Tips
- Most patients will require systemic treatment.
- Calcipotriene should not be combined with salicylic acid, which deactivates the molecule.
Medical treatment
Topical
- Potent to superpotent topical corticosteroids applied twice daily with or without occlusion with gradual reduction over months.
- Calcipotriene is often combined or alternated with potent topical corticosteroids.
systemic
- Acitretin : 10 – 50 mg per day
- Methotrexate : 7.5 – 20 mg per week over three to six weeks.
- Cyclosporine :2.5 – 5.0 mg/kg per day for a maximum of one year to be decreased by 0.5 mg/kg to 1.0 mg/kg if hypertension or abnormal renal function test results are seen.
- Etanercept :50 mg twice weekly for 24 wks.
- Infliximab : 5 mg/kg at weeks zero, two, and six, and then every eight weeks.
- Adalimumab :40 mg SC every two wks for a total of three months
- Ustekinumab :45 mg (less than 100 kg) or 90 mg SC (100 kg or more) every three months.
- Secukinumab :300 mg (90 kg or more) or 150 mg SC (<less than 90 kg) every week from baseline to week three then every four weeks.
- Ixekizumab :160 mg SC at week zero then 80 mg every two weeks up until week 12 then 80 mg every four weeks.
Physical treatment
- PUVA.
- NB-UVB.
- Monochromatic excimer laser.
#Palmoplantar Psoriasis #Palmoplantar Psoriasis treatment