Treatment of intertriginous psoriasis: from the Medical Board of the National Psoriasis Foundation.
BACKGROUND
Involvement of areas of the skin fold is common in patients with psoriasis although the exact incidence is unknown. This report summarizes studies regarding the therapy of intertriginous psoriasis.


OBJECTIVE
A task force of the National Psoriasis Foundation Medical Board was convened to evaluate treatment options. Our aim was to arrive at a consensus on therapy for intertriginous or inverse psoriasis.


METHODS
Reports in the literature were reviewed regarding psoriasis affecting the skin-fold areas and its therapy.


CONCLUSIONS
There are few evidence-based studies on the treatment of intertriginous psoriasis.


RESULTS
The recommended short-term (2-4 weeks) therapy for inverse psoriasis is low- to mid-potency topical steroids. For long-term therapy, topical calcipotriene (calcipotriol) or one of the immunomodulating agents, pimecrolimus or tacrolimus, is favored.


CONCLUSIONS
Low- to mid-potency topical steroids are recommended as first-line, short-term treatment. It is recommended that their use should either be of limited duration (less than 2-4 weeks) or that the lowest effective strength be used intermittently for long-term care to minimize the potential for risks. Calcipotriene (calcipotriol), pimecrolimus, and tacrolimus, while not as highly efficacious as topical steroids, are associated with fewer long-term risks and are therefore recommended for long-term therapy when feasible.
Kalb
Robert E
RE
Department of Dermatology, State University of New York School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Bagel
Jerry
J
Korman
Neil J
NJ
Lebwohl
Mark G
MG
Young
Melodie
M
Horn
Elizabeth J
EJ
Van Voorhees
Abby S
AS
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000465:Algorithms; D002117:Calcitriol / Q000031:analogs & derivatives / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy*
D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents; D007155:Immunologic Factors; C055085:calcipotriene; D002117:Calcitriol