Topical vitamin D analogs available to treat psoriasis

Psoriasis is a chronic and currently incurable inflammatory skin disease, affecting 2% to 3% of the US population. The cost of care in the United States for hospitalizations, outpatient physician visits, phototherapy, prescription therapies, and over-the-counter medications is estimated to be more than $650 million per year. Guidelines developed by the American Academy of Dermatology in 2009 state that approximately 80% of these patients with psoriasis have mild to moderate disease that can be managed with topical agents, including corticosteroids and vitamin D analogs. Topical vitamin D analogs provide "steroid-sparing" effects and a favorable safety profile. Many experts, including a recent consensus conference, classify topical vitamin D agents as first-line therapy for psoriasis either as monotherapy or in combination with topical steroids due to a synergistic, complementary effectiveness. Vitamin D analogs are an indispensable component of the current physician's armamentarium for psoriasis treatment. This review, therefore, is oriented to give a comprehensive understanding of this group of drugs and display the available clinical data for each formulation.