Traditional therapies in the management of moderate to severe chronic plaque psoriasis: an assessment of the benefits and risks.
Psoriasis is a chronic, recurrent disease that affects between 1% and 3% of the population. Patients with moderate to severe disease generally require phototherapy (e.g. narrowband ultraviolet B radiation), photochemotherapy (oral psoralen plus ultraviolet A radiation) or systemic agents (e.g. ciclosporin, methotrexate, oral retinoids, fumaric acid esters) to control their disease adequately. In general, these therapeutic modalities have proven to be highly effective in the treatment of psoriasis. However, potentially serious toxicities can limit their long-term use. Given that there is no standard therapeutic approach for patients with moderate to severe psoriasis, the benefits and risks of phototherapy, photochemotherapy and systemic therapy must be weighed carefully for each patient, and treatment individualized accordingly. This review summarizes the benefits and risks of traditional, nonbiological therapies for moderate to severe chronic plaque psoriasis.
Naldi
L
L
Clinica Dermatologica, Ospedali Riuniti, Largo Barozzi, 1-24128 Bergamo, Italy. luigi.naldi@gised.it
Griffiths
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D000284:Administration, Oral; D002908:Chronic Disease; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects; D005363:Ficusin / Q000008:administration & dosage / Q000009:adverse effects; D005650:Fumarates / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D011701:PUVA Therapy / Q000009:adverse effects / Q000379:methods; D017319:Photosensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects; D011565:Psoriasis / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D012176:Retinoids / Q000008:administration & dosage / Q000009:adverse effects; D018570:Risk Assessment / Q000379:methods; D014467:Ultraviolet Therapy / Q000009:adverse effects / Q000379:methods
D003879:Dermatologic Agents; D005650:Fumarates; D007166:Immunosuppressive Agents; D017319:Photosensitizing Agents; D012176:Retinoids; D016572:Cyclosporine; D005363:Ficusin; D008727:Methotrexate