Psoriasis Patient Information Fact Sheet
Acitretin (Soriatane) is a retinoid that may be given in severe psoriasis. Acitretin must not be used by women who are pregnant, or who intend to become pregnant during therapy or at any time for at least 3 years following discontinuation of therapy. Acitretin also must not be used by women who may not use reliable contraception while undergoing treatment and for at least 3 years following discontinuation of treatment. Acitretin should be prescribed only by dermatologists who have special competence in the diagnosis and treatment of severe psoriasis, are experienced in the use of systemic retinoids, and understand the risk of teratogenicity. Because of Acitretin's potential to cause birth defects in unborn children, prescribers and patients must adhere to a strict program to educate women of childbearing potential and their healthcare providers about the serious risks associated with acitretin and to help prevent pregnancies from occurring with the use of this drug.
Tazarotene (Tazorac) is a topical retinoid used in the treatment of mild to moderate psoriasis. The gel is applied once daily and can be used to treat up to 10% of total body surface area. Vitamin D analogues such as calcipotriene (Dovonex) or calcitriol (Vectical) prevent the increased growth of skin cells seen in psoriasis plaques. The advantages of these products are that they do not smell and do not stain clothing. Taclonex combines calcipotriol and the corticosteroid betamethasone; it is available as an ointment or suspension and can be used to treat psoriasis on areas of the body or the scalp, for up to four weeks.
Cyclosporine (Neoral) may be prescribed for severe psoriasis when other treatments have not worked. It is only used under strict medical supervision. Methotrexate (Trexall) is another powerful drug and is usually given as tablets. As it can have other potentially serious effects on bone marrow, its use must be carefully monitored and it will only be given in severe cases.
Adalimumab (Humira), etanercept (Enbrel), infliximab (Remicade) and ustekinumab (Stelara) are relatively new drugs administered by injection that can be used for moderate to severe chronic plaque psoriasis in patients who have failed to respond to, or who are intolerant of, or cannot take other systemic treatments, including cyclosporine, methotrexate and PUVA.
National Psoriasis Foundation: www.psoriasis.org
Last reviewed: August 2011