Psoriasis — SCE Dermatology MCQ
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Correct answer: C — Phosphodiesterase-4 inhibitor
Apremilast is an oral phosphodiesterase-4 (PDE4) inhibitor. PDE4 inhibition increases intracellular cyclic AMP (cAMP) levels, which downregulates inflammatory mediators (TNF-alpha, IL-17, IL-23) and upregulates anti-inflammatory mediators (IL-10). It is approved for moderate plaque psoriasis when conventional systemic therapies are inappropriate. Common side effects include nausea, diarrhoea, and weight loss. It does not require routine blood monitoring (unlike Methotrexate/Ciclosporin). Apremilast is positioned between conventional systemics and biologics in the treatment pathway.
Reference: NICE TA419 2016 Apremilast for psoriasis; BAD 2020