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American Academy of Dermatology Issues New Guidelines For The Management of Psoriasis With Topical Therapies
Date:3/2/2009

prescribed medications.

Length of Use

The use of topical therapies can be both intermittent and long-term. For example, it is generally recommended that more potent agents should be used on a short-term basis to allow for clearing of psoriasis, after which patients should be instructed to use these agents intermittently for long-term management. It was determined that this strategy may pose less risk of side effects than continuous treatment. On the other hand, patients who require continuous topical treatment should be instructed to use the least potent agent that can adequately control the condition or be transitioned to a topical agent that is associated with the lowest long-term risk.

"Although topical agents for psoriasis are usually well tolerated without significant side effects, it is important that patients receive regular examinations by their dermatologists - whether they use medications over the long term or intermittently - as unsupervised use of potent topical medications is not recommended," said Dr. Hanke.

Application Amount

In terms of the amount of topical medication that generally should be applied to affected skin, dermatologists refer to the "fingertip unit" as the recommended guidance. One fingertip unit is approximately 500 mg, and recommendations for the number of units needed to cover affected areas are offered. For example, three fingertip units are required to adequately cover psoriasis on the scalp, whereas eight fingertip units are needed for the entire leg and foot. This method provides a means for patients to more accurately dose their topical medications.

Patient Compliance/Adherence

Lastly, dermatologists agree that poor compliance (or adherence) to topical treatment of psoriasis is a major issue for the majority of patients. "Many factors contribute to the lack of adherence to a topical treatment regimen, including frus
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SOURCE American Academy of Dermatology
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