Topical Therapies for Psoriasis: Improving Management Strategies and Patient Adherence

Semin Cutan Med Surg. 2016 Mar;35(2 Suppl 2):S36-44; quiz S45. doi: 10.12788/j.sder.2016.006.

Abstract

Psoriasis is a chronic disease that has a substantial effect on quality of life of patients and often needs long-term treatment. Topical treatments for psoriasis include corticosteroids, vitamin D derivatives, tazarotene, anthralin, tacrolimus, pimecrolimus, and newer formulations of tar. Although many of these treatments are effective, they must be prescribed appropriately and used consistently for a period of weeks to months before clinical evidence of improvement can be seen and patients perceive that the treatment is working. As such, medication dosage/schedule, choice of vehicle, and especially patient adherence to medication are key factors for a treatment to be effective. Addressing patient preferences about treatments and concerns about treatment-related toxicities and managing their expectations represent additional aspects of patient care. Therapies such as calcipotriene and betamethasone dipropionate (Cal/BD) fixed combination foam and new drugs and vehicles continuously enhance the treatment landscape for psoriasis. Because adherence to topical treatment can be a major difficulty, keeping the treatment regimen simple and using new and sophisticated treatment vehicles that are acceptable to patients can likely improve treatment outcomes.

Keywords: Allergy; corticosteroids; foam vehicle; medication adherence; psoriasis; topical therapy; vitamin D.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Cutaneous
  • Anthralin / administration & dosage
  • Betamethasone / administration & dosage
  • Betamethasone / analogs & derivatives
  • Calcitriol / administration & dosage
  • Calcitriol / analogs & derivatives
  • Dermatologic Agents / administration & dosage*
  • Dermatologic Agents / therapeutic use
  • Drug Combinations
  • Drug Therapy, Combination
  • Evidence-Based Medicine
  • Glucocorticoids / administration & dosage
  • Humans
  • Nicotinic Acids / administration & dosage
  • Patient Compliance*
  • Pharmaceutical Vehicles / administration & dosage
  • Practice Guidelines as Topic
  • Psoriasis / diagnosis
  • Psoriasis / drug therapy*
  • Quality of Life*
  • Severity of Illness Index
  • Tacrolimus / administration & dosage
  • Tacrolimus / analogs & derivatives
  • Treatment Outcome
  • Vitamin D / administration & dosage

Substances

  • Dermatologic Agents
  • Drug Combinations
  • Glucocorticoids
  • Nicotinic Acids
  • Pharmaceutical Vehicles
  • Vitamin D
  • calcipotriene
  • pimecrolimus
  • tazarotene
  • betamethasone-17,21-dipropionate
  • Betamethasone
  • Calcitriol
  • Anthralin
  • Tacrolimus