Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies.
Psoriasis is a common, chronic, inflammatory, multi-system disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this third of 6 sections of the guidelines of care for psoriasis, we discuss the use of topical medications for the treatment of psoriasis. The majority of patients with psoriasis have limited disease (<5% body surface area involvement) and can be treated with topical agents, which generally provide a high efficacy-to-safety ratio. Topical agents may also be used adjunctively for patients with more extensive psoriasis undergoing therapy with either ultraviolet light, systemic or biologic medications. However, the use of topical agents as monotherapy in the setting of extensive disease or in the setting of limited, but recalcitrant, disease is not routinely recommended. Treatment should be tailored to meet individual patients' needs. We will discuss the efficacy and safety of as well as offer recommendations for the use of topical corticosteroids, vitamin D analogues, tazarotene, tacrolimus, pimecrolimus, emollients, salicylic acid, anthralin, coal tar, as well as combination therapy.
Menter
Alan
A
Baylor University Medical Center, Dallas, Texas, USA.
Korman
Neil J
NJ
Elmets
Craig A
CA
Feldman
Steven R
SR
Gelfand
Joel M
JM
Gordon
Kenneth B
KB
Gottlieb
Alice
A
Koo
John Y M
JY
Lebwohl
Mark
M
Lim
Henry W
HW
Van Voorhees
Abby S
AS
Beutner
Karl R
KR
Bhushan
Reva
R
D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D006801:Humans; D011565:Psoriasis / Q000188:drug therapy*; D014807:Vitamin D / Q000031:analogs & derivatives
D000305:Adrenal Cortex Hormones; D014807:Vitamin D