What is Psoriasis? (Psoriasis Treatment)

Psoriasis Treatment

Psoriasis is characterized by red, thickened plaques with a silvery scale. The lesions vary in size and degree of inflammation. Psoriasis is categorized as localized or generalized, based on the severity of the disease and its overall impact on the patient's quality of life and well-being. Patient education about the disease and the treatment options is important. Medical treatment for localized psoriasis begins with a combination of topical corticosteroids and coal tar or calcipotriene. For lesions that are difficult to control with initial therapy, anthralin or tazarotene may be tried. The primary goal of therapy is to maintain control of the lesions. Cure is seldom achieved. If control becomes difficult or if psoriasis is generalized, the patient may benefit from phototherapy, systemic therapy and referral to a physician who specializes in the treatment of psoriasis. (Am Fam Physician 2000;61:725-33,736.)

Psoriasis affects about 2 percent of the U.S. population. In 1990, psoriasis was the reason for more than 1 million visits to physicians.¹ In the past, the treatment of psoriasis was primarily managed by dermatologists; this disorder accounted for only 0.4 percent of skin-related visits to family physicians.² The number of patients treated by family physicians, however, is likely to have steadily increased as more patients seek medical care of psoriasis from their primary care physicians.

This article describes an algorithmic treatment approach for primary care physicians. The algorithm is based on treatment guidelines for psoriasis published by the American Academy of Dermatology,³ supplemented by a review of the medical literature. There currently are no evidence-based guidelines for the treatment of psoriasis. Because localized plaque psoriasis is the most common form, the algorithm focuses on the treatment psoriasis.

Psoriasis Treatment