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Emerging paradigm shift toward proactive topical treatment of psoriasis: A narrative review

Psoriasis (PsO) requires safe and effective long‐term management to reduce the risk of recurrence and decrease the frequency of relapse. Topical PsO therapies are a cornerstone in the management of PsO though safety concerns limit the chronic, continuous use of topical corticosteroids and/or vitamin...

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Autores principales: Papp, Kim A., Dhadwal, Gurbir, Gooderham, Melinda, Guenther, Lyn, Turchin, Irina, Wiseman, Marni, Yeung, Jensen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286633/
https://www.ncbi.nlm.nih.gov/pubmed/34418251
http://dx.doi.org/10.1111/dth.15104
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author Papp, Kim A.
Dhadwal, Gurbir
Gooderham, Melinda
Guenther, Lyn
Turchin, Irina
Wiseman, Marni
Yeung, Jensen
author_facet Papp, Kim A.
Dhadwal, Gurbir
Gooderham, Melinda
Guenther, Lyn
Turchin, Irina
Wiseman, Marni
Yeung, Jensen
author_sort Papp, Kim A.
collection PubMed
description Psoriasis (PsO) requires safe and effective long‐term management to reduce the risk of recurrence and decrease the frequency of relapse. Topical PsO therapies are a cornerstone in the management of PsO though safety concerns limit the chronic, continuous use of topical corticosteroids and/or vitamin D(3) analogs. Evidence‐based guidelines on optimal treatment targets and maintenance therapy regimens are currently lacking. This review explores the evidence supporting approaches to maintenance topical therapy for PsO including continuous long‐term therapy, chronic intermittent use, step‐down therapy, sequential or pulse therapy regimens, and proactive maintenance therapy. Several unaddressed questions are discussed including how and when to transition from acute to maintenance therapy, strategies for monitoring long‐term treatment, the role of topical maintenance therapy in the context of systemic and biologic therapies, risks of maintenance therapy, prescribing a topical preparation suitable for patients' preferences and skin type, and key concepts for patient education to maximize long‐term outcomes. Overall, emerging evidence supports a paradigm shift toward proactive treatment once skin is completely clear as a strategy to enhance disease control without compromising safety.
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spelling pubmed-92866332022-07-19 Emerging paradigm shift toward proactive topical treatment of psoriasis: A narrative review Papp, Kim A. Dhadwal, Gurbir Gooderham, Melinda Guenther, Lyn Turchin, Irina Wiseman, Marni Yeung, Jensen Dermatol Ther Review Articles Psoriasis (PsO) requires safe and effective long‐term management to reduce the risk of recurrence and decrease the frequency of relapse. Topical PsO therapies are a cornerstone in the management of PsO though safety concerns limit the chronic, continuous use of topical corticosteroids and/or vitamin D(3) analogs. Evidence‐based guidelines on optimal treatment targets and maintenance therapy regimens are currently lacking. This review explores the evidence supporting approaches to maintenance topical therapy for PsO including continuous long‐term therapy, chronic intermittent use, step‐down therapy, sequential or pulse therapy regimens, and proactive maintenance therapy. Several unaddressed questions are discussed including how and when to transition from acute to maintenance therapy, strategies for monitoring long‐term treatment, the role of topical maintenance therapy in the context of systemic and biologic therapies, risks of maintenance therapy, prescribing a topical preparation suitable for patients' preferences and skin type, and key concepts for patient education to maximize long‐term outcomes. Overall, emerging evidence supports a paradigm shift toward proactive treatment once skin is completely clear as a strategy to enhance disease control without compromising safety. John Wiley & Sons, Inc. 2021-09-14 2021 /pmc/articles/PMC9286633/ /pubmed/34418251 http://dx.doi.org/10.1111/dth.15104 Text en © 2021 The Authors. Dermatologic Therapy published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Review Articles
Papp, Kim A.
Dhadwal, Gurbir
Gooderham, Melinda
Guenther, Lyn
Turchin, Irina
Wiseman, Marni
Yeung, Jensen
Emerging paradigm shift toward proactive topical treatment of psoriasis: A narrative review
title Emerging paradigm shift toward proactive topical treatment of psoriasis: A narrative review
title_full Emerging paradigm shift toward proactive topical treatment of psoriasis: A narrative review
title_fullStr Emerging paradigm shift toward proactive topical treatment of psoriasis: A narrative review
title_full_unstemmed Emerging paradigm shift toward proactive topical treatment of psoriasis: A narrative review
title_short Emerging paradigm shift toward proactive topical treatment of psoriasis: A narrative review
title_sort emerging paradigm shift toward proactive topical treatment of psoriasis: a narrative review
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286633/
https://www.ncbi.nlm.nih.gov/pubmed/34418251
http://dx.doi.org/10.1111/dth.15104
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