Table 1.

Safety concerns associated with biologics and drugs used for the management of psoriasis.

Drug/biologic	Safety concern
Methotrexate	Abnormalities, such as myelosuppression or fetal death Pulmonary fibrosis Hepatotoxicity, gastrointestinal irritation, and hypersensitivity Severe skin problems
Psoralen with UVA	Photosensitivity and photo damage Skin toxicity, skin cancer, and nausea Delayed sunburn, erythema, and ocular damage
Cyclosporin	Hypertension Hepatotoxicity, nephrotoxicity, and immunosuppression Increased triglyceride levels and cutaneous malignancy
Oral retinoids	Abnormalities, such as myelosuppression or fetal death Hypertension, hepatotoxicity, and nephrotoxicity Alopecia (dose related) and elevated triglyceride levels Ophthalmic irritation, such as drying Myalgia and worsened condition in long term therapy
Fumaric acid	Gastrointestinal irritation, transient renal damage, and flushing
Etanercept	Severe infectious conditions, such as tuberculosis and heart failure Pancytopenia and neurological events
Adalimumab	Infections, such as TB and respiratory tract infection Reaction at the site of injection or hypersensitivity reaction Lymphoma and neurological events
Efalizumab	Immune-mediated reaction
Alefacept	Malignancy and lymphopenia