Topical Therapies in Psoriasis.

Area of Science:

• Dermatology
• Pharmacology

Background:

• Topical therapy is a cornerstone in psoriasis management, ranging from monotherapy for mild cases to adjuvant treatment for moderate-to-severe disease.
• Emollients serve as valuable adjuncts, while traditional agents like anthralin and coal tar, though less common, offer cost-effective options for refractory conditions.

Purpose of the Study:

• To review the current landscape of topical therapies for psoriasis.
• To highlight the utility of various topical agents, including corticosteroids, vitamin D analogs, and older treatments, across different disease severities and locations.

Main Methods:

• Literature review of topical treatment modalities for psoriasis.
• Analysis of agent efficacy based on disease severity, location (scalp, nails, facial/flexural, palmoplantar), and combination therapy potential.

Main Results:

• Topical corticosteroids (TCS) vary in potency based on lesion location; higher potency for palmoplantar/thick lesions, lower for facial/flexural areas.
• Combination therapies, such as salicylic acid with TCS or calcineurin inhibitors, enhance penetration and efficacy.
• Vitamin D analogs, tazarotene, and calcineurin inhibitors (tacrolimus, pimecrolimus) offer alternatives or adjuncts, particularly for specific sites like the face and intertriginous areas.

Conclusions:

• A diverse range of topical agents, including established and older treatments, can be effectively utilized for psoriasis management.
• Tailoring topical therapy based on disease severity, location, and patient factors is crucial for optimal outcomes.
• Integrating non-corticosteroid options can help mitigate long-term side effects associated with topical corticosteroids.