Document Detail

Topical treatments in psoriasis: today and tomorrow.
MedLine Citation:
PMID:  18755361     Owner:  NLM     Status:  MEDLINE    
Topical therapy in psoriasis is of use in mild cases. It is also applied as an adjunct to phototherapy and systemic treatments in moderate to severe cases. Long-established pharmaceuticals such as cignolin, tar preparations, and glucocorticoids are still in use. Newer topical agents such as vitamin A and D derivatives are gradually replacing them. Combining a vitamin D derivative and a strong glucocorticoid now seems to be the most efficient way to treat psoriasis when topical agents are indicated. There is a growing list of "alternative" treatment options, where evidence is generally absent. Rewarding investments should perhaps be directed at intervening with molecules of innate immunity. Superfluous activation of natural immune system cascades is now in view as the major culprit in psoriasis, replacing the T-cell hypothesis of the disease. Agents directed at tumor necrosis factor alpha, Toll-like receptors, and neutrophils may have great impact in future topical therapy of psoriasis. Finally, innovations in the development of more targeted glucocorticoids and vitamin A and D derivatives, where desired effects are better separated from undesired side effects, may lead to an increased benefit/risk ratio of these nuclear receptor-directed therapies.
Jan D Bos; Phyllis I Spuls
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinics in dermatology     Volume:  26     ISSN:  0738-081X     ISO Abbreviation:  Clin. Dermatol.     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-08-29     Completed Date:  2009-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8406412     Medline TA:  Clin Dermatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  432-7     Citation Subset:  IM    
Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands.
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MeSH Terms
Administration, Cutaneous
Psoriasis / drug therapy*

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