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Scientific article
Open access
English

Topical Treatment of Psoriasis Vulgaris: The Swiss Treatment Pathway

Published inDermatology, vol. 237, no. 2, p. 166-178
Publication date2021
First online date2021-01-06
Abstract

Topical treatment is crucial for the successful management of plaque psoriasis. Topicals are used either as a stand-alone therapy for mild psoriasis or else in combination with UV or systemic treatment for moderate-to-severe disease. For the choice of a suitable topical treatment, the formulation matters and not just the active substances. This expert opinion paper was developed via a non-structured consensus process by Swiss dermatologists in hospitals and private practices to illustrate the current treatment options to general practitioners and dermatologists in Switzerland. Defining treatment goals together with the patient is crucial and increases treatment adherence. Patients' personal preferences and pre-existing experiences should be considered and their satisfaction with treatment and outcome regularly assessed. During the induction phase of "classical" mild-to-moderate psoriasis, the fixed combination of topical calcipotriol (Cal) 50 μg/g and betamethasone dipropionate (BD) 0.5 mg/g once daily is frequently used for 4-8 weeks. During the maintenance phase, a twice weekly (proactive) management has proved to reduce the risk of relapse. Of the fixed combinations, Cal/BD aerosol foam is the most effective formulation. However, the individual choice of formulation should be based on a patient's preference and the location of the psoriatic plaques. Tailored recommendations are given for the topical management of specific areas (scalp, facial, intertriginous/genital, or palmoplantar lesions), certain symptoms (hyperkeratotic or hyperinflammatory forms) as well as during pregnancy or a period of breastfeeding. As concomitant basic therapy, several emollients are recommended. If topical treatment alone does not appear to be sufficient, the regimen should be escalated according to the Swiss S1-guideline for the systemic treatment of psoriasis.

eng
Keywords
  • Calcineurin inhibitors
  • Corticosteroids
  • Fixed combination
  • Psoriasis
  • Topical management
  • Vitamin D3 analogues
  • Administration, Cutaneous
  • Adrenal Cortex Hormones / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage
  • Breast Feeding
  • Dermatologic Agents / administration & dosage
  • Drug Combinations
  • Face
  • Female
  • Humans
  • Induction Chemotherapy / standards
  • Maintenance Chemotherapy / standards
  • Male
  • Patient Care Planning
  • Patient Preference
  • Practice Guidelines as Topic
  • Pregnancy
  • Psoriasis / drug therapy
  • Scalp
  • Switzerland
Citation (ISO format)
MAUL, Julia-Tatjana et al. Topical Treatment of Psoriasis Vulgaris: The Swiss Treatment Pathway. In: Dermatology, 2021, vol. 237, n° 2, p. 166–178. doi: 10.1159/000512930
Main files (1)
Article (Published version)
Identifiers
ISSN of the journal1018-8665
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141downloads

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