Background. Patients with moderate-to-severe psoriasis are often treated with systemic immunosuppressant agents that decrease immune system function. For the elderly, these medications are often problematic due to their already immunosuppressed state and comorbidities. However, there are few studies examining the effects of these medications on the elderly age group. Therefore, there is often discomfort among dermatologists treating elderly patients with psoriasis in utilizing systemic agents, frequently resulting in inadequate treatment. Objective. We review the safety profiles of systemic treatments often used to treat psoriasis and their possible adverse risks to the geriatric population. Methods. We conducted a search of PubMed’s Medline database of articles published from 2000 to 2011, which resulted in 14 articles. Conclusion. Treating geriatric patients with moderate-to-severe psoriasis remains a challenge due to immunosenescence and comorbidities. More studies focusing on psoriasis treatment safety in the geriatric population are needed. 1. Introduction Psoriasis is a chronic, debilitating skin disease that affects approximately 2.6% of the general population [1]. Patients with psoriasis develop erythematous, scaly, and well-demarcated plaques that are often pruritic and can be painful. Due to its chronic nature, psoriasis increasingly affects the geriatric population. A US study in 1991 reported that the highest rate of psoriasis, 113/100,000 population, occurred in the 60- to 69-year age group [2]. With the growing geriatric population expected to compose 25% of the US population by 2020, the prevalence of psoriasis is also expected to rise [3]. There are two key challenges for treating an older patient with psoriasis. The first key challenge involves the already immunosuppressed state of the elderly, also known as immunosenescence. Immunosenescence is a term that describes the immunosuppressed state of the elderly due to natural aging [4]. This is due to a marked decrease in T-cell function with aging as well as other age-related changes in innate immunity [5]. As a result of immunosenescence, the elderly are at a higher risk than younger age groups to develop cancer, infectious disease, neurodegenerative disease, and chronic inflammatory diseases such as atherosclerosis. However, immunosuppressive therapies are considered the mainstay for managing psoriasis and make up the majority of systemic psoriasis treatments. The second key problem in treating geriatric patients with psoriasis is that the elderly often have comorbid illnesses that can
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