Psoriasis Uncovered

What exactly is on-treatment remission in psoriasis? Listen as rheumatologist Dr. Jeffrey Stark discusses this question with dermatologist Dr. April Armstrong and patient advocate Elizabeth Park.
On-treatment remission is a relatively new term being applied to the management of psoriasis. What does this mean for treatment goals and why is it important to address that last 10% of residual skin involvement? is it truly possible to attain skin clearance? Listen as rheumatologist Dr. Jeffrey Stark, head of medical immunology at UCB asks such questions and more with internationally recognized dermatologist and researcher Dr. April Armstrong, Chief of Dermatology at UCLA and patient advocate Elizabeth Park offering her perspective of living with plaque psoriasis since age 11.
The intent of this episode is to identify what on-treatment remission is and why it is important to achieve in the management of psoriasis. 
This episode is sponsored by UCB. 
Timestamps:
0:00 Intro to Psoriasis Uncovered and guest welcome to dermatologist Dr. April Armstrong, Professor and Chief of Dermatology, University of California Los Angeles (UCLA) and patient advocate Elizabeth Park who shares her perspective on living with psoriasis. 
1:05 The evolution of psoriasis management over the last 15 years from a better understanding of the disease and treatment to attain clear skin.   
3:30 Elizabeth's early days of diagnosis and management of her psoriasis at a young age.
 7:20 How talking to my doctor and advocating for myself changed my psoriasis management.
 8:47 Why clearing even residual psoriasis plaques is important to reducing the inflammatory storm and subsequent risks associated with psoriasis.
11:43 Psoriasis is more than what's visible on the skin.                                                                                                                                                        
12:08 How Elizabeth stays vigilant about changes and chooses to live her life. 
13:00 The concept of on-treatment remission vs a cure, and how it relates to psoriasis and guidelines in use for other diseases.
16:14 The official definition of on-treatment remission in psoriasis.
19:35 The mental load of having psoriasis and what clearance or remission means to Elizabeth.
21:56 Nuances of on-treatment remission vs tight disease control.
23:56 As a chronic disease, ongoing treatment is necessary.
26:15 We are living in an exciting time where through use of advanced therapies, clearance is possible for many people.
Key Takeaways:
·       Introduced in June 2025 through a consensus statement from the Medical Board of the National Psoriasis Foundation, on-treatment remission is a new view of managing psoriasis made possible through a greater understanding of the disease and the evolution of systemic treatments.   
·       Attaining complete clearance and remission of psoriasis is possible with current and ongoing treatment.
 ·       Intervening early in psoriasis management to control the cytokine storm and attain remission may help prevent progression of related           comorbidities like cardiovascular disease or psoriatic arthritis.
Guest Bios:  
April Armstrong, M.D., M.P.H. is an internationally renowned dermatologist and clinical researcher who is a Professor and Chief of Dermatology at the University of California Los Angeles (UCLA) where she specializes in inflammatory skin diseases such as psoriasis, atopic dermatitis, and hidradenitis suppurativa (HS). Dr. Armstrong is also the Co-Director for Network Resources at the UCLA Clinical and Translational Research Institute. She has conducted over 150 clinical trials and published over 600 articles in scientific journals.                        Dr.  Armstrong holds multiple leadership positions including Past Chair of the National Psoriasis Foundation Medical Board, Co-President of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), councilor for the International Psoriasis Council, and board member for the International Dermatology Outcome Measures, and the American Academy of Dermatology.
Elizabeth Park is a patient advocate and volunteer for the National Psoriasis Foundation. She developed plaque psoriasis in 2008 after being misdiagnosed with seborrheic dermatitis. For most of her adolescence she managed her scalp psoriasis with topicals and phototherapy. In college her psoriasis became worse and she sought other treatment options which included oral systemic treatments and biologics. She is vigilant about changes to her skin and does what she can to live a healthy life to stay on top of her disease management.
Resources:
"Redefining Remission: A new definition for patients, providers and payers" Advance Online. S. Schlosser. July 2025.
