Comprehensive psoriasis treatment
Dr Álvaro González Cantero
A comprehensive approach to better disease control and overall health
Psoriasis is not always limited to plaques on the skin, nor is it always adequately controlled with standard treatment regimens. In many patients, its impact extends beyond visible lesions and requires careful assessment not only of skin disease activity, but also of quality of life, potential comorbidities and each patient’s individual clinical context.
For this reason, at the Psoriasis and Inflammatory Skin Diseases Unit at Grupo Pedro Jaén, we follow a comprehensive model of care designed to provide a more complete assessment, a more precise treatment strategy and follow-up that is better adapted to each patient’s circumstances.
My aim is to help you understand your condition more clearly, identify what you need at each stage and develop a treatment plan that provides the most effective, personalised and sustainable disease control possible over time.
Why take a comprehensive approach to psoriasis?
We now know that psoriasis is a complex inflammatory disease that, in many patients, should not be managed solely from the perspective of the skin.
In addition to skin lesions, psoriasis may be associated with other conditions that should also be considered, including psoriatic arthritis, cardiovascular risk, metabolic syndrome, fatty liver disease and the emotional impact of the disease.
There is another important consideration: not every patient with mild or moderate psoriasis has genuinely good disease control, and patients with severe psoriasis do not necessarily simply need “more treatment”. They may instead need a more detailed assessment and more precise clinical decisions.
Comprehensive care arises from precisely this need: not simply to treat individual lesions, but to understand each case more fully, identify associated problems at an early stage and adjust treatment according to specialist clinical judgement.
Who may particularly benefit from this approach?
Comprehensive psoriasis management may be particularly valuable for patients in situations such as:
- mild or moderate psoriasis with incomplete control;
- frequent flare-ups or poor response to previous treatments;
- complex or severe psoriasis;
- involvement of particularly troublesome or visible areas;
- uncertainty about whether treatment should now be changed or intensified;
- the need for a specialist second opinion;
- concerns about the impact of psoriasis on general health;
- an interest in a broader assessment of the disease and its comorbidities.
Not every patient needs the same approach. An essential part of our work is therefore to determine what each individual needs and at what stage.
What happens during the first consultation?
The first consultation is particularly important because it is when we begin to establish the treatment and follow-up strategy.
I spend sufficient time reviewing the history of the disease in detail, how it has progressed, which treatments have been used, what results have been achieved, what concerns the patient and how psoriasis is affecting everyday life.
For many patients, the first consultation involves more than simply “looking at the skin”. It is also about bringing together the patient’s overall clinical context and identifying issues that may be overlooked in shorter or less specialised assessments.
My aim at this first assessment is to understand the case fully before making decisions, because in psoriasis the difference often lies not in doing more, but in making better-informed decisions.
Examination and comprehensive patient assessment
Depending on the individual case, comprehensive psoriasis assessment may include different examinations and investigations designed to provide a better understanding of the disease and its potential impact on overall health.
Skin examination
We perform a thorough examination of the skin, paying particular attention to the lesions that concern the patient most, special locations and the actual impact of the disease on quality of life.
Cardiovascular risk assessment
One of the important components of this approach is cardiovascular risk assessment. We now know that psoriasis, particularly moderate and severe disease, is associated with an increased risk of cardiovascular disease.
For this reason, we carry out an assessment aimed at identifying patients who may be at greater risk at an early stage, allowing preventive measures to be considered when appropriate.
Assessment of specific clinical situations
In selected cases, comprehensive assessment may also include specific considerations such as plans for pregnancy, nail involvement or the need for additional investigations to refine diagnosis and follow-up.
Assessment of fatty liver disease and other metabolic comorbidities
Psoriasis is associated with metabolic abnormalities in many patients, and these may require specific assessment.
This forms part of the broader clinical perspective through which we approach the disease.
