In perioperative management of immunotherapies for dermatologic patients, which can be continued?

• A. Both
• B. Corticosteroids
• C. csDMARDs
• D. None

Answer: (A)

Continuing immunomodulatory therapies around surgery is often appropriate because stopping them can lead to disease flares or adrenal insufficiency, while continuing them can minimize disruption of the skin disease control. Corticosteroids are usually kept through the perioperative period to maintain hormonal balance; for major procedures, a planned stress-dose steroid protocol helps the body handle surgical stress. Immunomodulatory csDMARDs, such as methotrexate or others used in dermatology, are frequently continued for minor procedures to prevent flares and maintain control, with the understanding that decisions for more major operations are individualized based on infection risk and wound healing concerns. In many perioperative plans for dermatologic patients, both corticosteroids and csDMARDs can be continued, with adjustments guided by the surgery type, patient comorbidity, and disease activity.