| | Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies published online 17 February 2009. Psoriasis is a common, chronic, inflammatory, multi-system disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this third of 6 sections of the guidelines of care for psoriasis, we discuss the use of topical medications for the treatment of psoriasis. The majority of patients with psoriasis have limited disease (<5% body surface area involvement) and can be treated with topical agents, which generally provide a high efficacy-to-safety ratio. Topical agents may also be used adjunctively for patients with more extensive psoriasis undergoing therapy with either ultraviolet light, systemic or biologic medications. However, the use of topical agents as monotherapy in the setting of extensive disease or in the setting of limited, but recalcitrant, disease is not routinely recommended. Treatment should be tailored to meet individual patients' needs. We will discuss the efficacy and safety of as well as offer recommendations for the use of topical corticosteroids, vitamin D analogues, tazarotene, tacrolimus, pimecrolimus, emollients, salicylic acid, anthralin, coal tar, as well as combination therapy. a Baylor University Medical Center, Dallas, Texas b Department of Dermatology, Murdough Family Center for Psoriasis, Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio c Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama d Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina e Department of Dermatology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania f Division of Dermatology, Evanston Northwestern Healthcare and Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois g Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts h Department of Dermatology, University of California–San Francisco, San Francisco, California i Department of Dermatology, Mount Sinai School of Medicine, New York, New York j Department of Dermatology, Henry Ford Hospital, Detroit, Michigan k Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania l Anacor Pharmaceuticals, Inc, Palo Alto, California m American Academy of Dermatology, San Francisco, California  Reprint requests: Reva Bhushan, PhD, 930 E Woodfield Rd, Schaumburg, IL 60173.
The authors' conflict of interest/disclosure statements appear at the end of the article. PII: S0190-9622(09)00012-7 doi:10.1016/j.jaad.2008.12.032 © 2009 American Academy of Dermatology, Inc. Published by Elsevier Inc All rights reserved. | |
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