In touch with psoriasis: topical treatments and current guidelines
Authors:
- 21 April 2011
- journal article
- review article
- Published by Wiley in Journal of the European Academy of Dermatology and Venereology
- Vol. 25 (s4) , 3-8
Abstract
This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6–10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild‐to‐moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side‐effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two‐compound calcipotriol/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two‐compound calcipotriol/betamethasone dipropionate was shown to be suitable for intermittent long‐term treatment of mild‐to‐moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild‐to‐moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.Keywords
This publication has 16 references indexed in Scilit:
- German evidence-based guidelines for the treatment of Psoriasis vulgaris (short version)Archives of Dermatological Research, 2007
- Efficacy Results of a 52-Week, Randomised, Double-Blind, Safety Study of a Calcipotriol/Betamethasone Dipropionate Two-Compound Product (Daivobet®/Dovobet®/Taclonex®) in the Treatment of Psoriasis VulgarisDermatology, 2006
- Consistency of data in six phase III clinical studies of a two‐compound product containing calcipotriol and betamethasone dipropionate ointment for the treatment of psoriasisJournal of the European Academy of Dermatology and Venereology, 2005
- A pooled analysis of studies with a new calcipotriene/betamethasone two-compound product in psoriasis vulgarisJournal of the American Academy of Dermatology, 2004
- Prolonged occlusion in the treatment of psoriasis: A clinical and immunohistologic studyJournal of the American Academy of Dermatology, 1995
- The Goeckerman regimen in two psoriasis day care centersJournal of the American Academy of Dermatology, 1983
- Preliminary Report: Modified Goeckerman Therapy for Hospitalized Patients: Ambulatory Day Care Center and Improved Quantitative DosimetryJournal of Investigative Dermatology, 1981
- Long-term modified Goeckerman regimen for psoriasis using an ultraviolet B light source in the homeJournal of the American Academy of Dermatology, 1981
- Clearing of resistant psoriasis with anthralinArchives of Dermatology, 1967
- The Approach to PsoriasisBMJ, 1953