyof 180 patients. Br J Rheumatol. 1991;30(4):245-250

Arthritis Rheum. 2009 Feb 15;61(2):233-9. doi: 10.1002/art.24172.Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: a population-based study.Wilson FC1, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM.

https://www.ncbi.nlm.nih.gov/pubmed/19177544?dopt=Abstracthttps://www.ncbi.nlm.nih.gov/pubmed/?term=Wilson FC[Author]&cauthor=true&cauthor_uid=19177544https://www.ncbi.nlm.nih.gov/pubmed/?term=Icen M[Author]&cauthor=true&cauthor_uid=19177544https://www.ncbi.nlm.nih.gov/pubmed/?term=Crowson CS[Author]&cauthor=true&cauthor_uid=19177544https://www.ncbi.nlm.nih.gov/pubmed/?term=McEvoy MT[Author]&cauthor=true&cauthor_uid=19177544https://www.ncbi.nlm.nih.gov/pubmed/?term=Gabriel SE[Author]&cauthor=true&cauthor_uid=19177544https://www.ncbi.nlm.nih.gov/pubmed/?term=Kremers HM[Author]&cauthor=true&cauthor_uid=19177544

1. Torre Alonso JC et al. Psoriatic arthritis (PA): a clinical, immunological and radiological studyof 180 patients. Br J Rheumatol. 1991;30(4):245-250. 2018.2. Mansouri B, et al. Comparison of coronary artery calcium scores between patients with psoriasis and type 2 diabetes. JAMA Dermatol. 2016;152(11):1244-1253.3. Lerman JB, et al. Coronary plaque characterization in psoriasis reveals high-risk features that improve after treatment in a prospective observational study. Circulation. 2017;136(3):263-276.

Fig 3. Relative risk of myocardial infarction with age for

psoriasis patients. Reproduced with permission from:

Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ,

Troxel AB. Risk of myocardial infarction in patients with

psoriasis. JAMA. 2006;296(14):1735-1741 Copyright

2006

Armstrong EJ, Harskamp CT, Armstrong AW. Psoriasis and major adverse cardiovascular events: a systematic review and meta-analysis of observational studies. J Am Heart Assoc. 2013;2(2):e000062.

RELATIVE RISK MILD PSORIASIS SEVERE PSORIASIS

MACE 1.03 (95% CI 0.86-1.125) 1.39 (95% CI 1.11-1.74)

MYOCARDIAL INFARCT 1.29 (95% CI 1.02-1.63) 1.70 (95% CI 1.32-2.18).

STROKE 1.12 (95% CI 1.08-1.16) 1.56 (95% CI 1.32-1.84).

Reprinted from Journal of the American Academy of Dermatology, 76(1). Wu JJ, GuerinA, Sundaram M, et al. Cardiovascular event risk assessment in psoriasis patients treated withtumor necrosis factor-alpha inhibitors versus methotrexate. pages 81-90.

1. Elmets CA et al. Joing AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities. J Am Acad Dermatol 2019; 80:1073-113.2. Dowlatshahi EA, Wakkee M, Arends LR, Nijsten T. The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: a systematic review and meta-analysis. J Invest Dermatol. 2014;134(6):1542-1551.3. Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies. Nutr Diabetes. 2012;2:e54.

WebMD

PRODUCT MONOGRAPH ACTIKERALL® fluorouracil and salicylic acid Solution (0.5%/10%) Topical Antineoplastic Agent

Stockfleth E, Kerl H, Zwingers T, Willers C. Low-dose 5-fluorouracil in combination with salicylic acid as a new lesion-directed option to treat topically actinic keratoses: histological and clinical study results. Br J Dermatol 2011;165(5):1101-8