Treatment of intertriginous psoriasis: From the Medical Board of the National Psoriasis Foundation - 08/08/11
National Psoriasis Foundation
Correspondence to: Abby S. Van Voorhees, MD, Hospital of the University of Pennsylvania, 2 Rhoads 3400 Spruce St, Philadelphia, PA 19104.Abstract |
Background |
Involvement of areas of the skin fold is common in patients with psoriasis although the exact incidence is unknown. This report summarizes studies regarding the therapy of intertriginous psoriasis.
Objective |
A task force of the National Psoriasis Foundation Medical Board was convened to evaluate treatment options. Our aim was to arrive at a consensus on therapy for intertriginous or inverse psoriasis.
Methods |
Reports in the literature were reviewed regarding psoriasis affecting the skin-fold areas and its therapy.
Limitations |
There are few evidence-based studies on the treatment of intertriginous psoriasis.
Results |
The recommended short-term (2-4 weeks) therapy for inverse psoriasis is low- to mid-potency topical steroids. For long-term therapy, topical calcipotriene (calcipotriol) or one of the immunomodulating agents, pimecrolimus or tacrolimus, is favored.
Conclusions |
Low- to mid-potency topical steroids are recommended as first-line, short-term treatment. It is recommended that their use should either be of limited duration (less than 2-4 weeks) or that the lowest effective strength be used intermittently for long-term care to minimize the potential for risks. Calcipotriene (calcipotriol), pimecrolimus, and tacrolimus, while not as highly efficacious as topical steroids, are associated with fewer long-term risks and are therefore recommended for long-term therapy when feasible.
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| Supported by the National Psoriasis Foundation. |
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| Disclosure: Dr Kalb is a consultant and/or investigator for Amgen, Abbott, Astellas, Centocor, Genentech, and Warner-Chilcott and his practice provides phototherapy services. Dr Bagel is a clinical investigator for Centocor and a speaker for Amgen, Genentech, Abbott, Astellas, and Novartis, and his practice provides phototherapy services. Dr Korman is an investigator for or receives grant support from Abbott Laboratories, Amgen, Astellas, Biogen Idec, Centocor, Genentech, Genmab, Novartis, Peplin, and Seattle Genetics. He is also a speaker or consultant for Abbott Laboratories, Amgen, Genentech, Genmab, Novartis, and Peplin, and his practice provides phototherapy services. Dr Lebwohl is an investigator for Abbott Laboratories, Amgen, Astellas, Centocor, Connetics, Galderma, Genentech, 3M, Novartis, and Warner Chilcott. He is also a consultant for Abbott, Amgen, Astellas, BristolMyersSquibb, Centocor, Connetics, Galderma, Genentech, 3M, Novartis, Pfizer, and Warner Chilcott and speaker for Abbott, Amgen, Astellas, Centocor, Chester Valley, Connetics, Galderma, Genentech, 3M, Novartis, PharmaDerm, and Warner Chilcott, and his practice provides phototherapy services. Ms Young is a speaker for Abbott, Amgen, Connetics, and Genentech, an advisory board member for Abbott, Amgen, and Genentech, and her clinic provides phototherapy services. Dr Horn was an employee of the National Psoriasis Foundation. The National Psoriasis Foundation receives unrestricted funding from Abbott Immunology, Amgen and Wyeth, Astellas Pharma Inc, Barrier Therapeuics, Beiersdorf, Centocor, Daavlin, Galderma Laboratories, Genentech, National Biologic Corporation, Neutrogena, Photomedex, Stiefel Laboratories, and Warner Chilcott. Dr Van Voorhees has received grant support from Amgen, Astellas, and Warner Chilcott. She has been a consultant, advisory board member, or speaker for Abbott, Amgen, Centocor, Connetics, Genentech, and Warner Chilcott and a drug safety monitoring board member for Synta. She is a major stockholder in Merck. She provides phototherapy services as well. |
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| Reprints not available from the authors. |
Vol 60 - N° 1
P. 120-124 - janvier 2009 Retour au numéro
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