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Psoriasis — SCE Dermatology MCQ

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HardInflammatory DermatosesPsoriasisSCE Dermatology

A 55-year-old woman with extensive plaque psoriasis asks about the 'proactive' use of biologics. What does 'proactive' biologic therapy refer to in psoriasis management?

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Correct answer: B — Continuous biologic therapy maintaining disease control to prevent flares and cumulative inflammatory damage

The best answer is “Continuous biologic therapy maintaining disease control to prevent flares and cumulative inflammatory damage”. NICE recommends treatment matched to severity, high-impact sites, functional burden, comorbidity and prior response; narrowband UVB is a finite specialist option for plaque or guttate psoriasis that topical therapy cannot control. The alternatives “Using biologics as rescue therapy, after specialist assessment, when the full phenotype supports it”, “Using sub-therapeutic biologic doses, when the full phenotype supports it, within an appropriate UK pathway”, “Treating during flares, within an appropriate UK pathway, after clinicopathological correlation”, “Alternating between different biologics, after clinicopathological correlation, after specialist assessment, when the full phenotype supports it” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE CG153 psoriasis recommendations: https://www.nice.org.uk/guidance/cg153/chapter/Recommendations