From the Guidelines
Treatment options for psoriasis include topical therapies, phototherapy, and systemic medications depending on severity, with the most recent guidelines recommending a personalized approach based on disease severity, affected body areas, comorbidities, and patient preferences 1. For mild to moderate cases, first-line treatments include:
- Topical corticosteroids (such as betamethasone or clobetasol)
- Vitamin D analogs (calcipotriene)
- Retinoids (tazarotene) These are typically applied once or twice daily to affected areas. For more widespread or resistant cases, phototherapy using UVB light or PUVA (psoralen plus UVA) may be administered 2-3 times weekly for several weeks. When psoriasis is severe or unresponsive to other treatments, systemic options include oral medications like:
- Methotrexate (10-25mg weekly)
- Cyclosporine (2.5-5mg/kg/day)
- Acitretin (10-50mg daily) Newer biologic therapies targeting specific immune pathways include:
- TNF inhibitors (adalimumab, etanercept)
- IL-17 inhibitors (secukinumab, ixekizumab)
- IL-23 inhibitors (guselkumab, risankizumab)
- IL-12/23 inhibitors (ustekinumab) These biologics are typically administered by injection every 1-12 weeks depending on the specific medication. Psoriasis is caused by accelerated skin cell turnover driven by immune system dysfunction, and these treatments work by reducing inflammation, normalizing skin cell production, or modulating immune responses, as supported by recent guidelines 1. The choice of treatment should be based on the most recent and highest quality evidence, with consideration of individual patient factors and preferences 1.