Optimizing topical therapy for psoriasis

Abstract

There are a wide variety of topical treatment options for psoriasis. Despite their effectiveness in clinical trials, control of psoriasis in clinical practice remains a challenge. A multitude of factors limits patients’ use of medication, including frustration with poor efficacy, inconvenience, fear of side effects, financial restraints, vague application instructions, complicated regimens and unpleasant treatment characteristics. The first step to optimize topical therapy is to develop a physician–patient relationship that contributes to realistic expectations and proper use of medication. Patients should be involved in the choice of medications and vehicles. Topical corticosteroids form the foundation of treatment and topical vitamin D analogs and other noncorticosteroid agents can be used as complements to optimize long-term results.