April W. Armstrong, MD, MPH; Geroge C. Gondo, MA; Joseph F. Merola, MD, MMSc; et al "Defining On- Treatment Remission in Plaque Psoriasis" A Consensus Statement from the National Psoriasis Foundation Medical Board. JAMA Dermatology, June 2025.

Description:
Do you wonder if TB testing is needed when on a biologic for psoriasis and/or psoriatic arthritis and why? Hear the answer to such questions and more from dermatologist Dr. G. Scott Drew as he addresses recent recommendations.          
Join host Archie Franklin as he discusses the latest recommendations from NPF and the International Psoriasis Council about routine testing for tuberculosis (TB) with treatments for psoriasis and psoriatic arthritis such as TNF-inhibitors, IL-17's, IL-23's and others with NPF Medical Board member and leading dermatologist Dr. G. Scott Drew from Mid-Ohio Dermatology.   
This episode identifies when a screening for tuberculosis (TB) is needed based on the type of treatment for psoriasis and psoriatic arthritis given recent recommendations from the National Psoriasis Foundation and the International Psoriasis Council.   
Timestamps:
  (0:00)        Intro to Psoriasis Uncovered & guest welcome dermatologist Dr. G. Scott Drew.                                                                                          (1:00)         What is tuberculosis (TB) and why testing is required with TNF-alpha inhibitors.                                                                                  (4:22)         Frequency of testing for TB and if false positive results occur.                                                                                                                      (6:15)         Do other immunosuppressants require TB testing?                                                                                                                                            (8:14)         Testing may create barriers to access or unnecessary testing.                                                                                                                          (11:03)       Release of new recommendations from the IPC and the NPF Medical Board offering  guidance of when to test for tuberculosis                          prior to and during treatment of psoriatic disease.                                                                                                                                          (15:37)       No longer need to wait to start therapy like the IL-17's or IL-23's to see the impact on quality of life.                                                      (18:26)       TB recommendations for other targeted medications like JAK inhibitors, PDE4, or the new oral IL-23 agent.                                  (19:15)        Implications of the recommendations for clinical trials.                                                                                                                                (20:13)        Become a member of NPF and visit the website to access resources and stay aware of the latest information impacting the care                       and treatment of psoriasis and psoriatic arthritis.
 Key Takeaways:
·       Due to the contagious nature of tuberculosis, a mycobacteria infection that affects the lungs and other parts of the body, and the increased risk associated with suppressing TNF-alpha, a TB screening is required prior to initiating and during some treatments for psoriasis and psoriatic arthritis.
 
·       With more advanced and targeted psoriatic disease treatments now available, the National Psoriasis Foundation and the International Psoriasis Council joint position statement recommends that TB screening is no longer needed with use of IL-17 or IL-23 treatments. 
 
·       TB screening may still be appropriate for specific populations and when symptoms are present based on a clinician's assessment.
Guest Bio:
Dr. G. Scott Drew is a medical and surgical dermatologist with Mid-Ohio Dermatology Associates where he specializes in inflammatory diseases such as psoriasis, believing strongly in dermatology and patient care. He is board certified in both Dermatology and Family Practice. In addition to his clinical practice, Dr. Drew is a member of the clinical faculty at Ohio State University, College of Osteopathic Medicine and participates in multiple dermatologic research protocols at five locations in central Ohio. He has been published in numerous peer-reviewed journals, contributed to scientific symposia, and authored textbook chapters. Dr. Drew is a fellow of the American Osteopathic College of Dermatology and the American Academy of Dermatology, he is past president of the Marion Academy of Medicine, a member of the American Osteopathic Association, and is a member of the National Psoriasis Foundation's Medical Board contributing to the development of guidelines and consensus statements. He is passionate about education providing lectures both nationally and internationally on medical, surgical, and cosmetic dermatology. Resources:
Joint position statement from the National Psoriasis Foundation Medical Board and the International Psoriasis Council on routine testing for latent tuberculosis infection prior to and during treatment of psoriasis patients with interleukin 17 or interleukin 23 inhibitors. Journal of the American Academy of Dermatology. Vol . 94/3; P802-809. March 2026.

