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Psoriasis Treatment:
 

Plaque Psoriasis: (Psoriasis Vulgaris)

Available treatment choices:

Topical

  • Mild corticosteroid
  • Potent corticosteroid
  • Tars
  • Anthralin
  • Calcipotriol/calcipotriene
  • Tazarotene
  • Calcipotriol + corticosteroid (i.e., Dovobet®)

Systemic

  • Acitretin
  • Methotrexate
  • Cyclosporine

Light

  • UVB
  • Narrow-band UVB (311nm)
  • PUVA

For Mild - Localized Psoriasis Treatment

Try topical therapy first with a single agent or best combination from a different class of drug.

  • Mild steroid alone
  • Mild steroid + one of the following: calcipotriol (i.e., Dovobet®), tazarotene, tar, anthralin
  • Potent steroid in pulses, for example, on weekends only
  • Potent steroid + one of the following: calcipotriol, tazarotene, tar, anthralin

Dovobet® can be used as an initial or flare-up treatment. Since Dovobet® contains betamethasone dipropionate, a strong corticosteroid, the guidance of a physician should be sought if daily application does not resolve the plaque after 4 weeks. Dovonex® can also be used for long-term treatment.

When your psoriasis is extensive or symptomatic

  • Topical therapy is always the first option to discuss.
  • Ultraviolet light is most useful when large surface areas need to be treated.
  • UVB has been used for many years, narrow-band UVB is gaining popularity, although it takes more time, but the side-effects are likely to be less.
  • PUVA is effective and gives a longer period of remission, but there is an increased risk of skin cancer - it is used when UVB has not worked.
  • Acitretin can be added to both UVB and PUVA.
  • Methotrexate and cyclosporine are very effective and can be rotated to minimize accumulative side-effects