Topical Therapy II: Retinoids, Immunomodulators, and Others



Tazarotene is the only topical retinoid approved for treatment of psoriasis. Although it is used primarily for plaque psoriasis, it may be beneficial for palmoplantar and nail psoriasis. Use in combination with a mid- to high potency topical steroid enhances efficacy and reduces irritancy and the atrophogenic potential of steroids. Thrice a week use with a twice weekly superpotent topical steroid may maintain improvement long-term. Addition of tazarotene to broadband or narrowband UVB, or PUVA phototherapy enhances efficacy and decreases the total dose of ultraviolet radiation. The calcineurin inhibitors pimecrolimus and tacrolimus are not approved for treatment of psoriasis, although they are efficacious and well tolerated in the treatment of intertriginous, facial and genital psoriasis. The use of tar and anthralin has declined with the development of cosmetically elegant, efficacious treatments that do not stain the skin or clothing. Although coal tar contains many known carcinogens, use in psoriasis has not been associated with an increase in skin cancer. Addition of tar to erythemogenic UVB does not enhance efficacy.


Topical Therapy Retinoids Immunomodulators Tazarotene Calcineurin inhibitors Pimecrolimus Tacrolimus Tar Anthralin Psoriasis 


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© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Division of DermatologyWestern University, The Guenther Dermatology Research CentreLondonCanada

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