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Updated: Mar 20, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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[Psoriasis in special localizations].

A Schmieder1, W K Peitsch2

  • 1Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland.

Der Hautarzt; Zeitschrift Fur Dermatologie, Venerologie, Und Verwandte Gebiete
|May 25, 2016
PubMed
Summary
This summary is machine-generated.

Plaque psoriasis commonly affects challenging areas like the scalp, nails, and intertrigines, impacting quality of life and increasing psoriatic arthritis risk. Treatment requires location-specific strategies, with topical therapies often preferred for scalp and inverse psoriasis.

Keywords:
BiologicalsIntertrigoNailScalpTopical steroids

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Area of Science:

  • Dermatology
  • Rheumatology

Background:

  • Plaque psoriasis frequently involves the scalp, nails, and intertriginous areas.
  • These specific locations can be uniquely or predominantly affected, causing significant stigma.
  • Psoriasis in these areas is linked to a higher risk of developing psoriatic arthritis.

Purpose of the Study:

  • To review the clinical presentation of psoriasis in challenging locations.
  • To survey current evidence for treating psoriasis affecting the scalp, nails, and intertrigines.
  • To highlight the importance of location-specific treatment considerations.

Main Methods:

  • Literature review of clinical presentations.
  • Evidence synthesis for topical and systemic treatments.
  • Analysis of treatment efficacy and safety data.

Main Results:

  • Scalp psoriasis shows high evidence for topical steroids and vitamin D analogues; TNF antagonists and apremilast are effective for refractory cases.
  • Nail psoriasis often shows limited response to topical treatments, necessitating systemic therapies for severe forms.
  • Inverse psoriasis has scarce controlled trial data, but topical steroids, vitamin D analogues, dithranol, and calcineurin inhibitors are used clinically.

Conclusions:

  • Psoriasis in challenging locations requires tailored treatment approaches.
  • Topical therapies are first-line for scalp and inverse psoriasis, while systemic agents are crucial for severe nail psoriasis.
  • Further research is needed for inverse psoriasis treatment guidelines.