Background: Currently, no formalized international consensus guidelines exist to direct optimal topical
treatment including long-term treatment.
Objective: In this survey, we aim to examine if and which topicals are used in clinical practice in
long-term continuous treatment of psoriasis and how topicals are used in treating specific sites of
the body.
Methods: A questionnaire was distributed electronically to dermatologists from the International
Psoriasis Council (IPC) representing 26 countries.
Results: The top three topicals used across all severities of disease were topical corticosteroids, vitamin
D analogs, and potent topical corticosteroids in combination with vitamin D analogs. On locations
where the skin is thin, flexural and genital psoriasis, lower potency topical corticosteroids were
used, whereas on other sites, in particular in palmoplantar psoriasis, superpotent topical corticosteroids
and combination vitamin D analogs/corticosteroids were used.
Conclusions: It is relevant to optimize localized therapy for all severities of psoriasis reconciling disease
activity (stable vs. unstable disease), localization of the lesions and the individual patient and
his/her perspectives on disease control. Topical therapies are valuable treatments for classical mild disease
and may have a position in some patients with more severe manifestations.
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