Description: 
How do GLP-1 receptor agonists or GIP agonists work and what is the impact for my psoriatic disease? Hear dermatologist Dr. Ronald Prussick and cardio-immunologist Dr. Brittany Weber answer such questions and more.          
Join host Archie Franklin as he takes a deep dive into the use of GLP-1 receptor agonists and GIP agonists and the convergence of systemic inflammation related to psoriatic disease with renowned dermatologist and Vice Chair of the NPF Medical Board, Dr. Ronald Prussick from Washington Dermatology Center in Rockville and Frederick, MD, and, cardio-immunologist Dr. Brittany Weber, Director of the Cardio-Rheumatology/ Cardio-Dermatology Program at the University of Texas Southwestern. Learn more about the use of incretin hormones, the impact of weight management on psoriatic disease, metabolic and cardiovascular risk, as well as results from the TOGETHER-Pso and TOGETHER-PsA clinical trials.
 This episode addresses the actions of incretin hormones (GLP-1 receptor agonist and GIP agonist) and how such use may be beneficial in the management of inflammation related to psoriasis and psoriatic arthritis.
 Thank you to Lilly for their support of this program activity.
 Timestamps:
(0:00)  Intro to Psoriasis Uncovered & guest welcome dermatologist Dr. Ronald Prussick and cardio-immunologist Dr. Brittany Weber. 
(1:35)  What are incretin hormones and how GLP-1 or GIP receptor agonists (RA) inhibit appetite to initiate weight loss.
(3:29)  Why GLP-1 RAs are of interest in the management of psoriasis and psoriatic arthritis.
(5:23)  The metabolic, cardiovascular, and psoriatic disease convergence.
(7:19)  Will reduction of inflammation impact cardiovascular risk?
(10:59) Treatment challenges associated with having psoriatic disease and being overweight or obese.
(13:45)  Key points around the use of GLP-1 receptor agonists when managing psoriasis and psoriatic arthritis.
(17:06)  Results of the TOGETHER-PsO and TOGETHER-PsA phase 3 clinical trials combining use of an IL-17 inhibitor and a GIP and GLP-1                receptor agonist therapy.
(19:07)  Having the conversation of adding a GLP-1 RA medication to a treatment regimen.
(22:40)  The paradigm shift of GLP-1 receptor agonists and the impact they can have on shared inflammatory pathways.
Key Takeaways:
·       Glucagon-like peptide-1 (GLP-1) receptor agonists and glucose-dependent insulinotropic polypeptide (GIP) agonists are two incretin hormones that assist in managing excess body weight -- which as a result can be helpful in managing inflammation in the body.
 
·       Psoriasis isn't just a skin and joint disease. It's a complex network of systemic inflammation with shared inflammatory pathways that worsens with increased weight impacting the severity of the disease, and accelerates the risk of metabolic dysfunction, and cardiovascular disease.
 
·       The best outcomes occur as a result of multidisciplinary collaboration to address the impact of excess weight and systemic inflammation. If you are struggling to lose weight with diet and exercise, speak with your medical team about your options including the use of GLP-1 or GIP agonists.  
Guest Bios:
Renowned dermatologist Ronald Prussick, M.D., Medical Director of the Washington Dermatology Center in Rockville and Fredrick, Maryland, specializes in the treatment of psoriasis along with other diseases of the skin, hair, and nails. Dr. Prussick is also a Clinical Associate Professor in Dermatology at George Washington University in Washington, D.C.. Dr. Prussick has a research interest in the impact of diet on psoriatic disease and metabolic health, first becoming interested after being involved in Dr. Joel Gelfand and Dr. Nehal Mehta's work in vascular inflammation trials using FDG-PET/CT scans to view systemic and cardiovascular inflammation associated with psoriatic disease. Dr. Prussick has since participated in the development of the 2018 Dietary Recommendations for Adults with Psoriasis or Psoriatic Arthritis and more recently the position statement "GLP-1 Receptor Agonists in Psoriasis: A Primer from the National Psoriasis Foundation Medical Board". Dr. Prussick is Vice Chair of the NPF Medical Board which provides clinical direction, treatment guidance, and education oversight to the organization and its Executive leaders.
