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Updated: May 12, 2026
11:39
The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Topical treatments for chronic plaque psoriasis
Anne R Mason1, James Mason, Michael Cork
1Centre for Health Economics, The University of York, York, UK. anne.mason@york.ac.uk.
The Cochrane Database of Systematic Reviews
|April 2, 2013
Summary
Topical corticosteroids and vitamin D analogues are effective for chronic plaque psoriasis. Corticosteroids show fewer local side effects than vitamin D, but long-term safety data on skin atrophy are lacking.
Area of Science:
- Dermatology
- Pharmacology
- Clinical Trials
Background:
- Chronic plaque psoriasis is the most common form of psoriasis, characterized by redness, thickness, and scaling.
- First-line management typically involves topical treatments like vitamin D analogues and corticosteroids.
Purpose of the Study:
- To compare the effectiveness, tolerability, and safety of topical treatments for chronic plaque psoriasis against placebo.
- To compare vitamin D analogues (alone or combined) with other topical treatments.
Main Methods:
- Systematic review and meta-analysis of 177 randomized controlled trials (34,808 participants).
- Searches updated to February 2011 and August 2012 across multiple databases.
- Data extracted on efficacy, local/systemic adverse events, and withdrawals.
Main Results:
- Most vitamin D analogues and corticosteroids were more effective than placebo.
- Very potent corticosteroids showed greater benefits than potent ones.
- Combined vitamin D/corticosteroid treatment outperformed monotherapy for body and scalp psoriasis.
- Corticosteroids had fewer local adverse events (e.g., burning, irritation) than vitamin D.
- No significant difference in systemic adverse effects between topical agents.
Conclusions:
- Corticosteroids are as effective as vitamin D analogues with lower local adverse event rates.
- Evidence on the long-term risk of skin dermal atrophy with corticosteroid use is limited.
- Further research is needed for long-term maintenance treatment and safety data.
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