Objectives: Deepen the understanding on the available topical treatments and get a clear picture on the multitude of conventional and new biologics on the market. and
Introduction: Psoriasis is a chronic inflammatory skin disease that severely affects patients’ quality of life. It is of particular relevance if areas such as the face, the scalp, the hands, nails and the genital area is affected. In recent years, a multitude of new treatment options have become available.
Materials / method: Systematic Reviews and Guidelines have been developed to guide practitioners through the plethora of new treatment options. The results from high quality systematic reviews and network-meta-analysis will be presented. Key recommendations from the guidelines will be summarized.
Results: The mainstay of topical treatment are topical corticosteroids and vitamin d and its analogues. As mycosis may play a role as an aggravating factor in the face and on the scalp, antimycotic treatment may be beneficial in these areas. Among the systemic conventional treatments, methotrexate and fumaric acid can be recommended, cyclosporine is another option, but its long term use is limited. Some of the biologics are achieving very high response rates, especially the group of anti IL17 and anti Il 23.
Conclusion: For everyday clinical practice with an aesthetic focus, topical corticosteroids and vitamin d as well as antimycotic treatements may play the major role. In case of moderate disease, the conventionals are the mainstay treatment. For severe disease, the biologics with high efficacy and a fast onset of action should be preferred.
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