 Brittany Weber, M.D., Ph.D. is a cardio-immunologist who is the Director of the Cardio-Rheumatology/ Cardio-Dermatology Program at the University of Texas Southwestern. She is also a member of the Division of Cardiology, a clinical investigator, and imaging specialist. Dr. Weber's research integrates advanced imaging, molecular biology, clinical trials, and population health to understand how systemic inflammation and immune deregulation drives cardiovascular dysfunction. Prior to joining UT Southwestern in 2025, Dr. Weber served on the faculty at Harvard Medical School and was the Director of the Cardio-Rheumatology Clinic at Brigham and Women's Hospital, a nationally recognized clinic addressing inflammation-related heart disease through collaborative, patient centered care. Dr. Weber is also an author on the position statement "GLP-1 Receptor Agonists in Psoriasis: A Primer from the National Psoriasis Foundation Medical Board".
Resources:
"The Metabolic Collison and How You Can Take Control with Psoriatic Disease" podcast episode with dermatologist Dr. Ronald Prussick and registered dietitian Danielle Cahalan  
"NPF Medical Board Issues GLP-1 Primer for Dermatologists" Press Release
"Finding My Path to Managing Psoriatic Disease and Excess Weight" podcast episode featuring dermatologist Dr. Erin Boh, patient advocate Brian Lehrschal, and moderator Jennifer Bomberger.

Description:
"When joint pain is present, the diagnosis of psoriatic arthritis needs to be made as soon as possible, ideally within six months to limit joint inflammation" Dr. Vinod Chandran mentions as he discusses efforts to identify a diagnostic test for those at risk of developing psoriatic arthritis.         
Join host Jeff Brown as he speaks with leading rheumatologist and clinician scientist Dr. Vinod Chandran, Director of the Gladman Krembil Psoriatic Arthritis Program, Schroeder Arthritis Institute, University Health Network and the Departments of Medicine, Laboratory Medicine and Pathobiology, and the Institute of Medical Science at the University of Toronto to learn more about the progress and promising results towards developing a psoriatic arthritis diagnostic test through multi-omic assays and identifying the distinct differences between psoriasis and psoriatic arthritis. 
This episode provides an update on the progress to date of the NPF PsA Diagnostic Test grant initiative which has shown promising results with a potential test entering prospective study in multiple sites soon. 
 Thank you to Johnson and Johnson for their support of this program activity.
Timestamps:
(0:00)          Intro to Psoriasis Uncovered & guest welcome rheumatologist Dr. Vinod Chandran. 
  (0:52)          It is challenging to diagnose psoriatic arthritis with many factors leading to a delay in diagnosis.
(4:56)          The start of Dr. Chandran's involvement with the PsA Diagnostic Test Grant project.  
(7:55)          The different types of omics and the definition of multi-omic.
(9:57)          How the multi-omic approach is used to find biomarkers relative to a specific disease pattern.
(11:08)        Development of a predictive or prevention-based test using gene expression.     
(13:46)        First year results identify 200 markers across different omic approaches that distinguish psoriatic arthritis from psoriasis. 
  (14:58)        The significance of MRNA vs mIcroRNA's use in development of a diagnostic test and how critical that is to dissemination of a                     potential test.
(17:08)        Identifying the skin-joint axis in relation to different types of arthritis.
(20:20)        Next steps to moving the diagnostic test research forward as a prospective study in multiple sites and the cost effectiveness of                  delivering the test.
  (23:13)        If you have psoriasis, musculoskeletal, back, and joint pain think of psoriatic arthritis and be diagnosed early to maintain a good                 quality of life.