Screening for psoriatic arthritis
Psoriatic arthritis is one of the most important comorbidities associated with psoriasis. For this reason, early detection forms an important part of comprehensive assessment, using appropriate screening tools and, when required, specialist support.
Arterial ultrasound assessment
Arterial ultrasound has a particularly relevant role within this model because it provides additional information about vascular health in patients with psoriasis and supports an approach focused on prevention.
Assessment of emotional wellbeing
Psoriasis can have a significant impact on emotional wellbeing. Comprehensive care should therefore also provide space to listen, understand and, where necessary, offer appropriate professional support.
Assessment of cardiovascular risk factors
Smoking, obesity, high blood pressure, lipid abnormalities, insulin resistance and other cardiovascular risk factors should be considered as part of an overall health assessment rather than as isolated findings.
Skin examination in psoriasis
Cardiovascular risk assessment in psoriasis
Ultrasound assessment in psoriasis
Joint assessment in psoriasis
An individualised treatment plan
Following the initial assessment, we develop a treatment and follow-up plan tailored to each patient.
This plan is based not only on the extent of skin lesions, but on a broader set of factors:
- type of psoriasis;
- location;
- disease course;
- impact on quality of life;
- response to previous treatments;
- presence of comorbidities;
- and specific goals for disease control and follow-up.
The aim is to develop a realistic, precise and effective strategy that reduces the impact of psoriasis on the patient’s life as far as possible.
Beyond treatment: follow-up and clinical decision-making
Psoriasis is a chronic disease, which means that follow-up is an essential part of treatment.
Establishing an initial strategy is not enough. It is also necessary to assess how the patient responds, whether disease control is adequate, whether adverse effects have occurred, whether clinical needs have changed and whether the treatment plan should be adjusted.
In complex cases, the difference often lies not simply in starting a treatment, but in knowing how to maintain it, optimise it, change it at the appropriate time and make well-founded clinical decisions over the longer term.
A model for patients who need a more detailed approach
This approach may be particularly useful for patients who are not achieving satisfactory control and would benefit from a more detailed, precise assessment that also takes their overall health into account.
Comprehensive psoriasis treatment therefore involves more than providing access to advanced therapeutic options. Its real value lies in combining a high degree of specialisation, a broad clinical perspective, experience in complex cases, active research and sufficient consultation time to develop a strategy genuinely adapted to each patient.
Dr Álvaro González Cantero
Medical registration number: 454505859
My aim is to minimise the impact of psoriasis on your life
In-person consultations in Madrid and specialist assessment
I work as a dermatologist and psoriasis specialist at Hospital Universitario Ramón y Cajal and within the Psoriasis and Chronic Inflammatory Skin Diseases Unit at Grupo Pedro Jaén in Madrid, where I combine clinical practice with research.
I follow a comprehensive model of psoriasis care designed to manage both mild and moderate cases that may be difficult to control in everyday life and more severe or complex cases that require advanced treatment strategies.
Because psoriasis can also be associated with other comorbidities, my approach includes their early identification, prevention and, where necessary, treatment, with the aim of reducing their potential impact on the patient’s overall health.
Further information about advanced treatments
If you would like to learn more specifically about biological therapies, their indications, safety and the importance of specialist clinical judgement in their use, you can visit the Biological Therapy for Psoriasis section.
Dr Álvaro González Cantero
Consultations at Grupo Pedro Jaén
About me
I work as a dermatologist and psoriasis specialist at Hospital Universitario Ramón y Cajal and within the Psoriasis and Chronic Inflammatory Skin Diseases Unit at Grupo Pedro Jaén in Madrid, where I combine clinical practice with research.
I follow a comprehensive model of psoriasis care designed to manage both mild and moderate cases that may be difficult to control in everyday life and more severe or complex cases that require advanced treatment strategies.
Because psoriasis can also be associated with other comorbidities, my approach includes their early identification, prevention and, where necessary, treatment, with the aim of reducing their potential impact on the patient’s overall health.
