Treatment of psoriasis with topical agents: Recommendations from a Tuscany Consensus

Abstract

Psoriasis is a chronic and relapsing inflammatory skin disease, clinically characterized by erythematous and scaly plaques. Treatment approach is mainly driven by disease severity, though several factors should be considered in order to identify the optimal therapeutic choice. Mild psoriasis may be treated with a wide array of topical agents including corticosteroids, vitamin D analogs, keratolytics, and calcipotriol/betamethasone propionate compound. Because guidelines may not provide practical indications regarding the therapeutic approach, the use of topical agents in psoriasis is more individually tailored. In order to homogenize the standard of care, at least in a local setting, we collected the real-life-based recommendations for the use of topical therapies from an expert panel, the Tuscany Consensus Group on Psoriasis, representing all leading centers for psoriasis established in Tuscany. With this document, this consensus group sought to define principles guiding the selection of therapeutic agents with straightforward recommendations derived from a real-life setting.

Polyethylene Glycol Ointment Alleviates Psoriasis-Like Inflammation Through Down-Regulating the Function of Th17 Cells and MDSCs

“…Psoriasis is a disease that requires lifelong treatment, which imposes a great economic burden to the affected patients (14)(15)(16). At present, the first-line external medicine for the clinical treatment of psoriasis includes steroids, vitamin D 3 derivatives, retinoic acid, and calcineurin inhibitors (17)(18)(19)(20), which can inhibit the proliferation and differentiation of keratinocytes, the activation of T cells, and the release of inflammatory factors.…”

Rapamycin ameliorates psoriasis by regulating the expression and methylation levels of tropomyosin viaERK1/2 andmTORpathways in vitro and in vivo

“…Due to the complex pathogenesis of psoriasis, there are very few effective treatments for the patients of psoriasis . Traditionally, various topical therapies can be used to treat the patients with mild disease of psoriasis, such as topical retinoids, corticosteroids, vitamin D and its analogues . And the combination treatment of topical agents and other adjuvant therapies was the major therapeutic strategy for the severe psoriasis patients; however, its effects are very limited …”

Management of a Chronic Skin Disease in Primary Care: An Analysis of Early-Career General Practitioners’ Consultations Involving Psoriasis

“…They may be seeking a convenient prescriber performing a routine, discrete administrative task rather than a GP involved in ongoing, considered management of their chronic disease. Possible sequelae of such a situation are different providers delivering uncoordinated medicine regimens that do not facilitate a logical progression of treatment based on response to past medications [34][35][36]. Furthermore, holistic care of patients is likely to be compromised with a lack of addressing physical and psychosocial morbidities.…”