Key Takeaways:
·       Given challenges associated with diagnosing psoriatic arthritis and the impact on quality of life, in 2019 NPF launched the PsA Diagnostic Test Grant project with the goal of developing an early stage test that would identify and diagnose those with psoriatic arthritis before debilitating  joint damage begins.  
·       Progress towards a PsA Diagnostic Test includes the study of multi-omic data sets where 200 distinct biomarkers have been identified leading to a greater understanding of the different pathways between psoriatic arthritis, psoriasis, and the skin joint axis. 
·       A potential diagnostic test is now moving towards the prospective study phase. Until the test is available and if joint pain is present and you have psoriasis, ask your health care provider if it could be psoriatic arthritis and treat appropriately. 
Guest Bio:
Vinod Chandran, MBBS, MD, DM, PhD is a rheumatologist, clinician scientist, and Director of the Gladman Krembil Psoriatic Arthritis Program, Schroeder Arthritis Institute, University Health Network and the Departments of Medicine, Laboratory Medicine and Pathobiology, and the Institute of Medical Science at the University of Toronto where he is also a Professor of Medicine. His specialties include internal medicine, immunology, rheumatology, and genetic epidemiology. His research focus is on the development of biomarker-based strategies to improve early diagnosis and prognosis of psoriasis and psoriatic arthritis, identification of new treatment targets especially for those who do not respond to current therapies, and strategies to reduce the impact of disease. Dr. Chandran is a Co-Vice President of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis or GRAPPA. He is an active collaborator in a multi-center research consortia such as the International Psoriasis and Arthritis Research Team and the Spondyloarthritis Research Consortium of Canada. Dr. Chandran is the recipient of research funding from the National Psoriasis Foundation for his work in identifying a "Multi-omic Diagnostic Test for PsA in Psoriasis Patients".
Resources:
"Understanding the NPF Psoriatic Arthritis Diagnostic Test Grant Outcomes" Advance Online. February 18, 2026. 
"Managing Chronic Pain with Psoriatic Arthritis" Psoriasis Uncovered podcast episode with physiatrist Dr. Erin Maslowski, LB Herbert who lives with psoriatic disease, and moderator Susan McClelland-Tobert, a retired pediatric cardiologist who also lives with psoriatic disease.
Glossary of terms:
mRNA: Messenger RNA carries protein information or instructions from the DNA in a cell's nucleus to the cell's interior where the sequence is read and translated into corresponding amino acids for growing protein chains.
Micro-RNA (miRNA):  Micro-RNA act as the regulator. They are short and bind to specific target mRNA's to degrade or inhibit production of protein.

Description:
"What is metabolic disease and why do I have it on top of psoriatic disease?" Hear dermatologist Dr. Ronald Prussick and registered dietitian Danielle Cahalan explore this collision of diseases and how you can take control to help reduce the impact of inflammation.         
 Join host Corinne Rutkowski as she discusses why metabolic disease occurs with psoriasis and psoriatic arthritis and what can be done to improve overall health with dermatologist and Vice Chair of the NPF Medical Board, Dr. Ronald Prussick from Washington Dermatology Center in Rockville and Frederick, MD, and Danielle Cahalan, a registered dietitian and coach with All Access Dietitians. Listen as they also discuss the four pillars of health, the latest evidence around use of the Mediterranean Diet with psoriatic disease, key nutrients that impact overall health from omega 3's, polyphenols, and fiber, to making small sustainable changes.
 This episode offers information to help explain the connection between metabolic and psoriatic disease and what can be done to decrease health risks associated with both diseases through sustainable changes.
Timestamps:
(0:00)  Intro to Psoriasis Uncovered & guest welcome dermatologist Dr. Ronald Prussick and registered dietitiand and coach                  Danielle Cahalan.                                                                                             
(1:27)  Definition of metabolic disease and why the risk is higher among those with psoriasis or psoriatic arthritis.
(3:11)  How this bi-directional relationship impacts the management of psoriasis and psoriatic arthritis.
