Topical Therapies for Psoriasis

Topical Moisturisers for the Management of Psoriasis Vulgaris

“…Tar-based formulations are indicated for the management of chronic, stable forms of plaque-type psoriasis and scalp psoriasis, whereas their use might be limited in sensitive areas such as around the genitals due to their irritation potential [87]. The choice of management strategy for psoriasis is driven by the skin's dryness and itchiness; inflammation and redness; scaliness and thickness [6,35,45,86,87,91,99].…”

“…Keratolytics (Figure 4) such as salicylic acid are readily used as active ingredients in many topical formulations, but may have particular utility when it comes to psoriasis as the disease is characterised by a build-up of keratinocytes on the skin. Keratolytics promote the physiologic skin shedding process and also decrease cell-tocell cohesion in the SC, in effect loosening the glue that keeps keratinocytes together [87,99]. Salicylic acid has been shown to aid in the removal of excessive keratin in psoriatic plaques and to produce desquamation of the SC while being safe to use and not effecting qualitative or quantitative changes in the structure of the viable epidermis [100].…”

“…It is often used as either monotherapy or as part of combination therapy to reduce the size and scale of psoriatic plaques [15,100]. Keratolytics have proven to be particularly effective in reducing psoriatic plaque thickness if prescribed several days prior starting a first-line treatment (i.e., corticosteroids) for localised psoriasis or in specific areas such as the scalp [87,99].…”

“…As a result, there is a scientific rationale for their use in the management of psoriasis, either individually or in combination. This rationale assumes that such formulation blends are selected on the basis of their individual mechanism of action and the biophysical effects they exert on psoriatic skin, which may offer the possibility of synergistic efficacy as well as a reduction in the occurrence of cosmetic problems and side effects (Figure 6) [99].…”

Topical therapy of psoriasis

“…Thus, newer topical formulations should have improved drug-delivery mechanisms with appropriate cosmetic elegance which can be used on many areas of the body including hair-bearing sites to ensure therapeutic efficacy and improved adherence. [ 8 ] Liposomes, microemulsions, solid lipid nanoparticles, nanostructured lipid carriers, and micelles may have the potential to encapsulate antipsoriatic drugs for topical application. In addition, techniques such as iontophoresis, electroporation, and lasers can be used to enhance penetration of the stratum corneum.…”