2nd May 2024

A 40-year-old woman with a history of plaque psoriasis presents with worsening symptoms.

A 40-year-old woman with a history of plaque psoriasis presents with worsening symptoms. She has multiple red, scaly plaques covering approximately 20% of her body surface area, including her trunk and limbs. The plaques are itchy and causing significant discomfort. She has previously tried topical therapies without much improvement.

Investigation:

Clinical assessment: Moderate to severe plaque psoriasis

Which is the most appropriate next step in management?