TARS. Their role in the treatment of psoriasis

The clinical experience reported by these studies does not definitively answer the question of whether or not all or even most tars are effective in the treatment of psoriasis. Information supports both views. With the present data, the following statements seem appropriate: 1. Tar alone may be helpful for a subset of individuals with mild to moderate psoriasis. Because the majority of patients with psoriasis have less than severe disease, this group numerically represents the majority of office-treated patients. For these patients, tars are not unreasonable to use in appropriate clinical circumstances. 2. Crude coal tar is not likely more beneficial than modified tar or gels. These latter preparations have much better patient acceptance and compliance because of decreased odor, staining, and messiness. 3. Overall, the potential severity of side effects from tars is less than that from anthralin and much less than that from topical corticosteroids (atrophy, rebound). 4. Clinical experience confirms that tar preparations can be effective when other modalities fail or cannot be used for reasons of adverse effects or otherwise. 5. Tar shampoos are considered useful therapeutic agents for active clearing therapy and for maintenance. 6. When combined with suberythemogenic ultraviolet light B, tar can be a useful agent. It has fewer side effects in terms of burning and irritation than does aggressive ultraviolet B therapy alone. The effect of maximal erythemogenic ultraviolet light B therapy is not enhanced with tar. Practically speaking, however, the majority of psoriatic patients do not require, or are not able to avail themselves of, convenient controlled ambulatory ultraviolet light therapy.