In patients very bothered by plaque psoriasis, when systemic medication is considered, the methotrexate (a so-called conventional immunosuppressant injectable or administered orally) is a reference medication (1,2). In case of insufficient effectiveness, an anti-TNF alpha immunosuppressant (a so-called biological drug administered by injection) is an option. Subcutaneous anti-interleukin immunosuppressants (also classified among so-called biological drugs) are generally more effective than an anti-TNF alpha in reducing or eliminating lesions in the short term, but there is less hindsight on their use. L’apremilastan immunosuppressive phosphodiesterase type 4 inhibitor administered orally, has not brought progress. All of these medications are associated with sometimes serious side effects, including infections and cancers (1,2)
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