Effectiveness of topical therapy for psoriasis: results of a national survey

Topical therapy is the major treatment approach for patients with psoriasis. However, the effectiveness of available drugs (response rates and long-term maintenance) is not well known. This study investigated the current perceptions of American dermatologists on the effectiveness of topical medications for patients with mild or limited psoriasis. In a survey of 225 American dermatologists, class I to II topical steroids were regarded as most effective: 29 percent of dermatologists expected most of their patients to experience clearing of lesions when treated with these agents. Much lower response rates were found with medium and low-potency steroids, anthralin, or tars. The percentage of patients whose skin remained clear of lesions decreased to 50 percent while receiving maintenance corticosteroid therapy by three months and to 29 percent after one year. Topical corticosteroids were considered less effective than the available photo/systemic therapies by 79 percent of physicians. More effective topical modalities need to be developed to treat patients with mild/limited psoriasis.