Table 1:
Treatments for Psoriasis
Level 1:
Topical Therapies
Level 2: Phototherapies
Level 3:
Systemic Therapies
(High Efficacy, High Toxicity)
Level 4:
Systemic Therapy
(Moderate Efficacy, Low to Moderate Toxicity)*
Level 5:
Innovative Systemic Therapy
(Moderate Efficacy, High Toxicity)*
Level 6:
Biologic Immunomodulator Systemic Therapy
Emollients

Keratolytics

  • Salicylic acid
  • Lactic acid
  • Urea
Calcipotriene
Anthralin (usually short contact)

Corticosteroids

  • Topical
  • Hydrocolloid occlusive dressing
  • Intralesional injections
Coal tar
Tazarotene
Natural sunlight
Ultraviolet B
(UVB) light

UVB light and
coal tar
   
(Goeckerman     regimen)

UVB light and anthralin
    
(Ingram regimen)

UVB narrowband light

    (311 nm to 313     nm)

Psoralen and ultraviolet A (UVA) light (PUVA)
Psoralen, UVA light and UVB light
Acitretin (may be combined with UVB light or with PUVA)
Methotrexate
Cyclosporine
Sulfasalazine
Hydroxyurea
Calcitriol
Antibiotics
Azathioprine
6-thioguanine
Mycophenolate
mofetil
Tacrolimus
Alefacept
Efalizumab
Etanercept
Infliximab*
Adalimumab*
*Not approved for psoriasis treatment by the US Food and Drug Administration
Copyright 2004 The Cleveland Clinic Foundation

Return to Psoriasis Chapter