Progress in Topical Therapy for Psoriasis

Abstract

　Topical therapy is the primary therapeutic option in the treatment of mild to moderate psoriasis. In Japan, topical corticosteroids and/or vitamin D₃ analogues have been commonly used. Corticosteroids exhibit rapidly and notable efficacy for psoriasis, but have local side-effects such as skin atrophy, telangiectasia and folliculitis when corticosteroids are used in excessive duration. Topical corticosteroids can lead to a pustular flare of psoriasis once discontinued when used in high doses. Vitamin D₃ analogues have similar efficacy with strong corticosteroids, but have few side-effects, including skin irritation. Although as monotherapy, vitamin D₃ analogues are less effective than very strong or the strongest class of corticosteroids, individual combination regimens of corticosteroids and vitamin D₃ analogues were reported. Recently, the new two-composed product of corticosteroid and vitamin D₃ analogue was introduced in Japan. Clinical trials demonstrated that this combination product was more effective than either agent used alone, and side-effects were decreased compared with long-term monotherapy with corticosteroids. The combination product of corticosteroid/vitamin D₃ analogue is recommended as first-line induction therapy for mild to moderate psoriasis.