If you are on immunosuppressant medication, you should have received a letter from your GP surgery and dermatology department, advising you on your level of risk and whether you should self-isolate until further notice, even if you don’t have COVID-19 symptoms. You should follow the guidance provided by your healthcare professional. The British Association of Dermatologists (BAD) have provided guidance to healthcare professionals on how to manage their patients with psoriasis who are on immunosuppressant medication, which is summarised below.
People with ‘moderate risk’ should be especially careful to follow the government guidance on social distancing (which classifies people who take immunosuppressants as ‘vulnerable people’). You would be at moderate risk if you meet ALL of the following criteria:
- You do not have any of the following risk factors for more severe illness:
Over 70 years’ old, diabetes mellitus, pregnancy, any pre-existing lung disease (e.g. asthma on medication), chronic kidney disease, any history of ischaemic heart disease or hypertension on treatment, or other factors your healthcare professional judges to be a risk.
- Your condition is well-controlled with your medication; this means you have no or minimal symptoms of psoriasis
- You are taking just one type of immunosuppressant (aside from rituximab or infliximab), OR
- You are taking a biologic (aside from rituximab or infliximab), plus a standard dose of methotrexate, OR
- You are taking just one standard oral immunosuppressant (such as methotrexate, azathioprine or ciclosporin) plus hydroxychloroquine or sulfasalazine.
People with ‘high risk’ should shield themselves (i.e. self-isolate until further notice). This advice applies if you meet ANY of the following criteria:
- You are taking two types of immunosuppressant medication, other than those combinations listed in the ‘moderate risk’ advice above
- You are using a corticosteroid (e.g. prednisolone) at a dose of 20 mg or more, or 0.5mg/kg or more, per day for more than 4 weeks
- You are using a corticosteroid (e.g. prednisolone) at a dose of 5 mg or more per day for more than 4 weeks, plus at least one other immunosuppressant medication
- You have taken cyclophosphamide at any dose orally, or if you have received it as an intravenous (IV) dose within last 6 months
- If you are taking rituximab or infliximab for your psoriasis
You shouldn’t stop taking your medication, or change how much you take, unless advised to do so by your healthcare professional.
Contact your healthcare professional if you have symptoms consistent with COVID-19 or any other infection.