TNF and psoriasis: When patients have either uncontrolled underlying disease with mild psoriatic involvement or controlled disease with moderate-to-severe psoriatic involvement, recommendations have been made to switch to a different TNF inhibitor while starting psoriasis-targeted therapy. In uncontrolled underlying disease and moderate-to-severe psoriatic involvement, patients should discontinue the TNF-α inhibitor and switch to a different drug class, such as an IL-17 inhibitor (secukinumab) for treatment [8,9].