(6:54)  The four pillars of health that can be used to reduce the risk of metabolic disease.  
(11:17) Does an anti-inflammatory diet exist?
(13:46) What is the Mediterranean diet and the foods that are typically included.
(16:32) The impact of the Mediterranean diet on systemic inflammation, metabolic health, and severity of psoriatic disease.
(21:03) The three types of healthy fats – what they are, how they work, and where to find them.
(24:50) The high polyphenol Mediterranean diet from what that means to choosing nutrient dense, colorful foods.
(28:04) The koebnerization of the gut microbiome and the impact of the Mediterranean diet and high fiber.
(30:59) The DASH diet in combination with the Mediterranean diet lowers oxidative stress and inflammation.
(33:14) Sustainability of the Mediterranean diet and flexing behavioral health changes long term. 
(37:43) Start with small habit changes and then build from there to have an impact on your metabolic health. 
Key Takeaways:
·       Research shows a bi-directional relationship between psoriasis and excess body weight leading to increasing severity of disease, decrease in treatment effectiveness, and the development of metabolic syndrome, a group of conditions which together raise the risk of coronary heart disease, stroke, and diabetes.
·       What you choose to eat can make an impact in managing inflammatory markers, metabolic health to increase insulin sensitivity, decrease high blood pressure, improve lipids and the gut microbiome, as well as support neuro protection and decrease cognitive decline.
·       Create small sustainable habits that make positive changes to your immune system and gradually work towards building a foundation that benefits your overall health.
Guest Bios:
Renowned dermatologist Ronald Prussick, M.D. is the Medical Director of the Washington Dermatology Center in Rockville and Fredrick, Maryland where he specializes in the treatment of psoriasis along with other diseases of the skin, hair, and nails with the latest technology and products. Dr. Prussick is also a Clinical Associate Professor in Dermatology at George Washington University in Washington, D.C.. Dr. Prussick has a research interest in the impact of diet on psoriatic disease and metabolic health. He first became interested after being involved in Dr. Joel Gelfand and Dr. Nehal Mehta's work in vascular inflammation trials using FDG-PET?CT scans to view systemic and cardiovascular inflammation associated with psoriatic disease. Dr. Prussick also participated in the development of the 2018 Dietary Recommendations for Adults with Psoriasis or Psoriatic Arthritis from the Medical Board of the NPF, which offered a review of studies addressing the impact of dietary interventions in people with psoriasis and psoriatic arthritis. Dr. Prussick is Vice Chair of the NPF Medical Board which provides clinical direction, treatment guidance, and provides education oversight to the organization and its Executive leaders.
Danielle Cahalan, MS, RDN is a licensed and registered dietitian and coach with All Access Dietitians which offers virtual nutrition support services in AZ, CA, CO, CT, FL, IL, IN, MA, MO, MT, NJ, NY, NC, OR, PA, SC, TX, VA, WA, WI, and WY. All Access Dietitians infuses the science of motivation, habit formation, and sustainable behavior change into every session that addresses weight management and metabolic health, to women's health and digestive support. Danielle's primary focus during sessions is to help her clients find that intersection between enjoyment and satisfaction with their food choices that also support their health through sustenance. It's about finding that balance between feeling empowered, energized, and confident in the ability to make decisions that impact health, wellness, and longevity.
Resources:
"Mediterranean Diet Pyramid: Guidelines for Healthy Eating" © 2009 Oldways Preservation and Exchange Trust www.oldwayspt.org and UCSF Weill Institute for Neurosciences Memory and Aging Center.
DASH Eating Plan (Dietary Approaches to Stop Hypertension). February 25, 2026. NIH (National Heart, Lung, and Blood Institute) 
Mediterranean Diet and Patients With Psoriasis: The MEDIPSO Randomized Clinical Trial. AMA Dermatology . Dec. 1, 2025 
The Mediterranean Diet as a Potential Solution to the Gut Microbiome Dysbiosis in Psoriasis Patients Journal of Psoriasis and Psoriatic Arthritis 2024 Jan 9.